Brexpiprazole - Revision history

MDElliottMD: Category taxonomy (#23): retag to house-compliant neuroleptic categories

2026-05-22T14:41:18Z

Category taxonomy (#23): retag to house-compliant neuroleptic categories

← Older revision		Revision as of 14:41, 22 May 2026
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	}}		}}

	[[Category:Second-~~Generation Antipsychotics (SGAs / Atypicals)~~]]		[[Category:Second-generation neuroleptics]]
	[[Category:Neuroleptics]]		[[Category:Neuroleptics]]
	[[Category:Third-~~Generation Antipsychotics~~]]		[[Category:Third-generation neuroleptics]]
	[[Category:Atypical Antipsychotics]]		[[Category:Atypical Antipsychotics]]
	~~[[Category:Antipsychotics]]~~
	[[Category:Dopamine Partial Agonists]]		[[Category:Dopamine Partial Agonists]]
	[[Category:Psychotic Disorders]]		[[Category:Psychotic Disorders]]
	[[Category:Adjunctive Antidepressants]]		[[Category:Adjunctive Antidepressants]]

MDElliottMD: Dedupe migration per interface-claude 2026-05-20: Antipsychotics / Neuroleptics merged into canonical Neuroleptics. Member retagged.

2026-05-19T18:00:16Z

Dedupe migration per interface-claude 2026-05-20: Antipsychotics / Neuroleptics merged into canonical Neuroleptics. Member retagged.

← Older revision		Revision as of 18:00, 19 May 2026
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	}}		}}

	~~[[Category:Antipsychotics / Neuroleptics]]~~
	[[Category:Second-Generation Antipsychotics (SGAs / Atypicals)]]		[[Category:Second-Generation Antipsychotics (SGAs / Atypicals)]]
	[[Category:Neuroleptics]]		[[Category:Neuroleptics]]

MDElliottMD: Em-dash sweep: replace em-dash with comma per project rule; PendellsCorner verbatim quotes preserved.

2026-05-19T03:16:05Z

Em-dash sweep: replace em-dash with comma per project rule; PendellsCorner verbatim quotes preserved.

← Older revision		Revision as of 03:16, 19 May 2026
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	\| brand = Rexulti		\| brand = Rexulti
	\| classes = Atypical antipsychotic, D2/5HT1A partial agonist with stronger α1A, 5HT2A, 5HT1A activity than aripiprazole		\| classes = Atypical antipsychotic, D2/5HT1A partial agonist with stronger α1A, 5HT2A, 5HT1A activity than aripiprazole
	\| mechanism = Partial agonist at D2 and 5HT1A. Antagonist at 5HT2A, α1A, α1B, α2C. More potent 5HT2A antagonism, 5HT1A partial agonism, and α1 antagonism (relative to D2 partial agonism) than aripiprazole — proposed to reduce akathisia and enhance affective/cognitive effects.		\| mechanism = Partial agonist at D2 and 5HT1A. Antagonist at 5HT2A, α1A, α1B, α2C. More potent 5HT2A antagonism, 5HT1A partial agonism, and α1 antagonism (relative to D2 partial agonism) than aripiprazole, proposed to reduce akathisia and enhance affective/cognitive effects.
	\| uses = Schizophrenia (FDA-approved 2015). Adjunctive treatment of major depressive disorder (2015). '''Agitation associated with dementia due to Alzheimer disease''' (FDA-approved May 2023 — first agent specifically approved for this problem). Investigational for PTSD (combined with sertraline).		\| uses = Schizophrenia (FDA-approved 2015). Adjunctive treatment of major depressive disorder (2015). '''Agitation associated with dementia due to Alzheimer disease''' (FDA-approved May 2023, first agent specifically approved for this problem). Investigational for PTSD (combined with sertraline).
	\| starting_dose = Schizophrenia: 1 mg PO daily × 4 days, then 2 mg daily × 3 days, then 4 mg daily. MDD adjunct: 0.5-1 mg daily, increase to 2 mg max. AD agitation: 0.5 mg daily, titrate to 2-3 mg daily.		\| starting_dose = Schizophrenia: 1 mg PO daily × 4 days, then 2 mg daily × 3 days, then 4 mg daily. MDD adjunct: 0.5-1 mg daily, increase to 2 mg max. AD agitation: 0.5 mg daily, titrate to 2-3 mg daily.
	\| preparations = 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg tablets		\| preparations = 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg tablets
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	\| pregnancy = Limited data; National Pregnancy Registry available		\| pregnancy = Limited data; National Pregnancy Registry available
	\| legal = Rx		\| legal = Rx
	\| intro = '''Brexpiprazole''' (brand name Rexulti) is a 'pip' D2/5HT1A partial agonist FDA-approved for schizophrenia (2015), adjunctive treatment of major depressive disorder (2015), and — in a landmark 2023 approval — '''agitation associated with Alzheimer dementia'''. It is the first FDA-approved medicine specifically for AD agitation. Compared to its 'pip' cousin aripiprazole, brexpiprazole has relatively stronger 5HT2A antagonism, 5HT1A partial agonism, and α1 antagonism — proposed to reduce akathisia and enhance affective/cognitive efficacy.		\| intro = '''Brexpiprazole''' (brand name Rexulti) is a 'pip' D2/5HT1A partial agonist FDA-approved for schizophrenia (2015), adjunctive treatment of major depressive disorder (2015), and, in a landmark 2023 approval, '''agitation associated with Alzheimer dementia'''. It is the first FDA-approved medicine specifically for AD agitation. Compared to its 'pip' cousin aripiprazole, brexpiprazole has relatively stronger 5HT2A antagonism, 5HT1A partial agonism, and α1 antagonism, proposed to reduce akathisia and enhance affective/cognitive efficacy.

