Objective. To assess clinical features of therapeutic efficacy and tolerability of asenapine (saphris) in stopping acute psychotic attacks in patients with endogenous mental diseases and to determine spectrum of action of this drug. Material and methods. We examined 30 female inpatients with acute hallucinatory/delusive and mania/delusive states in attack-like schizophrenia and endogenous affective psychosis. Treatment was conducted according to standard schedule during 42 days. Saphris was used in sublingual tablets in daily dose 20 mg (10 mg in morning and 10 mg at night). Clinical/psychopathological and psychometric methods were applied. Results. To the end of the study, the positive effect was achieved in 86.6% of the patients with ≥30% reduction in PANSS scores. Good (reduction by 50—60%) and marked (reduction by ≥70%) effects were identified in 33.3% and 23.3% patients, respectively. To the 42nd day, the reduction in the severity of disorders was 57.3% on average in the whole group, 54.1% in the subgroup of hallucinatory/delusive psychosis and 62.1% in the patients with mania/delusive states. Distinct sedative, antimania, antipsychotic and antiparaphrenia components were detected in the spectrum of psychotropic action of saphris. Adverse effects were observed in 76.7% of the patients with predominance of neurological symptoms (39.9%) and mental side-effects (34.0%). Somatic/autonomic (20.7%) and other side-effects (5.4%) were less frequent. Mild side-effects (71.2%) were most frequent in the structure of the severity. Conclusion. According to the results of therapeutic efficacy and tolerability of saphris as well as the high compliance of patients, recommendations for using this medication in psychiatric practice were developed.