Brexpiprazole: A Review in Schizophrenia

Area of Science:

• Psychiatry
• Pharmacology
• Neuroscience

Background:

• Brexpiprazole is an oral atypical antipsychotic approved for schizophrenia treatment.
• It acts as a partial agonist at dopamine D2 and serotonin 5-HT1A receptors, and an antagonist at serotonin 5-HT2A receptors.
• Its pharmacological profile suggests a potentially lower risk of adverse events and extrapyramidal symptoms compared to aripiprazole.

Purpose of the Study:

• To evaluate the efficacy and tolerability of brexpiprazole in treating schizophrenia.
• To assess brexpiprazole's effectiveness in both acute exacerbations and maintenance treatment of schizophrenia.
• To compare the adverse event profile of brexpiprazole with aripiprazole.

Main Methods:

• Clinical trials involving adult patients with schizophrenia.
• Administration of brexpiprazole at doses of 1-4 mg/day.
• Comparison with placebo for acute symptomatology, psychosocial functioning, and time to relapse.
• Assessment of adverse events, QT interval, metabolic parameters, and weight gain.

Main Results:

• Brexpiprazole (2-4 mg/day) significantly improved overall symptomatology and psychosocial functioning in acute schizophrenia.
• Maintenance treatment with brexpiprazole (1-4 mg/day) significantly delayed relapse and stabilized/improved symptoms and functioning.
• The drug was generally well tolerated, with a low incidence of adverse effects, clinically insignificant QT and metabolic changes, and moderate weight gain.

Conclusions:

• Brexpiprazole is an effective therapeutic option for schizophrenia, offering benefits in both acute and maintenance phases.
• Its distinct pharmacological profile may lead to a reduced incidence of adverse events compared to other antipsychotics.
• Brexpiprazole expands treatment options for patients with schizophrenia.