	The AD agitation approval carries the antipsychotic class black-box warning for increased mortality in elderly dementia patients; FDA approval rested on demonstrating a favorable risk-benefit ratio in this population specifically for the problem.		The AD agitation approval carries the antipsychotic class black-box warning for increased mortality in elderly dementia patients; FDA approval rested on demonstrating a favorable risk-benefit ratio in this population specifically for the problem.

MDElliottMD: Sweep: "indications" -> "problems" sitewide terminology update (preserves MedTemplate param name)

2026-05-19T01:37:43Z

Sweep: "indications" -> "problems" sitewide terminology update (preserves MedTemplate param name)

← Older revision		Revision as of 01:37, 19 May 2026
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	\| classes = Atypical antipsychotic, D2/5HT1A partial agonist with stronger α1A, 5HT2A, 5HT1A activity than aripiprazole		\| classes = Atypical antipsychotic, D2/5HT1A partial agonist with stronger α1A, 5HT2A, 5HT1A activity than aripiprazole
	\| mechanism = Partial agonist at D2 and 5HT1A. Antagonist at 5HT2A, α1A, α1B, α2C. More potent 5HT2A antagonism, 5HT1A partial agonism, and α1 antagonism (relative to D2 partial agonism) than aripiprazole — proposed to reduce akathisia and enhance affective/cognitive effects.		\| mechanism = Partial agonist at D2 and 5HT1A. Antagonist at 5HT2A, α1A, α1B, α2C. More potent 5HT2A antagonism, 5HT1A partial agonism, and α1 antagonism (relative to D2 partial agonism) than aripiprazole — proposed to reduce akathisia and enhance affective/cognitive effects.
	\| uses = Schizophrenia (FDA-approved 2015). Adjunctive treatment of major depressive disorder (2015). '''Agitation associated with dementia due to Alzheimer disease''' (FDA-approved May 2023 — first agent specifically approved for this ~~indication~~). Investigational for PTSD (combined with sertraline).		\| uses = Schizophrenia (FDA-approved 2015). Adjunctive treatment of major depressive disorder (2015). '''Agitation associated with dementia due to Alzheimer disease''' (FDA-approved May 2023 — first agent specifically approved for this problem). Investigational for PTSD (combined with sertraline).
	\| starting_dose = Schizophrenia: 1 mg PO daily × 4 days, then 2 mg daily × 3 days, then 4 mg daily. MDD adjunct: 0.5-1 mg daily, increase to 2 mg max. AD agitation: 0.5 mg daily, titrate to 2-3 mg daily.		\| starting_dose = Schizophrenia: 1 mg PO daily × 4 days, then 2 mg daily × 3 days, then 4 mg daily. MDD adjunct: 0.5-1 mg daily, increase to 2 mg max. AD agitation: 0.5 mg daily, titrate to 2-3 mg daily.
	\| preparations = 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg tablets		\| preparations = 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg tablets
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	\| intro = '''Brexpiprazole''' (brand name Rexulti) is a 'pip' D2/5HT1A partial agonist FDA-approved for schizophrenia (2015), adjunctive treatment of major depressive disorder (2015), and — in a landmark 2023 approval — '''agitation associated with Alzheimer dementia'''. It is the first FDA-approved medicine specifically for AD agitation. Compared to its 'pip' cousin aripiprazole, brexpiprazole has relatively stronger 5HT2A antagonism, 5HT1A partial agonism, and α1 antagonism — proposed to reduce akathisia and enhance affective/cognitive efficacy.		\| intro = '''Brexpiprazole''' (brand name Rexulti) is a 'pip' D2/5HT1A partial agonist FDA-approved for schizophrenia (2015), adjunctive treatment of major depressive disorder (2015), and — in a landmark 2023 approval — '''agitation associated with Alzheimer dementia'''. It is the first FDA-approved medicine specifically for AD agitation. Compared to its 'pip' cousin aripiprazole, brexpiprazole has relatively stronger 5HT2A antagonism, 5HT1A partial agonism, and α1 antagonism — proposed to reduce akathisia and enhance affective/cognitive efficacy.

