Discussion
hypoesthesia, schizophrenia
This purpose of this study is to determine the efficacy of D-sorbitol in masking the bitter taste of asenapine. To our knowledge, this is the first intervention study with using D-sorbitol in patients with schizophrenia. There have been reports from asenapine clinical trials regarding the bitter taste of asenapine. The FDA has approved a black cherry-flavored sublingual tablet [Although D-sorbitol is more effective in masking bitterness in basic research, other substances, such as glycerin, propylene glycol, saccharin, and xylitol, can mask the bitter taste of asenapine [In 2019, the FDA approved an asenapine formulation that may improve adherence. However, other factors may affect adherence. There is concern that compliance will decline because of economic reasons, i.e., its high price [This study has several limitations. Our investigation does not include participants who discontinued asenapine owing to bitter taste, hence the evaluation of D-sorbitol could change if the sample population changes. Another limitation is that this study does not evaluate oral hypoesthesia as a parameter because bitterness is the main target of evaluation. Inclusion of patients newly taking asenapine and evaluation of oral hypoesthesia are needed in future studies. If this study can clarify the effect of D-Sorbitol on the bitterness of asenapine, it will be helpful to both patients and doctors as one way to improve adherence to asenapine.