What is Brexpiprazole: Uses, Dosage, Side Effects and More

Brexpiprazole is a newer antipsychotic medication that helps balance certain brain chemicals to improve mood, thinking, and behavior. Your doctor might prescribe it if you're dealing with schizophrenia or as an additional treatment for major depression when other medications haven't provided enough relief on their own.

This medication works differently from older antipsychotics, often causing fewer troublesome side effects while still providing effective symptom management. Understanding how brexpiprazole works and what to expect can help you feel more confident about your treatment journey.

What is Brexpiprazole?

Brexpiprazole belongs to a group of medications called atypical antipsychotics or second-generation antipsychotics. It was approved by the FDA in 2015 and represents one of the newer options in mental health treatment.

Unlike older antipsychotic medications, brexpiprazole is designed to work more selectively on brain receptors. This targeted approach often means you're less likely to experience some of the movement-related side effects that were common with earlier medications in this class.

The medication comes as oral tablets that you take by mouth, typically once daily. Your doctor will work with you to find the right dose that provides the most benefit with the fewest side effects.

What is Brexpiprazole Used For?

Brexpiprazole has two main approved uses that your doctor might recommend. First, it can treat schizophrenia in adults, helping reduce symptoms like hallucinations, delusions, and disorganized thinking.

Second, it serves as an add-on treatment for major depressive disorder when antidepressants alone haven't provided enough improvement. In this case, you'd continue taking your current antidepressant while adding brexpiprazole to enhance the overall effect.

Your doctor might also consider brexpiprazole for other conditions, though these would be off-label uses. They'll discuss with you whether this medication fits your specific situation and treatment goals.

How Does Brexpiprazole Work?

Brexpiprazole works by affecting dopamine and serotonin, two important brain chemicals that influence mood, thinking, and behavior. It acts as what doctors call a "partial agonist," meaning it can both activate and block certain brain receptors depending on what your brain needs.

This balancing act helps stabilize brain chemistry without completely shutting down these important pathways. Think of it as fine-tuning rather than completely changing how your brain processes these chemicals.

Compared to some other antipsychotics, brexpiprazole is considered to have a gentler approach. It's designed to provide therapeutic benefits while minimizing some of the more challenging side effects that can occur with stronger medications in this class.

How Should I Take Brexpiprazole?

You can take brexpiprazole with or without food, whichever feels more comfortable for you. Taking it with food might help reduce any stomach upset, though this isn't necessary for the medication to work properly.

Most doctors recommend taking brexpiprazole at the same time each day to maintain steady levels in your system. Many people find it easiest to take it in the morning, but your doctor might suggest a different timing based on how it affects you.

Swallow the tablet whole with water or another beverage. Don't crush, chew, or break the tablet, as this can affect how the medication is absorbed into your system.

If you're switching from another antipsychotic medication, your doctor will create a specific plan for the transition. This might involve gradually reducing your old medication while slowly increasing brexpiprazole to prevent withdrawal symptoms or symptom return.

How Long Should I Take Brexpiprazole For?

The length of treatment with brexpiprazole depends on your specific condition and how well you respond to the medication. For schizophrenia, this is typically a long-term treatment that may continue for months or years to maintain symptom control.

If you're taking brexpiprazole as an add-on for depression, your doctor will monitor your progress and may adjust the treatment plan over time. Some people may need it for several months, while others might benefit from longer-term use.

Never stop taking brexpiprazole suddenly without talking to your doctor first. Even if you're feeling better, stopping abruptly can lead to withdrawal symptoms or a return of the symptoms you were treating.

Your doctor will work with you to determine the right duration for your treatment, considering factors like your symptom improvement, side effects, and overall health goals.

What Are the Side Effects of Brexpiprazole?

Like all medications, brexpiprazole can cause side effects, though not everyone experiences them. Understanding what to watch for can help you feel more prepared and know when to reach out to your healthcare provider.

