Brexpiprazole (Rexulti)

Brexpiprazole (Trade name: Rexulti) is an antipsychotic in the atypical antipsychotic class commonly used in the treatment of schizophrenia. It is also used as an adjunctive medication in major depressive disorder.

History

Brexpiprazole has features that both overlap and contrast with an older medication, aripiprazole. Brexpiprazole was developed due to concerns about impulse-control problems that developed in the use of aripiprazole (due to dopamine partial agonism). Brexpiprazole was thus designed with dopamine agonism “dialed back” a bit, and it generally has less problems with impulse-control symptoms.

Pharmacokinetics of Brexpiprazole

Brexpiprazole: Cytochrome P450 Metabolism

Substrate of (Metabolized by)
Induces
Inhibits
  • Adult schizophrenia
  • Major depressive disorder, adjunctive therapy with an antidepressant

Dosing for Brexpiprazole

Starting
Titration
Maximum
Taper
  • Brexpiprazole comes in