Abstract
Brexpiprazole is a second generation antipsychotic, a partial agonist of serotonin 5-HT1A, dopamine D2 receptors and antagonist of noradrenergic α1B/2C and serotonin 5-HT2A receptors. Brexpiprazole showed efficacy in acute and long-term treatment of schizophrenia, agitation in Alzheimer dementia and as an adjunct therapy to antidepressants in refractory major depressive disorder (MDD).
Brexpiprazole was superior to placebo in the reduction of positive, negative and depressive symptoms, as well as in improvement of social functioning of schizophrenia patients. It has been approved by the European Medicines Agency for treatment of adult schizophrenia in the EU, in the US has also indication for adjunctive treatment of antidepressants for MDD.
The most frequent adverse effects include mild weight gain and akathisia, which are not in schizophrenia patients significantly different from placebo. Advantages of brexpiprazole are once-daily dosing, good tolerability, and lack of negative effects on QTc interval and sexual function.
If its efficacy and very good safety profile in elderly patients with dementia is replicated, brexpiprazole may become a safe therapeutic option for a vulnerable geriatric population in need of antipsychotic treatment.