- Last edited on February 19, 2021
Brexpiprazole (Rexulti)
Primer
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
See also article: Introduction to Pharmacology
Pharmacokinetics of Brexpiprazole
See also article: Cytochrome (CYP) P450 Metabolism
Brexpiprazole: Cytochrome P450 Metabolism
Substrate of (Metabolized by) | |
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Induces | |
Inhibits |
Pharmacodynamics
Mechanism of Action
Toxicity
Indications
- Adult schizophrenia
- Major depressive disorder, adjunctive therapy with an antidepressant
Dosing
Dosing for Brexpiprazole
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Titration | |
Maximum | |
Taper |
Formulations
- Brexpiprazole comes in
Monitoring
Contraindications
Absolute
Relative
Drug-Drug Interactions
Side Effects
Adverse Events
Clinical Pearls
Special Populations
Geriatric
See main article: Geriatric Pharmacology
Pediatric
See main article: Pediatric Pharmacology
Obstetric and Fetal
See main article: Obstetric and Fetal Pharmacology
Medically Ill
See main article: Psychotropic Dosing in the Medically Ill