Brexiprazole: Uses And Side Effects Of This Psychotropic Drug
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 adjuvant 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 that should be taken, mechanism of action, uses and side effects.
Brexiprazole is a second-generation antipsychotic drug (atypical antipsychotic). Its mechanism of action, until now unknown, causes the amount of certain substances in the brain to be modified. It is known, however, that the mechanism is related to dopamine, serotonin and norepinephrine main brain neurotransmitters.
Typical and atypical antipsychotics
Compared to typical or first-generation antipsychotics, atypicals are more advanced and produce fewer side effects, interacting with fewer neurotransmitters or substances.
Besides, In the case of schizophrenia, they have the advantage that they not only treat the positive symptoms of the same (hallucinations, disorganized language, delusions,…) (as the typical ones do), but they also treat the negative symptoms of schizophrenia (avolition, emotional flattening, depression,…), although to a lesser extent extent. Typical antipsychotics, on the other hand, do not act on negative symptoms.
Origin of the drug
Brexitprazole It was discovered by the pharmaceutical company Otsuka Pharmaceutical Co., Ltd (Otsuka) and co-developed by Otsuka and Lundbeck. The US Food and Drug Administration (FDA) approved it as an adjuvant 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 because many adults with major depressive disorder (MDD) (specifically, 15 million in the United States) had a poor response to antidepressant monotherapy (that is, using only these drugs as treatment). To respond to this type of patient, brexiprazole emerged.
Mechanism of action
The mechanism of action of brexpiprazole in the treatment of major depressive disorder or schizophrenia is unknown. However, it is known that its mechanism of action is related to a combination of partial agonist activity at serotonin 5-HT1A receptors and dopamine D2 receptors
It also acts antagonistically on the 5-HT2A serotonin receptors. Brexiprazole also has a high affinity for these receptors, as well as for others, the alpha 1B/2C norepinephrine receptors. The fact that it has a high affinity means that it fits very well with them, that is, its effectiveness is high.
Indications
Brexitprazole It is indicated to treat the symptoms of schizophrenia and is also used as an antidepressant to treat depression in cases where symptoms cannot be relieved with antidepressants alone.
How is it taken?
Brexpiprazole It is taken orally, in tablet or pill format It is generally taken only once a day. It is recommended that it be taken at the same time every day.
If you miss a dose, you should take another one as quickly as possible, but skipping the missed dose if it is almost time for the next dose. It is important to never 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 of instability and difficulty maintaining balance.
There are other side effects, less frequent but more serious, that if they appear, you should see a doctor immediately. Some of these effects are: rash hives, itching, swelling of different parts of the face or body (for example the eyes, face, mouth, lips, tongue, throat, hands, feet, ankles or lower legs), difficulty breathing or swallowing, seizures, difficulty breathing, sore throat, cough, chills and other signs of infection, etc.
Precautions
Brexitprazole It is not indicated or approved to treat psychotic symptoms associated with dementia processes It is also not suitable for people under 18 years of age.
On the other hand, it is important to keep in mind that once treatment with brexiprazole is started, some people have expressed thoughts of suicide (especially if they were using the medication for the first time).
This is why we must be alert to possible changes in the person’s mood, as well as signs that lead us to think about self-harm or suicide.
Regarding pregnancy It 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 placebo-controlled clinical trials of 6 weeks duration, carried out on 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 attempts at treatment with antidepressant drugs. Furthermore, they had also not achieved an adequate response in a single-blind antidepressant therapy phase for 8 weeks.