The most common side effects that people experience are generally mild and often improve as your body adjusts to the medication:

• Weight gain (usually gradual and moderate)
• Headache
• Drowsiness or fatigue
• Nausea or stomach upset
• Dizziness
• Anxiety or restlessness
• Trouble sleeping
• Constipation

These effects are typically manageable and may lessen over time as your body gets used to the medication. Your doctor can suggest strategies to help minimize any discomfort you experience.

Some less common but more serious side effects require immediate medical attention. While these are rare, it's important to be aware of them:

• Unusual muscle movements or stiffness
• High fever with muscle rigidity
• Significant changes in blood pressure
• Severe dizziness or fainting
• Difficulty swallowing
• Seizures
• Thoughts of self-harm

If you experience any of these serious side effects, contact your doctor immediately or seek emergency medical care. These symptoms are uncommon but need prompt attention when they occur.

Who Should Not Take Brexpiprazole?

Brexpiprazole isn't suitable for everyone, and your doctor will carefully review your medical history before prescribing it. People with certain conditions or taking specific medications may need to avoid this treatment or use it with extra caution.

You should tell your doctor if you have any of these conditions before starting brexpiprazole:

• Dementia or Alzheimer's disease
• Heart problems or irregular heartbeat
• Low blood pressure
• Seizure disorders
• Diabetes or high blood sugar
• Liver or kidney disease
• History of stroke or blood clots
• Difficulty swallowing

Certain medications can interact with brexpiprazole, potentially increasing side effects or reducing effectiveness. Your doctor needs to know about all medications you're taking, including over-the-counter drugs and supplements.

Brexpiprazole is not approved for use in children or adolescents under 18. The safety and effectiveness in this age group haven't been established through clinical studies.

If you're pregnant, planning to become pregnant, or breastfeeding, discuss this with your doctor. They'll help you weigh the potential benefits and risks to determine the best treatment approach for your situation.

Brexpiprazole Brand Names

Brexpiprazole is available under the brand name Rexulti in the United States. This is the most common way you'll see it prescribed and dispensed at pharmacies.

Currently, Rexulti is the primary brand name for brexpiprazole, though generic versions may become available in the future. Your doctor or pharmacist will let you know which version you're receiving.

When discussing your medication with healthcare providers, you can refer to it by either name - brexpiprazole or Rexulti - and they'll understand you're talking about the same medication.

Brexpiprazole Alternatives

If brexpiprazole doesn't work well for you or causes troublesome side effects, several alternative medications might be suitable. Your doctor will consider your specific symptoms, medical history, and treatment goals when exploring other options.

For schizophrenia treatment, other atypical antipsychotics might be considered:

• Aripiprazole (Abilify)
• Olanzapine (Zyprexa)
• Quetiapine (Seroquel)
• Risperidone (Risperdal)
• Ziprasidone (Geodon)
• Paliperidone (Invega)

For depression add-on treatment, other options your doctor might consider include different antipsychotics or other classes of medications that can augment antidepressant therapy.

The choice of alternative depends on many factors, including your symptom pattern, side effect tolerance, other medications you're taking, and your personal preferences. Your doctor will work with you to find the most suitable option if brexpiprazole isn't the right fit.

Is Brexpiprazole Better Than Aripiprazole?

Brexpiprazole and aripiprazole (Abilify) are closely related medications that work in similar ways, but they have some important differences. Both are atypical antipsychotics that act as partial agonists on dopamine receptors, but brexpiprazole was developed to potentially offer some advantages.

Brexpiprazole may cause less restlessness and agitation compared to aripiprazole, which can be a significant benefit for some people. It also might be less likely to cause sleep problems or the jittery feeling that some people experience with aripiprazole.

However, aripiprazole has been available longer and has more extensive research behind it. It's also available in more formulations, including long-acting injections, and may be more affordable due to generic availability.

The "better" choice depends entirely on your individual response, side effect profile, and specific needs. Your doctor will help you determine which medication offers the best balance of benefits and tolerability for your situation.