Effects of brexpiprazole: A Synthesis of Findings from 12 Studies

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Original Abstract of the Article

Major Research Findings

Brexpiprazole is a second-generation antipsychotic medication that has been shown to be effective as an adjunct to antidepressant treatment for major depressive disorder (MDD) in adults. 2 Preliminary evidence suggests that brexpiprazole may be more effective in subgroups of depressed patients with sleep disturbances. 2 A clinical trial is underway to evaluate the relationship between changes in sleep-wake and circadian parameters and changes in depressive symptoms following adjunctive brexpiprazole treatment in young adults with MDD and sleep-wake disturbance. 2 Brexpiprazole has been shown to be effective in treating treatment-resistant depression (TRD), which affects about one in three adults with MDD. 7 However, brexpiprazole can have side effects, including weight gain, metabolic dysfunction, extrapyramidal symptoms, and tardive dyskinesia. 7

Benefits and Risks

Benefit Summary

Brexpiprazole has been shown to be effective in treating treatment-resistant depression (TRD). 7 It may also be more effective in subgroups of depressed patients with sleep disturbances. 2 A meta-analysis of fifteen studies found that serotonin-dopamine activity modulators (SDAMs), such as brexpiprazole, increased remission in patients with MDD. 11 Brexpiprazole may also be effective in treating agitation in Alzheimer's dementia.

Risk Summary

Brexpiprazole can have side effects, including weight gain, metabolic dysfunction, extrapyramidal symptoms, and tardive dyskinesia. 7 Brexpiprazole, aripiprazole, and cariprazine can affect milk supply and should be used with caution in breastfeeding mothers. 5

Comparison of Studies

Similarities

Multiple studies have found that brexpiprazole can be an effective treatment for depression, particularly in patients with treatment-resistant depression. 11 , 7 Most studies have also found that brexpiprazole can have side effects, including weight gain, metabolic dysfunction, extrapyramidal symptoms, and tardive dyskinesia. 7

Differences

Some studies suggest that brexpiprazole may be more effective in subgroups of depressed patients with sleep disturbances. 2 Other studies have shown that brexpiprazole is generally well-tolerated and may be an effective alternative to other antidepressant medications. 11 A case report found that brexpiprazole was effective in treating a patient with clozapine-resistant schizophrenia.

Consistency and Contradictions

The research on brexpiprazole is generally consistent in that it shows that brexpiprazole can be an effective treatment for depression, particularly in patients with treatment-resistant depression. 11 , 7 However, there is some contradictory evidence on whether brexpiprazole is more effective in certain subgroups of patients, such as those with sleep disturbances. 2 More research is needed to clarify these inconsistencies.

Practical Implications

Brexpiprazole may be an effective treatment option for patients with depression, particularly those with treatment-resistant depression. 11 , 7 However, it is important to be aware of the potential side effects of brexpiprazole, such as weight gain, metabolic dysfunction, extrapyramidal symptoms, and tardive dyskinesia. 7 Patients should discuss the benefits and risks of brexpiprazole with their doctor before starting treatment. 7 Brexpiprazole may also affect milk supply and should be used with caution in breastfeeding mothers. 5

Limitations of Current Research

There is limited research on the long-term effects of brexpiprazole. 3 More research is needed to compare the effectiveness of brexpiprazole to other antidepressant medications and to determine if brexpiprazole is more effective in certain subgroups of patients, such as those with sleep disturbances. 2 , 7

Future Research Directions

Future research should focus on the long-term effects of brexpiprazole, the effectiveness of brexpiprazole in different subgroups of patients, and the potential interactions between brexpiprazole and other medications. 2 , 7 Research should also investigate the effects of brexpiprazole on sleep. 2

Conclusion

Brexpiprazole is a promising medication for the treatment of depression, particularly for patients with treatment-resistant depression. 11 , 7 However, it is important to be aware of the potential side effects of brexpiprazole. 7 Patients should discuss the benefits and risks of brexpiprazole with their doctor before starting treatment. 7

Literature analysis of 12 papers
Positive Content
10
Neutral Content
1
Negative Content
1
Article Type
1
1
0
8
12
1.

