Brexiprazole: uses and side effects of this psychotropic drug

This drug is an antipsychotic used in some patients with schizophrenia or depression.

Brexiprazole is a second generation antipsychotic.. It was developed in the United States and began to be marketed there in 2015. It is used as an adjunctive treatment for patients with schizophrenia or major depressive disorder.

It is indicated for patients who have not responded well to treatments based solely on antidepressants. In this article we will learn about its characteristics, precautions to be taken, mechanism of action, uses and side effects.

Brexiprazole: an atypical antipsychotic

Brexiprazole is a second-generation antipsychotic drug (atypical antipsychotic). Its mechanism of action, so far unknown, modifies the amount of certain substances in the brain. It is known, however, that the mechanism is related to dopamine, serotonin and noradrenaline, the main neurotransmitters in the brain.the main brain neurotransmitters.

Typical and atypical antipsychotics

Compared to typical or first-generation antipsychotics, atypical antipsychotics are more advanced and produce fewer side effects, interacting with fewer neurotransmitters or substances.

In addition, in the case of schizophrenia, they have the advantage of treating not only the positive symptoms of schizophrenia of schizophrenia (hallucinations, disorganized language, delusions,...) (as the typical ones do), but they also treat the negative symptoms of schizophrenia (abulia, affective flattening, depression,...), although to a lesser extent. Typical antipsychotics, on the other hand, do not act on the negative symptoms.

Origin of the drug

Brexiprazole was discovered by Otsuka Pharmaceutical Co., Ltd. (Otsuka) and co-developed by Otsuka and Lundbeck. It was approved by the US Food and Drug Administration (FDA) as an adjunctive treatment for adults with major depressive disorder and as a treatment for schizophrenia in adults. It began to be marketed in 2015 in the US.

This was as a result of the fact that many adults with major depressive disorder (MDD) (specifically, 15 million in the US) had a poor response to Antidepressant monotherapy (i.e., using only these drugs as treatment). Brexiprazole was developed in response to this type of patient.

Mechanism of action

The mechanism of action of brexpiprazole in the treatment of major depressive disorder or schizophrenia is unknown. However, its mechanism of action is known to be related to a combination of partial agonist activity at serotonin 5-HT1A receptors and dopamine D2 receptors. partial agonist activity at serotonin 5-HT1A receptors and dopamine D2 receptors..

It also acts antagonistically at serotonin 5-HT2A receptors. Brexiprazole also has a high affinity for these receptors, as well as for other receptors, the alpha 1B/2C receptors of norepinephrine. The fact that it has a high affinity means that it fits very well with them, that is, that its efficacy is high.

Indications

Brexiprazole is indicated to treat the symptoms of schizophrenia and is also used as an antidepressant for treating depressionin cases where symptoms cannot be relieved by antidepressants alone.

How is it taken?

Brexpiprazole is taken orally, in tablet or pill form.. It is usually taken only once a day. It is recommended to take it at the same time every day.

In case you miss a dose, you should take another one as soon as possible, but skip the missed dose if it is almost time for the next dose. It is important never to take two doses at the same time.

Side effects

The side effects associated with brexiprazole are: headache, constipation, heartburn, tiredness, uncontrollable shaking of a part of the body, dizziness, feeling unsteady, and difficulty in breathing.dizziness, a feeling of instability and difficulty in maintaining balance.

There are other side effects, less frequent but more serious, that in case of appearing, you should go to the doctor immediately. Some of these effects are: rash urticaria, itching, inflammation of different parts of the face or body. (e.g. eyes, face, mouth, lips, tongue, throat, hands, feet, ankles or lower legs), difficulty breathing or swallowing, convulsions, difficulty breathing, sore throat, cough, chills and other signs of infection, etc.

Precautions

Brexiprazole is not indicated or approved for the treatment of psychotic symptoms associated with dementia.. It is also not suitable for people under 18 years of age.

On the other hand, it is important to take into account that once treatment with brexiprazole is started, some people have even expressed suicidal thoughts (especially if they were using the drug for the first time).

That is why we must be alert to possible mood changes in the person, as well as to signs that lead us to think of suicidal or self-harming ideas.

Regarding pregnancyIt is known that taking antipsychotics in the last 3 months of pregnancy can cause breathing problems, feeding problems, or withdrawal symptoms in the newborn.

Evidence

The efficacy of brexpiprazole was demonstrated in two 6-week, placebo-controlled clinical trials of brexpiprazoleThe efficacy of brexpiprazole was demonstrated in two 6-week, placebo-controlled clinical trials in adult patients who met DSM-IV-TR criteria for major depressive disorder (MDD).

Some of these patients also had symptoms of anxiety, and none of them had previously achieved an adequate response during 1 to 3 treatment attempts with antidepressant drugs. In addition, they had also failed to achieve an adequate response in an 8-week single-blind antidepressant therapy phase.