Brexpiprazole

Category: pharmacological

Aliases: Rexulti

Pharmacological Mechanism

Atypical antipsychotic — D2 + 5-HT1A partial agonist + 5-HT2A antagonist. Lower akathisia + activation than aripiprazole. Approved for schizophrenia + adjunct in MDD + Alzheimer-related agitation (2023).

Half-Life (t½)

PO: 91h

Dosing Guidelines

• PO: Typical 2 mg (Range: 0.25–4 mg)

Target Organ Systems

• nervous

Pathways It Modulates

• 5-HT2A psychedelic signaling (inhibitor) — 5-HT2A + D2 partial agonists
• Dopamine receptor signaling (activator) — D2 partial agonist

Chemical Identifiers

• PubChem CID: 11978813
• Formula: C25H27N3O2S
• Molecular weight: 433.57 g/mol
• InChIKey: ZKIAIYBUSXZPLP-UHFFFAOYSA-N
• SMILES: C1CN(CCN1CCCCOC2=CC3=C(C=C2)C=CC(=O)N3)C4=C5C=CSC5=CC=C4

References

• PMID 28750151
• PMID 31847007
• PMID 24947465