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Milsaperidone is an oral **atypical antipsychotic** developed by Vanda that was initially identified as the major active metabolite of iloperidone and later advanced as a distinct new chemical entity. Public sources describe milsaperidone as rapidly interconverting with iloperidone after oral dosing and being bioequivalent to iloperidone across the approved therapeutic dose range, while retaining a receptor-binding profile characterized by high affinity for **dopamine D2**, **serotonin 5-HT2A**, and **adrenergic alpha-1/alpha-2C** receptors. It is marketed in the United States as **Bysanti** tablets for schizophrenia and for the acute treatment of manic or mixed episodes associated with bipolar I disorder in adults, and it is also in Phase 3 development as adjunctive therapy for major depressive disorder.
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