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Edinoff AN, Wu NW, Maxey BS, Ren AL, Leethy KN, Girma B, Odisho A, Kaye JS, Kaye AJ, Kaye AM, Kaye AD, Mychaskiw G, Viswanath O, Urits I. Brexpiprazole for the Treatment of Schizophrenia and Major Depressive Disorder: A Comprehensive Review of Pharmacological Considerations in Clinical Practice. PSYCHOPHARMACOLOGY BULLETIN 2021; 51:69-95. [PMID: 34092824 PMCID: PMC8146559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Mood and psychotic disorders are a group of illnesses that affect behavior and cognition. Schizophrenia is characterized by positive symptoms, such as delusions and hallucinations, as well as negative symptoms. Major depressive disorder (MDD) is a mood disorder that affects the patient's emotions, energy, and motivation. Brexpiprazole works as a partial agonist at serotonin 5-hydroxytryptamine1A and dopamine D2 receptors and an antagonist at serotonin 5-hydroxytryptamine2A. Schizophrenia and MDD have a wide range of risk factors, both biological and environmental. Third generation antipsychotics, which include brexpiprazole, are the latest group of drugs to reach the market, demonstrating efficacy and tolerability. Patients with acute schizophrenia have responded well to brexpiprazole. In this regard, in patients who have MDD plus anxiety symptoms, brexpiprazole can be effective as an adjunctive therapy and can reduce anxiety symptoms. In summary, brexpiprazole has proved to be an effective alternative to typical or first and second-generation atypical antipsychotics.
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Affiliation(s)
- Amber N Edinoff
- Edinoff, MD, Wu, MD, Odisho, MD, Louisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine. Maxey, BS, Ren, BS, Leethy, BS, Louisiana State University Shreveport School of Medicine. Girma, MD, Alan D. Kaye, MD, PhD, Mychaskiw, DO, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Jessica S. Kaye, Adam M. Kaye, PharmD, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Aaron J. Kaye, MD, Medical University of South Carolina, Department of Anesthesiology, Charleston, SC. Viswanath, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE, Valley Anesthesiology and Pain Consultants-Envision Physician Services, Phoenix, AZ. Urits, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA
| | - Natalie W Wu
- Edinoff, MD, Wu, MD, Odisho, MD, Louisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine. Maxey, BS, Ren, BS, Leethy, BS, Louisiana State University Shreveport School of Medicine. Girma, MD, Alan D. Kaye, MD, PhD, Mychaskiw, DO, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Jessica S. Kaye, Adam M. Kaye, PharmD, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Aaron J. Kaye, MD, Medical University of South Carolina, Department of Anesthesiology, Charleston, SC. Viswanath, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE, Valley Anesthesiology and Pain Consultants-Envision Physician Services, Phoenix, AZ. Urits, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA
| | - Benjamin S Maxey
- Edinoff, MD, Wu, MD, Odisho, MD, Louisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine. Maxey, BS, Ren, BS, Leethy, BS, Louisiana State University Shreveport School of Medicine. Girma, MD, Alan D. Kaye, MD, PhD, Mychaskiw, DO, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Jessica S. Kaye, Adam M. Kaye, PharmD, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Aaron J. Kaye, MD, Medical University of South Carolina, Department of Anesthesiology, Charleston, SC. Viswanath, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE, Valley Anesthesiology and Pain Consultants-Envision Physician Services, Phoenix, AZ. Urits, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA
| | - Amy L Ren
- Edinoff, MD, Wu, MD, Odisho, MD, Louisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine. Maxey, BS, Ren, BS, Leethy, BS, Louisiana State University Shreveport School of Medicine. Girma, MD, Alan D. Kaye, MD, PhD, Mychaskiw, DO, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Jessica S. Kaye, Adam M. Kaye, PharmD, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Aaron J. Kaye, MD, Medical University of South Carolina, Department of Anesthesiology, Charleston, SC. Viswanath, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE, Valley Anesthesiology and Pain Consultants-Envision Physician Services, Phoenix, AZ. Urits, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA
| | - Kenna N Leethy
- Edinoff, MD, Wu, MD, Odisho, MD, Louisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine. Maxey, BS, Ren, BS, Leethy, BS, Louisiana State University Shreveport School of Medicine. Girma, MD, Alan D. Kaye, MD, PhD, Mychaskiw, DO, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Jessica S. Kaye, Adam M. Kaye, PharmD, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Aaron J. Kaye, MD, Medical University of South Carolina, Department of Anesthesiology, Charleston, SC. Viswanath, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE, Valley Anesthesiology and Pain Consultants-Envision Physician Services, Phoenix, AZ. Urits, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA
| | - Brook Girma
- Edinoff, MD, Wu, MD, Odisho, MD, Louisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine. Maxey, BS, Ren, BS, Leethy, BS, Louisiana State University Shreveport School of Medicine. Girma, MD, Alan D. Kaye, MD, PhD, Mychaskiw, DO, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Jessica S. Kaye, Adam M. Kaye, PharmD, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Aaron J. Kaye, MD, Medical University of South Carolina, Department of Anesthesiology, Charleston, SC. Viswanath, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE, Valley Anesthesiology and Pain Consultants-Envision Physician Services, Phoenix, AZ. Urits, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA
