<p>Brexpiprazole for the Treatment of Schizophrenia in Adults: An Overview of Its Clinical Efficacy and Safety and a Psychiatrist’s Perspective</p>

Abstract

While the prognosis of patients with schizophrenia has dramatically improved after the advent of chlorpromazine, the antipsychotics currently available are so numerous that it has become a challenge for psychiatrists to choose from among these drugs for each patient presenting for care. In addition, while numerous studies show that an effective antipsychotic should be continued indefinitely to prevent relapses or worsening, many patients appear to have difficulty remaining on any drug thus initiated. Brexpiprazole, a dopamine D 2 receptor partial agonist, appears to provide a unique profile that has much to offer in this light. Specifically, this novel drug is potentially better suited for long-term use, with decreased risk of extrapyramidal side effects, hyperprolactinemia, weight gain, psychosis, insomnia, akathisia, nausea/vomiting or restlessness, thus potentially facilitating patients’ reintegration into society. Indeed, brexpiprazole has been shown in randomized, double-blind, placebo-controlled trials to have proven efficacy not only in improving the symptoms of schizophrenia but in preventing relapses. It is also suggested in both short- and long-term studies that brexpiprazole offers a favorable safety and tolerability profile. This review also includes a proposed treatment algorithm incorporating brexpiprazole, based on the clinical trial results available, as well as on the authors’ clinical experience, where brexpiprazole may be best used as a drug of first choice for the treatment of schizophrenia. Thus, overall, brexpiprazole appears to play a more significant role in the treatment of schizophrenia than other antipsychotics.

Investigation of the effect of brexpiprazole on acute or relapse schizophrenia using the positive and negative syndrome scale: an experimental report

“…The ages of the patients were 10~19 years old (2), 20~29 years old (6), 30~39 years old (4), 40~49 years old (10), 50~59 years old (10), 60~69 years old (5), 70~79 years old (3), 80~89 years old (1) and 90~99 years old (1).…”

“…The efficacy of BPZ in the acute phase of schizophrenia is comparable to other second-generation antipsychotics such as quetiapine, aripiprazole and ziprasidone [9]. It has also been reported to improve symptoms of schizophrenia as well as prevent relapses [10] and improve depressive symptoms [11]. In terms of side effects, it has been reported to have fewer metabolic and cardiovascular side effects [9] and to reduce the risk of extrapyramidal symptoms, hyperprolactinaemia, weight gain, psychosis, insomnia, nausea/vomiting or restlessness [10].…”

“…It has also been reported to improve symptoms of schizophrenia as well as prevent relapses [10] and improve depressive symptoms [11]. In terms of side effects, it has been reported to have fewer metabolic and cardiovascular side effects [9] and to reduce the risk of extrapyramidal symptoms, hyperprolactinaemia, weight gain, psychosis, insomnia, nausea/vomiting or restlessness [10]. Investigation of the effect of brexpiprazole on acute or relapse schizophrenia using positive Brazilian Journal of Case Reports.…”

Treatment Discontinuation Among Patients with Schizophrenia Treated with Brexpiprazole and Other Oral Atypical Antipsychotics in Japan: A Retrospective Observational Study

“…This primary outcome was selected because at the time of study inception (as of December 2020), BRX was the latest drug to become available to patients with schizophrenia in Japan, and there were no studies comparing treatment continuation among antipsychotics including BRX. Additionally, BRX was developed to overcome the side effects of APZ (e.g., akathisia, restlessness, and insomnia), which is the only other D 2 partial agonist currently available and was marketed before brexpiprazole in Japan [ 19 ]. When > 1 index drugs were prescribed on the same date, they were counted as 1 day.…”

Strategies for Treatment of Disease-Associated Dementia Beyond Alzheimer's Disease: An Update

“…Brexpiprazole is a novel dual serotonin-dopamine activity modulator with partial agonist activity at 5-HT1A and D2/3 receptors and possesses potent antagonist effects on 5-HT2A, α1B-, and α2C-adrenergic receptors. Brexpiprazole reverses the PCP-induced cognitive impairment in the animal model [ 141 , 142 ]. Quetiapine (D2 and 5-HT2 antagonist), a new antipsychotic drug, prevents memory impairment by protecting the cultured cells against oxidative stress and decreases Aβ plaques in the brains of APP ⁄ presenilin-1 (PS-1) double-mutant mice.…”