	The AD agitation approval carries the antipsychotic class black-box warning for increased mortality in elderly dementia patients; FDA approval rested on demonstrating a favorable risk-benefit ratio in this population specifically for the ~~indication~~.		The AD agitation approval carries the antipsychotic class black-box warning for increased mortality in elderly dementia patients; FDA approval rested on demonstrating a favorable risk-benefit ratio in this population specifically for the problem.
	\| pharmacodynamics= D2 partial agonist (lower intrinsic activity than aripiprazole). 5HT1A partial agonist. 5HT2A, 5HT2B, 5HT7, α1A, α1B, α2C antagonist. H1 antagonism. Notable: lower D2 intrinsic activity and stronger 5HT2A antagonism may underlie reduced akathisia compared with aripiprazole.		\| pharmacodynamics= D2 partial agonist (lower intrinsic activity than aripiprazole). 5HT1A partial agonist. 5HT2A, 5HT2B, 5HT7, α1A, α1B, α2C antagonist. H1 antagonism. Notable: lower D2 intrinsic activity and stronger 5HT2A antagonism may underlie reduced akathisia compared with aripiprazole.
	\| effects = Weight gain (especially long-term), akathisia (reduced compared to aripiprazole), restlessness, headache, somnolence, increased fasting glucose. Class warning: increased mortality in elderly dementia-related psychosis. AD agitation ~~indication~~ acknowledges this risk with specific benefit-risk analysis.		\| effects = Weight gain (especially long-term), akathisia (reduced compared to aripiprazole), restlessness, headache, somnolence, increased fasting glucose. Class warning: increased mortality in elderly dementia-related psychosis. AD agitation problem acknowledges this risk with specific benefit-risk analysis.
	\| interactions = <pharmaInteractions/>		\| interactions = <pharmaInteractions/>
	}}		}}

