What is the use of Rexulti (Brexpiprazole)?

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Last updated: February 18, 2025View editorial policy

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From the Guidelines

Rexulti (brexpiprazole) is an atypical antipsychotic medication, primarily used for the treatment of schizophrenia and as an adjunctive treatment for major depressive disorder 1. The typical dose range for Rexulti is 1-4 mg once daily, with a maximum dose of 4 mg per day for schizophrenia and 3 mg per day for major depressive disorder. Treatment should be initiated at a dose of 1 mg once daily and gradually increased as needed and tolerated.

Key Considerations

  • Patients should be monitored for potential side effects, such as:
    • Weight gain
    • Metabolic changes
    • Extrapyramidal symptoms
  • Due to the risk of increased suicidal thoughts and behaviors in children, adolescents, and young adults, Rexulti should be used with caution in these populations 1.

Clinical Guidelines

The use of Rexulti is supported by various clinical guidelines, including those from the American Psychiatric Association and the National Institute for Health and Care Excellence 1. However, it is essential to note that antipsychotic polypharmacy, which involves the concurrent use of two or more antipsychotic medications, is generally not recommended unless necessary 1.

Important Side Effects

Some important side effects to consider when using Rexulti include:

  • Akathisia
  • Mortality
  • Hyperprolactinemia
  • Sexual dysfunction
  • Hypersalivation
  • Sedation/somnolence
  • Cognitive impairment
  • Diabetes mellitus 1

From the FDA Drug Label

Brexpiprazole is an atypical antipsychotic indicated for: Use as an adjunctive therapy to antidepressants for the treatment of major depressive disorder (MDD) in adults. Treatment of schizophrenia in adults.

The use of Rexulti (Brexpiprazole) is for:

  • Adjunctive treatment of major depressive disorder (MDD) in adults
  • Treatment of schizophrenia in adults 2

From the Research

Use of Rexulti (Brexpiprazole)

The use of Rexulti (Brexpiprazole) is primarily for the treatment of:

  • Schizophrenia in adult patients 3, 4, 5, 6
  • Major depressive disorder (MDD) as an adjunctive treatment to antidepressants 4, 5, 6, 7

Dosage and Administration

The recommended dose range for Brexpiprazole in the treatment of schizophrenia is:

  • 2-4 mg/day 3, 4
  • The recommended titration schedule is to start with 1 mg/day and increase to 2 mg/day on Day 5 to Day 7, then to 4 mg/day on Day 8 4

Efficacy

Brexpiprazole has been shown to be effective in:

  • Producing statistically significant and clinically meaningful improvements in overall symptomatology and psychosocial functioning compared with placebo in adults with acute exacerbation of schizophrenia 3
  • Delaying the time to relapse compared with placebo in patients who were already stabilized on the drug 3, 4
  • Demonstrating efficacy as an adjunctive treatment for major depressive disorder 5, 6, 7

Safety and Tolerability

Brexpiprazole is generally well-tolerated, with a relatively low incidence of:

  • Activating and sedating adverse effects 3
  • Extrapyramidal symptoms 3
  • Common adverse events include:
    • Increased weight 4, 5, 7
    • Akathisia 4, 5, 7
    • Somnolence 7

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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