Rexulti, a medication used to treat schizophrenia and as an add-on treatment for major depressive disorder, can cause several side effects. Common side effects include weight gain, somnolence, dizziness, and akathisia, which is a feeling of inner restlessness [1]. Some individuals may also experience fatigue, nausea, and dry mouth [1].
What are the serious risks associated with Rexulti?
A significant risk associated with Rexulti and other antipsychotic medications is an increased risk of death in elderly patients with dementia-related psychosis. This risk is primarily due to stroke or infections [1]. Rexulti is not approved for use in patients with dementia-related psychosis [1].
Another serious adverse reaction is neuroleptic malignant syndrome (NMS), a rare but potentially fatal condition characterized by high fever, muscle stiffness, altered mental status, and autonomic instability [1]. Tardive dyskinesia, a movement disorder that can be irreversible, is also a risk with long-term use [1]. Symptoms may include involuntary movements of the face, tongue, or jaw [1].
Are there any specific concerns for patients taking Rexulti for depression?
When used as an add-on treatment for major depressive disorder, Rexulti shares many of the same side effects as when used for schizophrenia [1]. In addition to the common side effects, patients may also experience insomnia and headache [1]. Increased suicidal thoughts and behaviors have been reported in children, adolescents, and young adults taking antidepressant medications, including Rexulti, though a causal relationship has not been established [1].
How does Rexulti work in the brain?
Rexulti, with the active ingredient brexpiprazole, is a partial agonist at dopamine D2 and serotonin 5-HT1A receptors, and an antagonist at serotonin 5-HT2A and 5-HT2B receptors [1]. This mechanism is thought to modulate the activity of dopamine and serotonin neurotransmitters, which play a role in mood, cognition, and behavior [1].
What is the patent status and exclusivity for Rexulti?
Information regarding specific patent expiry dates and market exclusivity for Rexulti can be found through resources like DrugPatentWatch.com [2]. Patents protect the intellectual property of a drug, and their expiration often opens the door for generic or biosimilar competition [2].
What are the alternatives to Rexulti?
For schizophrenia, alternative medications include other atypical antipsychotics and older typical antipsychotics [3]. For major depressive disorder, other add-on treatments may be considered, as well as different classes of antidepressants [3]. Treatment decisions are highly individualized and depend on a patient's specific condition, medical history, and response to previous therapies.