title: Adjunctive brexpiprazole for the treatment of major depressive disorder.
abstract: The lifetime prevalence of major depressive episodes in the United States is nearly 17%. Clinical trials and clinical effectiveness studies have demonstrated that many patients will fail to achieve remission using traditional monotherapy, contributing to significant morbidity and suffering. Because of this, augmentation strategies have been proposed to improve both treatment response and remission. Areas covered: Brexpiprazole is a second generation antipsychotic (SGA) approved by the US FDA in 2015 as an add-on treatment to an antidepressant medication for the treatment of adults with MDD, based on the results of two large-scale, randomized, placebo-controlled trials. It is thought to exert its antidepressant effect by a partial agonism of both the dopamine D2 and serotonin 5HT1A receptors. In addition, it also has potent antagonistic activity at 5HT2A, α1B and α2 C receptors, which may also contribute to monoamine transmission regulation. Expert Opinion: Overall, the tolerability of brexpiprazole is promising with relatively low rates of side effects and discontinuation rates, thus establishing it as a new option for the treatment of depression.
authors: a Psychiatry , Duke University Medical Center , Durham , NC , USA.
authors: John L
authors: JL
authors: Beyer
authors: a Psychiatry , Duke University Medical Center , Durham , NC , USA.|b Psychiatry , University of North Carolina , Chapel Hill, Durham , NC , USA.
authors: Richard H
authors: RH
authors: Weisler
mesh_terms: D000928:Antidepressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000378:metabolism / Q000523:psychology; D004298:Dopamine / Q000378:metabolism; D006801:Humans; D015363:Quinolones / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D017448:Receptors, Dopamine D2 / Q000819:agonists; D044263:Receptors, Serotonin, 5-HT1 / Q000378:metabolism; D058825:Serotonin 5-HT1 Receptor Agonists / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D013876:Thiophenes / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents; C581293:DRD2 protein, human; D015363:Quinolones; D017448:Receptors, Dopamine D2; D044263:Receptors, Serotonin, 5-HT1; D058825:Serotonin 5-HT1 Receptor Agonists; D013876:Thiophenes; C000591922:brexpiprazole; D004298:Dopamine
keywords: Depression; antidepressant; atypical antipsychotic; augmentation treatment; brexpiprazole