Effects of adjunctive brexpiprazole on patient life engagement in major depressive disorder: Post hoc analysis of Inventory of Depressive Symptomatology Self-Report data.

Author: McIntyreRoger S, TherrienFrançois, IsmailZahinoor, MeehanStine R, MiguelezMaia, LarsenKlaus Groes, ChenDalei, MacKenzieErin M, ThaseMichael E

Brexpiprazole efficacy
Life engagement

This study investigated the effects of brexpiprazole adjunct to antidepressant treatment on patient life engagement in individuals with major depressive disorder (MDD).

Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

2.

Effects of adjunctive brexpiprazole on sleep-wake and circadian parameters in youth with depressive disorders: study protocol for a clinical trial.

Author: CarpenterJoanne S, ZmicerevskaNatalia, CrouseJacob J, NichlesAlissa, GarlandAlexandra, SongYun Ju Christine, WilsonChloe, RohlederCathrin, McHughCatherine, LewekeF Markus, KoetheDagmar, ScottElizabeth M, HickieIan B

Brexpiprazole for MDD
Sleep disturbance treatment

This clinical trial will evaluate the effectiveness of brexpiprazole, an antipsychotic medication, in treating sleep-wake and circadian disturbances in young adults with major depressive disorder (MDD).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

Newer antipsychotics: Brexpiprazole, cariprazine, and lumateperone: A pledge or another unkept promise?

Author: BarmanRajdip, MajumderPradipta, DoifodeTejaswini, KablingerAnita

Antipsychotic side effects

Newer antipsychotic medications, such as brexpiprazole, cariprazine, and lumateperone, are being studied for their efficacy and tolerability in treating neuropsychiatric conditions. These medications show promise in short-term studies, but long-term data are limited. Further research is needed to compare their effectiveness to older antipsychotics.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

4.

A case report of clozapine-treatment-resistant schizophrenia successfully managed with brexpiprazole combination therapy.

Author: OrsoliniLaura, BellagambaSilvia, SalviVirginio, VolpeUmberto

Schizophrenia treatment

Clozapine is a medication used to treat schizophrenia, but some patients develop clozapine-resistant schizophrenia (CRS). This case report describes a young patient with CRS who was successfully treated with a combination of clozapine and brexpiprazole, and then switched to clozapine and a long-acting injectable aripiprazole.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

Aripiprazole, brexpiprazole, and cariprazine can affect milk supply: Advice to breastfeeding mothers.

Author: NaughtonSharna, O'HaraKate, NelsonJarren, KeightleyPhilip

Reduced milk supply

Dopamine Receptor Partial Agonist (DRPA) antipsychotic medications may lead to reduced milk supply in breastfeeding mothers. Further research is needed to better understand the effects of DRPAs on milk production.

ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

6.

Molecular Imaging of Dopamine Partial Agonists in Humans: Implications for Clinical Practice.

Author: HartXenia M, SchmitzChristian N, GründerGerhard

Improved antipsychotic efficacy

This review summarizes PET studies on the use of partial agonist antipsychotics aripiprazole, brexpiprazole, and cariprazine. The studies suggest that these drugs require a very high target engagement (>90%) for antipsychotic efficacy and that optimal plasma levels can be derived from PET studies.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

7.

Pharmacotherapies for Treatment-Resistant Depression: How Antipsychotics Fit in the Rapidly Evolving Therapeutic Landscape.

Author: JhaManish K, MathewSanjay J

Depression symptom improvement
Extrapyramidal symptoms
Metabolic dysfunction
Tardive dyskinesia
Weight gain

Treatment-resistant depression (TRD), affecting about one-third of adults with major depressive disorder, is associated with significant morbidity, mortality, and healthcare expenses. While atypical antipsychotics are approved for treating depression, they often provide limited remission and have concerning side effects, especially with long-term use.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

8.