| | - Amira Odisho
- Edinoff, MD, Wu, MD, Odisho, MD, Louisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine. Maxey, BS, Ren, BS, Leethy, BS, Louisiana State University Shreveport School of Medicine. Girma, MD, Alan D. Kaye, MD, PhD, Mychaskiw, DO, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Jessica S. Kaye, Adam M. Kaye, PharmD, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Aaron J. Kaye, MD, Medical University of South Carolina, Department of Anesthesiology, Charleston, SC. Viswanath, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE, Valley Anesthesiology and Pain Consultants-Envision Physician Services, Phoenix, AZ. Urits, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA
| | - Jessica S Kaye
- Edinoff, MD, Wu, MD, Odisho, MD, Louisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine. Maxey, BS, Ren, BS, Leethy, BS, Louisiana State University Shreveport School of Medicine. Girma, MD, Alan D. Kaye, MD, PhD, Mychaskiw, DO, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Jessica S. Kaye, Adam M. Kaye, PharmD, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Aaron J. Kaye, MD, Medical University of South Carolina, Department of Anesthesiology, Charleston, SC. Viswanath, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE, Valley Anesthesiology and Pain Consultants-Envision Physician Services, Phoenix, AZ. Urits, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA
| | - Aaron J Kaye
- Edinoff, MD, Wu, MD, Odisho, MD, Louisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine. Maxey, BS, Ren, BS, Leethy, BS, Louisiana State University Shreveport School of Medicine. Girma, MD, Alan D. Kaye, MD, PhD, Mychaskiw, DO, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Jessica S. Kaye, Adam M. Kaye, PharmD, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Aaron J. Kaye, MD, Medical University of South Carolina, Department of Anesthesiology, Charleston, SC. Viswanath, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE, Valley Anesthesiology and Pain Consultants-Envision Physician Services, Phoenix, AZ. Urits, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA
| | - Adam M Kaye
- Edinoff, MD, Wu, MD, Odisho, MD, Louisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine. Maxey, BS, Ren, BS, Leethy, BS, Louisiana State University Shreveport School of Medicine. Girma, MD, Alan D. Kaye, MD, PhD, Mychaskiw, DO, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Jessica S. Kaye, Adam M. Kaye, PharmD, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Aaron J. Kaye, MD, Medical University of South Carolina, Department of Anesthesiology, Charleston, SC. Viswanath, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE, Valley Anesthesiology and Pain Consultants-Envision Physician Services, Phoenix, AZ. Urits, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA
| | - Alan D Kaye
- Edinoff, MD, Wu, MD, Odisho, MD, Louisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine. Maxey, BS, Ren, BS, Leethy, BS, Louisiana State University Shreveport School of Medicine. Girma, MD, Alan D. Kaye, MD, PhD, Mychaskiw, DO, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Jessica S. Kaye, Adam M. Kaye, PharmD, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Aaron J. Kaye, MD, Medical University of South Carolina, Department of Anesthesiology, Charleston, SC. Viswanath, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE, Valley Anesthesiology and Pain Consultants-Envision Physician Services, Phoenix, AZ. Urits, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA
| | - George Mychaskiw
- Edinoff, MD, Wu, MD, Odisho, MD, Louisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine. Maxey, BS, Ren, BS, Leethy, BS, Louisiana State University Shreveport School of Medicine. Girma, MD, Alan D. Kaye, MD, PhD, Mychaskiw, DO, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Jessica S. Kaye, Adam M. Kaye, PharmD, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Aaron J. Kaye, MD, Medical University of South Carolina, Department of Anesthesiology, Charleston, SC. Viswanath, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE, Valley Anesthesiology and Pain Consultants-Envision Physician Services, Phoenix, AZ. Urits, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA
| | - Omar Viswanath
- Edinoff, MD, Wu, MD, Odisho, MD, Louisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine. Maxey, BS, Ren, BS, Leethy, BS, Louisiana State University Shreveport School of Medicine. Girma, MD, Alan D. Kaye, MD, PhD, Mychaskiw, DO, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Jessica S. Kaye, Adam M. Kaye, PharmD, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Aaron J. Kaye, MD, Medical University of South Carolina, Department of Anesthesiology, Charleston, SC. Viswanath, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE, Valley Anesthesiology and Pain Consultants-Envision Physician Services, Phoenix, AZ. Urits, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA
| | - Ivan Urits
- Edinoff, MD, Wu, MD, Odisho, MD, Louisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine. Maxey, BS, Ren, BS, Leethy, BS, Louisiana State University Shreveport School of Medicine. Girma, MD, Alan D. Kaye, MD, PhD, Mychaskiw, DO, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Jessica S. Kaye, Adam M. Kaye, PharmD, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Aaron J. Kaye, MD, Medical University of South Carolina, Department of Anesthesiology, Charleston, SC. Viswanath, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE, Valley Anesthesiology and Pain Consultants-Envision Physician Services, Phoenix, AZ. Urits, MD, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA
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