Maintenance script: Terminology sweep: drug/medication → medicine

2026-05-16T02:27:26Z

Terminology sweep: drug/medication → medicine

← Older revision		Revision as of 02:27, 16 May 2026
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	\| pregnancy = Limited data; National Pregnancy Registry available		\| pregnancy = Limited data; National Pregnancy Registry available
	\| legal = Rx		\| legal = Rx
	\| intro = '''Brexpiprazole''' (brand name Rexulti) is a 'pip' D2/5HT1A partial agonist FDA-approved for schizophrenia (2015), adjunctive treatment of major depressive disorder (2015), and — in a landmark 2023 approval — '''agitation associated with Alzheimer dementia'''. It is the first FDA-approved ~~medication~~ specifically for AD agitation. Compared to its 'pip' cousin aripiprazole, brexpiprazole has relatively stronger 5HT2A antagonism, 5HT1A partial agonism, and α1 antagonism — proposed to reduce akathisia and enhance affective/cognitive efficacy.		\| intro = '''Brexpiprazole''' (brand name Rexulti) is a 'pip' D2/5HT1A partial agonist FDA-approved for schizophrenia (2015), adjunctive treatment of major depressive disorder (2015), and — in a landmark 2023 approval — '''agitation associated with Alzheimer dementia'''. It is the first FDA-approved medicine specifically for AD agitation. Compared to its 'pip' cousin aripiprazole, brexpiprazole has relatively stronger 5HT2A antagonism, 5HT1A partial agonism, and α1 antagonism — proposed to reduce akathisia and enhance affective/cognitive efficacy.

	The AD agitation approval carries the antipsychotic class black-box warning for increased mortality in elderly dementia patients; FDA approval rested on demonstrating a favorable risk-benefit ratio in this population specifically for the indication.		The AD agitation approval carries the antipsychotic class black-box warning for increased mortality in elderly dementia patients; FDA approval rested on demonstrating a favorable risk-benefit ratio in this population specifically for the indication.

Maintenance script: Expand Brexpiprazole with Stahl-sourced detail (with skepticism)

2026-05-16T02:03:46Z

Expand Brexpiprazole with Stahl-sourced detail (with skepticism)

← Older revision		Revision as of 02:03, 16 May 2026
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	{{MedTemplate		{{MedTemplate
	~~\| generic = Brexpiprazole~~		\| brand = Rexulti
	\| brand = Rexulti		\| classes = Atypical antipsychotic, D2/5HT1A partial agonist with stronger α1A, 5HT2A, 5HT1A activity than aripiprazole
	~~\| structure =~~		\| mechanism = Partial agonist at D2 and 5HT1A. Antagonist at 5HT2A, α1A, α1B, α2C. More potent 5HT2A antagonism, 5HT1A partial agonism, and α1 antagonism (relative to D2 partial agonism) than aripiprazole — proposed to reduce akathisia and enhance affective/cognitive effects.
	\| classes = ~~Antipsychotic~~, ~~Neuroleptic~~		\| uses = Schizophrenia (FDA-approved 2015). Adjunctive treatment of major depressive disorder (2015). '''Agitation associated with dementia due to Alzheimer disease''' (FDA-approved May 2023 — first agent specifically approved for this indication). Investigational for PTSD (combined with sertraline).
	\| mechanism = D2~~/5-HT1A~~ partial ~~agonist; 5-HT2A~~/~~alpha antagonist~~		\| starting_dose = Schizophrenia: 1 mg PO daily × 4 days, then 2 mg daily × 3 days, then 4 mg daily. MDD adjunct: 0.5-1 mg daily, increase to 2 mg max. AD agitation: 0.5 mg daily, titrate to 2-3 mg daily.
	\| uses =		\| preparations = 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg tablets
	\| starting_dose =		\| fda_max = 4 mg/d (schizophrenia); 3 mg/d (AD agitation); 3 mg/d (MDD adjunct)
	\| preparations =		\| routes = Oral
	\| fda_max =		\| onset = Weeks for psychosis/depression; AD agitation benefit emerges over weeks
	\| routes =		\| duration = Daily dosing
	\| onset =		\| halflife = ~91 hours
	\| duration =		\| bioavailability = ~95%
	\| halflife =		\| pregnancy = Limited data; National Pregnancy Registry available
	\| bioavailability =		\| legal = Rx
	\| pregnancy =		\| intro = '''Brexpiprazole''' (brand name Rexulti) is a 'pip' D2/5HT1A partial agonist FDA-approved for schizophrenia (2015), adjunctive treatment of major depressive disorder (2015), and — in a landmark 2023 approval — '''agitation associated with Alzheimer dementia'''. It is the first FDA-approved medication specifically for AD agitation. Compared to its 'pip' cousin aripiprazole, brexpiprazole has relatively stronger 5HT2A antagonism, 5HT1A partial agonism, and α1 antagonism — proposed to reduce akathisia and enhance affective/cognitive efficacy.
	\| legal =
	\| intro =		The AD agitation approval carries the antipsychotic class black-box warning for increased mortality in elderly dementia patients; FDA approval rested on demonstrating a favorable risk-benefit ratio in this population specifically for the indication.
	~~\| pharmacokinetics =~~		\| pharmacodynamics= D2 partial agonist (lower intrinsic activity than aripiprazole). 5HT1A partial agonist. 5HT2A, 5HT2B, 5HT7, α1A, α1B, α2C antagonist. H1 antagonism. Notable: lower D2 intrinsic activity and stronger 5HT2A antagonism may underlie reduced akathisia compared with aripiprazole.
	\| pharmacodynamics =		\| effects = Weight gain (especially long-term), akathisia (reduced compared to aripiprazole), restlessness, headache, somnolence, increased fasting glucose. Class warning: increased mortality in elderly dementia-related psychosis. AD agitation indication acknowledges this risk with specific benefit-risk analysis.
	~~\| indications =~~		\| interactions = <pharmaInteractions/>
	~~\| dosing~~ =
	\| effects =
	\| interactions = <pharmaInteractions/>
	~~\| pregnancy_details =~~
	~~\| monitoring =~~
	~~\| counseling =~~
	~~\| anecdotes =~~
	~~\| seealso =~~
	~~\| references =~~
	}}		}}


