TLDR
- The FDA approved Vanda Pharmaceuticals’ new drug BYSANTI (milsaperidone) for Bipolar I manic episodes and Schizophrenia in adults
- VNDA stock surged up to 44% after-hours following the announcement
- BYSANTI is protected by a patent running to 2044, shielding Vanda from generic competition for nearly two decades
- This is Vanda’s second FDA approval in under two months, following NEREUS in December 2025
- BYSANTI is expected to launch by Q3 2026, with depression trial results due by end of 2026
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Vanda Pharmaceuticals just scored its second FDA approval in less than two months, and the market noticed.
Vanda Pharmaceuticals Inc., VNDA
The FDA gave the green light to BYSANTI — generic name milsaperidone — for the treatment of Bipolar I manic episodes and Schizophrenia in adults. The news sent VNDA stock up as much as 44% in after-hours trading.
BYSANTI is classified as a New Chemical Entity (NCE). That designation comes with strong legal protections, and Vanda’s patent on the drug runs all the way to 2044.
That’s nearly 20 years without generic competition. For a small-cap biotech, that’s a rare position to be in.
The December 2025 approval of NEREUS was the first win. BYSANTI is the second. Back-to-back approvals in this short a timeframe is not something VNDA investors were used to seeing.
BYSANTI moved through the FDA process faster than most new drugs. The reason is straightforward — it is closely related to iloperidone, which is sold under the brand name Fanapt.
Because milsaperidone converts to iloperidone in the body and shows similar drug levels and safety data, Vanda was able to lean on an existing body of evidence. That includes over 100,000 patient-years of real-world data.
That’s a meaningful head start when it comes to physician comfort and prescribing confidence.
How BYSANTI Works
The drug targets dopamine and serotonin pathways, a common mechanism in antipsychotic treatment. What sets it apart is its strong alpha-adrenergic binding, which may make it a preferred option for patients dealing with acute agitation and hostility.
That’s a specific clinical niche, and one that could help differentiate it from competitors already in the market.
The launch is expected by Q3 2026. Vanda has not yet disclosed pricing or commercialization partners.
What Comes Next
Vanda is already running trials using BYSANTI as a once-daily add-on treatment for major depressive disorder. Results are expected by the end of 2026.
If those results are positive, the addressable market expands well beyond Bipolar I and Schizophrenia. Depression is one of the largest drug markets in the world.
That potential upside is part of what drove after-hours buying. Investors are not just pricing in the current approval — they are looking ahead at what a depression indication could mean for revenue.
Prior to this announcement, analyst consensus on VNDA was sitting at “Sell” or “Flat.” That may change as the street re-evaluates the pipeline.
VNDA stock was up 38% after-hours at last check, with the FDA approval confirmed and a Q3 2026 commercial launch on the calendar.



