From the Research
Rexulti (brexpiprazole) is recommended for the treatment of schizophrenia at a target dose of 2-4 mg daily, and as an adjunctive treatment for major depressive disorder (MDD) at a target dose of 2 mg daily, with dosage adjustments necessary for patients with hepatic or renal impairment, or those taking CYP2D6 or CYP3A4 inhibitors. The medication should be taken at the same time each day with or without food, and patients should not abruptly discontinue Rexulti, as gradual tapering is recommended to avoid withdrawal symptoms 1. Rexulti works by modulating serotonin and dopamine activity in the brain, acting as a partial agonist at serotonin 5-HT1A and dopamine D2 receptors, with a pharmacological profile that suggests a lower propensity for activating adverse events and extrapyramidal symptoms compared to other antipsychotic agents 2. Some key points to consider when prescribing Rexulti include:
- Initial dose: 1 mg once daily for schizophrenia, with gradual increase to target dose
- Target dose: 2-4 mg daily for schizophrenia, and 2 mg daily for MDD
- Dosage adjustments: necessary for patients with hepatic or renal impairment, or those taking CYP2D6 or CYP3A4 inhibitors
- Common side effects: weight gain, akathisia (restlessness), and increased risk of suicidal thoughts in young adults, requiring careful monitoring during initial treatment 3, 4, 5. It is essential to carefully monitor patients for potential side effects and adjust the dosage accordingly to minimize the risk of adverse events.