Gone Too Soon: priorities for action to prevent premature mortality associated with mental illness and mental distress.

Author: O'ConnorRory C, WorthmanCarol M, AbangaMarie, AthanassopoulouNikoletta, BoyceNiall, ChanLai Fong, ChristensenHelen, Das-MunshiJayati, DownsJames, KoenenKarestan C, MoutierChristine Yu, TempletonPeter, BatterhamPhilip, BrakspearKaren, FrankRichard G, GilbodySimon, GurejeOye, HendersonDavid, JohnAnn, KabagambeWilbroad, KhanMurad, KesslerDavid, KirtleyOlivia J, KlineSarah, KohrtBrandon, LincolnAlisa K, LundCrick, MendenhallEmily, MirandaRegina, MondelliValeria, NiederkrotenthalerThomas, OsbornDavid, PirkisJane, PisaniAnthony R, PrawiraBenny, RachidiHala, SeedatSoraya, SiskindDan, VijayakumarLakshmi, YipPaul S F

Improved mental health
Improved physical health
Reduced inequality
Reduced premature mortality
Reduced stigma

This review examines the global problem of premature death due to suicide and physical comorbidities associated with mental illness. It identifies 12 overarching risk factors and mechanisms, and proposes 18 actionable solutions. These solutions prioritize integration of mental and physical healthcare, prevention, and optimizing intervention synergies across social-ecological levels. Key areas of action include accessible primary care, early life interventions, decriminalization of suicide, stigma reduction, and addressing socioeconomic inequalities.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

9.

Brexpiprazole-Pharmacologic Properties and Use in Schizophrenia and Mood Disorders.

Author: SiwekMarcin, Wojtasik-BakalarzKrzysztof, KrupaAnna Julia, ChrobakAdrian Andrzej

Mood disorder treatment
Schizophrenia treatment

Brexpiprazole is a third-generation antipsychotic that shows promise in treating schizophrenia, potentially addressing limitations of previous medications. It demonstrates favorable pharmacodynamic and pharmacokinetic profiles, indicating efficacy in managing negative, depressive, and cognitive symptoms.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

10.

Pharmacotherapy for Treatment-Resistant Depression: Antidepressants and Atypical Antipsychotics.

Author: VasCollin, JainAyush, TrivediMili, JhaManish Kumar, MathewSanjay J

Depression treatment
Akathisia
Tardive dyskinesia
Weight gain

Treatment-resistant depression (TRD) affects approximately one-third of patients with major depressive disorder. This abstract discusses the suboptimal remission rates with antidepressants in TRD and explores the use of atypical antipsychotics as augmentation agents. It highlights the benefits of these agents while emphasizing the need to weigh them against potential adverse events such as weight gain, akathisia, and tardive dyskinesia.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, U.S. Gov't, Non-P.H.S.Research funding provided by US government agencies other than the Public Health Service.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

11.

Efficacy and Safety of Adjunctive Serotonin-Dopamine Activity Modulators in Major Depression: A Meta-Analysis of Randomized Controlled Trials.

Author: MishraArchana, SarangiSudhir Chandra, MaitiRituparna, SoodMamta, ReetaK H

Reduced adverse events
Remission

This meta-analysis evaluated the effect of augmenting antidepressants with serotonin-dopamine activity modulators (SDAMs) in patients with major depression. SDAMs, such as aripiprazole and brexpiprazole, were found to increase remission rates and had no significant effect on serious adverse events.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

12.

Antipsychotics and risk of QT prolongation: a pharmacovigilance study.

Author: BordetConstance, GarciaPhilippe, SalvoFrancesco, TouafchiaAnthony, GalinierMichel, SommetAgnès, MontastrucFrançois

Reduced QTc prolongation
QTc prolongation

This study investigated the risk of QTc prolongation associated with different antipsychotics. While meta-analyses of clinical trials have suggested associations, no real-world studies have confirmed these findings.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

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