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Adjunctive Brexpiprazole: A Review in Major Depressive Disorder

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Abstract

Brexpiprazole (Rexulti®) is a serotonin-dopamine activity modulator, with a unique receptor binding profile and low intrinsic D2 activity suggestive of a lower potential than aripiprazole to cause activation-like adverse effects, such as akathisia. The drug was recently approved by the US FDA for adjunctive therapy with antidepressant treatment (ADT) in patients with major depressive disorder (MDD). In two phase III trials, adjunctive oral brexpiprazole 2 or 3 mg once daily was more effective than monotherapy with ADT in improving depressive symptoms in adults with MDD who demonstrated an incomplete response to previous treatment with ADT. Adjunctive brexpiprazole was generally well tolerated in clinical trials, which included treatment periods of up to 52 weeks. Results of ongoing trials should help position the drug in the treatment of MDD. In the meantime, brexpiprazole provides a valid option for patients with persistent symptoms despite standard antidepressant therapy.

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Acknowledgments

During the peer review process, the manufacturer of the agent under review was offered an opportunity to comment on this article. Changes resulting from comments received were made by the author on the basis of scientific and editorial merit.

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    Kate McKeage

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  1. Kate McKeage
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Correspondence to Kate McKeage.

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The preparation of this review was not supported by any external funding.

Conflicts of interest

Kate McKeage is a salaried employee of Adis/Springer, is responsible for the article content and declares no relevant conflicts of interest.

Additional information

The manuscript was reviewed by: A. M. Barr, Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada; A. H. Clayton, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, USA; W. H. Coryell, Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA.

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McKeage, K. Adjunctive Brexpiprazole: A Review in Major Depressive Disorder. CNS Drugs 30, 91–99 (2016). https://doi.org/10.1007/s40263-016-0320-0

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