Brexpiprazole vs Aripiprazole – Which Is The Best Antipsychotic for Schizophrenia?

Brexpiprazole (sold under the brand name Rexulti) is an antipsychotic medication. Also, it is known as a second-generation antipsychotic (SGA).

This drug works by altering the activity of certain natural substances in the human brain, including – serotonin type 2, dopamine type 2, and alpha 2 adrenergic receptors.

Rexulti was first approved in 2015 by the Food and Drug Administration to treat schizophrenia.

Uses

It is typically used to treat the symptoms of schizophrenia. In the present day, 20 antipsychotic drugs are approved for clinical use in the United States, with Rexulti being one of the most recent medications to become available.

Schizophrenia is a chronic debilitating mental illness described by abnormal behaviors, disordered thoughts, and anti-social behaviors. Risk factors for schizophrenia include:

  • drug abuse during adolescence and early adulthood;
  • autoimmune system abnormalities;
  • a father who is older in age;
  • a family history of the disorder.

Schizophrenia is surprisingly common, affecting 1 in every 100 people in the world with more than 2.5 million adults in the United States who have schizophrenia. According to data, about 3 out of 4 sufferers experience relapses and their signs and symptoms return or worsen.

The effectiveness of medicines in treating schizophrenia was evaluated in 1,310 participants in two 6-week clinical trials. It was shown to reduce the occurrence of the signs and symptoms of schizophrenia compared to placebo.

Furthermore, this medicine is used together with other drugs to treat the major depressive disorder (MDD) in adults. However, it is not approved by the FDA for the treatment of behavior disorders in older adults with dementia.

Dosage

The recommended dosage to treat schizophrenia is 2 mg to 4 mg once per day. The recommended starting dosage as an adjunctive treatment for the major depressive disorder is 0.5 mg or 1 mg once per day, taken by mouth.

Side Effects

Common side effects may include:

  • weight gain;
  • muscle pain;
  • back pain;
  • tremors;
  • stomach pain;
  • skin rash;
  • restlessness;
  • constipation;
  • heartburn;
  • dry mouth;
  • drowsiness;
  • diarrhea.

Rare side effects may include:

  • seizures;
  • neuroleptic malignant syndrome (occurs in response to neuroleptic or antipsychotic medication);
  • muscle problems which cause abnormal movement;
  • allergic reactions, with symptoms including – redness of the skin, especially around the mouth and chest pain;
  • having thoughts of suicide, especially in patients aged 24 years and younger;
  • type 2 diabetes mellitus;
  • deficiency of granulocytes (a category of white blood cells);
  • decreased white blood cells (the cells of the immune system);
  • decreased neutrophils (the most abundant type of granulocytes).

Due to the fact that this medicine may cause drowsiness, it is not recommended to use machinery, drive a car, until you know you can function normally.

There are no clinical studies done about the safety of this drug during pregnancy, hence, stay on the safe side and avoid it. Also, to be 100 percent sure that this drug is safe for you, tell your healthcare provider if you have:

  • trouble swallowing;
  • type 2 diabetes mellitus;
  • head injury;
  • brain tumor;
  • a history of seizures;
  • heart attack;
  • liver disease;
  • low white blood cell counts;
  • kidney disease;
  • high or low blood pressure;
  • heart disease;
  • high triglycerides;
  • high LDL and total cholesterol levels.

Aripiprazole

It is the brand name of Abilify, a psychotropic drug which alters brain chemical activity by blocking the receptors on nerves in the brain for a few neurotransmitters.

This medication is typically used to treat schizophrenia, depression, mania, autistic disorder, bipolar disorder (manic-depressive illness), and a few irritable behavior disorders.

In 2002, Abilify was first approved by the Food and Drug Administration to treat schizophrenia in adults and children ages 13 and older.

Uses

It is generally used to treat the symptoms of psychotic conditions, like – bipolar I disorder (manic depression) and schizophrenia.

Moreover, it is used to treat mood swings, irritability, symptoms of aggression, temper tantrums, as well as self-injury related to autistic disorder in children who are at least 6 years old.

Dosage

It comes in 3 forms to take by mouth: solution, tablets, and orally disintegrating tablets. In addition, it comes as an injectable solution only given by a doctor.

Take this medicine exactly as directed on your prescription label or by your healthcare provider. Do not take less or more of it than prescribed by your healthcare professional.

Side Effects

Common side effects may include:

  • weight gain;
  • nausea;
  • anxiety;
  • vomiting;
  • restlessness and feeling agitated;
  • constipation;
  • tiredness;
  • headache;
  • dizziness;
  • sleep problems;
  • stuffy nose;
  • mild stomach upset;
  • increased appetite;
  • drowsiness;
  • trouble swallowing;
  • muscle stiffness;
  • uncontrolled movements.

Rare side effects may include:

  • signs of infection;
  • seizures;
  • neuroleptic malignant syndrome;
  • mask-like expression of the face;
  • suicidal thoughts;
  • fainting;
  • muscle spasms;
  • shaking.

Long-term use of this medicine may lead to tardive dyskinesia (involuntary movements of the lips, jaw, and tongue), a potentially irreversible condition.

There is possible evidence of harm to the unborn baby, therefore, it is not recommended for pregnant women.

More importantly, it is not known precisely if this drug is safe in children younger than 10 with bipolar disorder or in children younger than 13 with schizophrenia.

Brexpiprazole vs Aripiprazole – Which Is The Best Antipsychotic for Schizophrenia?

Brexpiprazole is a second-generation antipsychotic especially produced to treat schizophrenia symptoms. On the other hand, aripiprazole is already being used since 2002, however, it is produced to treat an array of mental conditions, including bipolar disorder,  depression, mania, or autistic disorder. Both have similar side effects.

References

https://www.ncbi.nlm.nih.gov/pubmed/25882325
https://www.sciencedirect.com/science/article/pii/S092099641630161X
https://www.sciencedirect.com/science/article/pii/S0920996415003461
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2671949/

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