Brexpiprazole: so far so good.

Article Details

Citation

Das S, Barnwal P, Winston A B, Mondal S, Saha I

Brexpiprazole: so far so good.

Ther Adv Psychopharmacol. 2016 Feb;6(1):39-54. doi: 10.1177/2045125315614739.

PubMed ID
26913177 [ View in PubMed
]
Abstract

This article describes the role of a newly approved antipsychotic agent brexpiprazole in the treatment of schizophrenia and major depressive disorder. This drug has high affinity for 5-HT1A, 5-HT2A, D2 and alpha1B,2C receptors. It displays partial agonism at 5-HT1A and D2 receptors and potent antagonism at 5-HT2A and alpha1B,2C adrenergic receptors. It also has some affinity (antagonism) for D3, 5-HT2B, 5-HT7 and alpha1A,1D receptors, and moderate affinity for H1 and low affinity for M1 receptors. These all lead to a favorable antipsychotic profile in terms of improvement of cognitive performance and sleep patterns, as well as effects on affective states and potential to treat core symptoms in schizophrenia and major depressive disorder, including cognitive deficits with a low risk of adverse effects (extrapyramidal symptoms, metabolic complications, weight gain, akathisia potential) that are commonly encountered with other typical and second-generation antipsychotic drugs. In our review, we have made an attempt to decipher the pharmacological profile of brexpiprazole from two major trials (VECTOR and BEACON). We have also tried to give a concise but detailed overview of brexpiprazole by head to head comparison of the pharmacological profile of brexpiprazole and its earlier congeners aripiprazole and prototype antipsychotic drug chlorpromazine by accessing individual summaries of product characteristics from the US Food and Drug Administration database, 2015. Relevant preclinical and clinical studies associated with this drug have been discussed with emphasis on efficacy and safety concerns. From the studies done so far, it can be concluded that brexpiprazole can be an effective monotherapy for schizophrenia and as an adjunct to other antidepressant medications in major depressive disorder.

DrugBank Data that Cites this Article

Drugs
Drug Targets
DrugTargetKindOrganismPharmacological ActionActions
BrexpiprazoleHistamine H1 receptorProteinHumans
Unknown
Antagonist
Details
BrexpiprazoleMuscarinic acetylcholine receptor M1ProteinHumans
Unknown
Antagonist
Details
Drug Interactions
DrugsInteraction
Brexpiprazole
Cholecalciferol
The metabolism of Brexpiprazole can be decreased when combined with Cholecalciferol.
Brexpiprazole
Metoprolol
The metabolism of Brexpiprazole can be decreased when combined with Metoprolol.
Brexpiprazole
Venlafaxine
The metabolism of Brexpiprazole can be decreased when combined with Venlafaxine.
Brexpiprazole
Imipramine
The metabolism of Brexpiprazole can be decreased when combined with Imipramine.
Brexpiprazole
Quinine
The metabolism of Brexpiprazole can be decreased when combined with Quinine.