From the FDA Drug Label
DOSAGE AND ADMINISTRATION
2.2 Recommended Dosage for Adjunctive Treatment of Major Depressive Disorder (Adults) The recommended starting brexpiprazole tablets dosage for the adjunctive treatment of MDD in adults is 0.5 mg or 1 mg orally once daily. Titrate to 1 mg once daily, then titrate to the target dosage of 2 mg once daily (based on the patient’s clinical response and tolerability, increase the dosage at weekly intervals). The maximum recommended daily dosage is 3 mg.
2.3 Recommended Dosage for Schizophrenia (Adults) Adults The recommended starting brexpiprazole tablets dosage for the treatment of schizophrenia in adults is 1 mg orally once daily on Days 1 to 4. Titrate to 2 mg once daily on Day 5 through Day 7. On Day 8, the dosage can be increased to the maximum recommended daily dosage of 4 mg based on clinical response and tolerability The recommended target dosage is 2 mg to 4 mg once daily.
The recommended dosage of Rexulti (brexpiprazole) for patients with:
- Major Depressive Disorder (MDD): starting dose of 0.5 mg or 1 mg once daily, target dose of 2 mg once daily, and maximum dose of 3 mg once daily.
- Schizophrenia: starting dose of 1 mg once daily, target dose of 2-4 mg once daily, and maximum dose of 4 mg once daily 1.
From the Research
The recommended dosage of Rexulti (brexpiprazole) for patients with schizophrenia is 2-4 mg/day, and for major depressive disorder, it is 2 mg/day, as an adjunct to antidepressant medication. For schizophrenia, Rexulti is typically started at 1 mg once daily for the first 4 days, then increased to 2 mg once daily for days 5-7, followed by a target dose of 2-4 mg once daily 2. For major depressive disorder (MDD), Rexulti is used as an adjunctive treatment to antidepressants, starting at 0.5 or 1 mg once daily, with gradual increases to a target dose of 2 mg once daily 3. The medication should be taken at the same time each day with or without food. Dose adjustments are necessary for patients with moderate to severe hepatic or renal impairment and those taking strong CYP2D6 or CYP3A4 inhibitors. Rexulti works by acting as a partial agonist at serotonin 5-HT1A and dopamine D2 receptors, and as an antagonist at serotonin 5-HT2A receptors, helping to balance neurotransmitter activity in the brain. Common side effects include weight gain, akathisia (restlessness), and increased risk of suicidal thoughts in young adults, so regular monitoring is important, especially when initiating treatment or changing doses 4, 5, 6. It is essential to note that brexpiprazole has been shown to be effective in treating schizophrenia and MDD, with a relatively favorable tolerability profile compared to other antipsychotics 2, 3. However, long-term safety data and potential high costs are considerations in its use 5. Overall, brexpiprazole is a viable option for the treatment of schizophrenia and as an adjunctive treatment for MDD, with its dosage and administration guided by the patient's response and tolerability.