Brexpiprazole, a new oral antipsychotic that improves positive, negative, and affective symptoms of schizophrenia.

Compilation
Schizophrenia does not affect everyone in the same way, so individual treatment important. In this sense, the emergence of a new antipsychotic drug, brexpiprazole, marketed under the name Rexulti by the company Otsuka-Lundbeck Alliance, contributes to the personalization of treatment for schizophrenia.

For Dr. Marina Diaz Marsa, Vice President of the Spanish Society of Psychiatry and Mental Health (Sepsm) “It is important to put the patient at the center and make medicine more personalized, taking into account the profile and needs of the person with the disease, in order to offer them the best treatment. This also includes listening to their opinions and involving them in decisions made. This is part of the humanization of medicine and aims to ensure that treatment is tailored to the needs and symptoms of each person, based on a strong doctor-patient relationship.”

“It is important to put the patient at the center and make medicine more personalized, thinking about the profile and needs of the person with the disease, in order to offer them the best treatment.”

New treatment option for schizophrenia

This new oral antipsychotic, available in Spain from 1 April, is indicated for treatment of schizophrenia in adultsand has a differential mechanism of action, which modulates serotonergic, dopaminergic and noradrenergic activity, which is reflected in the profile of its effectiveness and tolerability. According to him Dr. Giovanni Martinotti, Professor of Psychiatry at the University of Studi G. d’Annunzio in Chieti, “It is a partial agonist with greater D2 receptor blocking, in addition to potent effects on serotonin receptors, so strong that it has antidepressant symptomatic potential, antinegative symptoms and pro-informative”.

Moreover, it shows improvement of Marder’s 5 factors PANSS (Positive and Negative Schizophrenia Syndrome Scale) one year of treatmentthat is, with positive and negative symptoms, disorganized thinking, hostility/uncontrollable agitation, and anxiety/depression, which for Dr. Martinotti are “an important influence because “When this drug is prescribed, we ensure the patient has the best therapeutic option based on their quality of life.”

“It is a partial agonist with greater D2 receptor blocking, in addition to potent effects on serotonin receptors, so strong that it has antidepressant symptomatic potential, antinegative symptoms and pro-informative”

Effective during treatment symptoms of schizophrenia both in acute phase as in the stage service According to Dr. Martinotti, ““It can cover all phases of the disorder, from the very beginning, when patients can become even more responsive and functional with the prospect of excellent long-term outcome.”

As the vice president of Sepsm explains: “The positive, negative and affective symptoms of schizophrenia have a very significant impact on the patient’s life, making interpersonal relationships and adaptation to the environment difficult.”

Good profile portability this drug affects low incidence of sedative and activating side effects (akathisia, restlessness, agitation, anxiety, insomnia). In addition, this new oral antipsychotic prevents relapses and promotes improved functionality.

“Positive, negative and affective symptoms of schizophrenia have a very significant impact on the patient’s life, complicating interpersonal relationships and adaptation to the environment”

What could this new therapeutic option provide?

For Dr. Martinotti, “Adherence to treatment ensures a lower chance of relapse. When using brexpiprazole, it is very difficult for the patient to interrupt therapy during the stabilization phase, since side effects are minimal or absent. Its good tolerability profile suggests significant improvements in function and quality of life.”

In this sense, Dr. Diaz Marza emphasizes that “The drug’s innovative mechanism of action, with fewer side effects than other antipsychotics while maintaining the same effectiveness for symptoms of schizophrenia, may promote treatment adherence and long-term quality of life.”

“Its good tolerability profile suggests significant improvements in function and quality of life.”

lack of therapeutic adherence This continues to be one of the main problems in the treatment of schizophrenia. Between 40-50% people with this diagnosis does not comply with prescribed treatment. “Furthermore, this situation worsens over time, reaching rates of up to 61% after four years of illness.”says the head of the psychiatry department of the San Carlos Clinical Hospital, who recalls that “Antipsychotic drugs are essential for the favorable development of schizophrenia.”

For this specialist”The modulatory effects on dopaminergic, serotonergic and noradrenergic activity make this antipsychotic particularly effective in the treatment of positive and affective symptoms of schizophrenia. Moreover, its effectiveness in preventing new psychotic outbursts and relapses may prevent the onset of negative symptoms. Its use is safe and has a positive effect on the control of psychotic symptoms, emotional dysregulation, irritability, anxiety, impulsivity and social cognition deficits associated with this disease.”

“Antipsychotic drugs are necessary for the favorable development of schizophrenia”

For patient profile A candidate for this pharmacological innovation, Dr. Martinotti believes that “Although all patients with schizophrenia can benefit from this new treatment, the preferred conditions occur early in the illness, in younger patients, in schizophrenic psychoses with affective symptoms, or in patients with schizophrenia and co-occurring substance use.”

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He development program comprises 13 clinical studies: 2 phase II studies, 8 phase III studies and 3 phase IIIb studies, which assessed its effectiveness and safety in the treatment of schizophrenia in the acute and maintenance phases, as well as its impact on selected aspects of the treatment of the disease. .

“This oral antipsychotic is emerging as a new alternative for people with schizophrenia with positive symptoms.”

In accordance with Susana Gomez-Luz, Director of Medicine and Market Access Lundbeck Iberia, “This oral antipsychotic is emerging as a new alternative for patients with schizophrenia with positive symptoms, that is, delusions, hallucinations and behavioral disorganization, both residual and emerging, with possible mood symptoms or tolerance problems, as it provides symptom control and improves functionality. »

According to Louise Arbat, Director of Medical Department, Otsuka Pharmaceutical Spain, “This new therapeutic option joins the portfolio of the Otsuka-Lundbeck Alliance for Schizophrenia to offer alternatives that allow treatment to be personalized for patients with different profiles and needs. In this case, it is an oral formulation with a different receptor profile from other available oral formulations that meets the needs of those who prefer this route of administration, thereby complementing our extended-release injectable formulations.”