	[[Category:Antipsychotics / Neuroleptics]]		[[Category:Antipsychotics / Neuroleptics]]
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	[[Category:Neuroleptics]]		[[Category:Neuroleptics]]
	[[Category:Third-Generation Antipsychotics]]		[[Category:Third-Generation Antipsychotics]]
			[[Category:Atypical Antipsychotics]]
			[[Category:Antipsychotics]]
			[[Category:Dopamine Partial Agonists]]
			[[Category:Psychotic Disorders]]
			[[Category:Adjunctive Antidepressants]]

MDElliottMD: Comprehensive categorization: +Third-Generation Antipsychotics

2026-05-15T18:42:09Z

Comprehensive categorization: +Third-Generation Antipsychotics

← Older revision		Revision as of 18:42, 15 May 2026
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	[[Category:Second-Generation Antipsychotics (SGAs / Atypicals)]]		[[Category:Second-Generation Antipsychotics (SGAs / Atypicals)]]
	[[Category:Neuroleptics]]		[[Category:Neuroleptics]]
			[[Category:Third-Generation Antipsychotics]]

MediaWiki default: Assign pharmacological categories from List_of_CNS-active_medicines

2026-05-14T15:06:51Z

Assign pharmacological categories from List_of_CNS-active_medicines

← Older revision		Revision as of 15:06, 14 May 2026
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	}}		}}


			[[Category:Antipsychotics / Neuroleptics]]
			[[Category:Second-Generation Antipsychotics (SGAs / Atypicals)]]
	[[Category:Neuroleptics]]		[[Category:Neuroleptics]]

MDElliottMD: Pharmacopedia: add

2026-05-14T03:30:43Z

Pharmacopedia: add <pharmaInteractions/>

← Older revision		Revision as of 03:30, 14 May 2026
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	\| dosing =		\| dosing =
	\| effects =		\| effects =
	\| interactions =		\| interactions = <pharmaInteractions/>
	\| pregnancy_details =		\| pregnancy_details =
	\| monitoring =		\| monitoring =

MDElliottMD: Pharmacopedia: remove contraindications parameter

2026-05-14T02:40:25Z

Pharmacopedia: remove contraindications parameter

← Older revision		Revision as of 02:40, 14 May 2026
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	\| dosing =		\| dosing =
	\| effects =		\| effects =
	~~\| contraindications =~~
	\| interactions =		\| interactions =
	\| pregnancy_details =		\| pregnancy_details =