Summary: Rexulti (brexpiprazole) is an atypical antipsychotic approved for treating major depressive disorder, particularly as an adjunct to traditional antidepressants. By targeting multiple brain receptors, it offers relief for those with treatment-resistant depression. Consulting a healthcare provider is vital to recognize if Rexulti for depression is the right choice for you.
In recent years, treatment options for mental health conditions have evolved considerably. Among these developments, Rexulti for depression has gained attention as a promising medication. But what exactly is Rexulti, how does it work, and can it provide the relief that patients with depression are seeking?
In this article, we will dive into the science behind Rexulti, explore its benefits, side effects, and suitability for different types of depression, and see how it fits within the broader landscape of antidepressant treatments.
What is Rexulti?
Rexulti (brexpiprazole) is an atypical antipsychotic medication that was initially approved by the FDA in 2015. While it is primarily known for treating schizophrenia, Rexulti has also gained traction for its adjunctive treatment of major depressive disorder (MDD). In simpler terms, it is often prescribed alongside traditional antidepressants for individuals who haven’t responded well to initial therapies such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs).
Rexulti works by modulating the activity of dopamine and serotonin receptors in the brain, which are crucial neurotransmitters involved in regulating mood, emotion, and cognition. As a partial agonist of dopamine D2 and serotonin 5-HT1A receptors and an antagonist of 5-HT2A receptors, Rexulti offers a balancing effect—reducing emotional extremes without causing severe sedation or emotional blunting, common with some other psychiatric medications.
How Does Rexulti Help Treat Depression?
For many individuals with major depressive disorder, standard treatments such as SSRIs (like sertraline) or SNRIs (like venlafaxine) provide insufficient relief. This is where Rexulti comes into play. When added as an adjunctive therapy—that is, used alongside other antidepressants—it helps improve symptoms such as:
- Persistent sadness
- Lack of motivation
- Feelings of worthlessness or hopelessness
- Difficulty concentrating
What sets Rexulti for depression apart is its unique mechanism of action. While traditional antidepressants primarily focus on serotonin levels, Rexulti targets both dopamine and serotonin pathways, broadening its effectiveness, particularly in treatment-resistant depression (TRD). Research indicates that combining Rexulti with antidepressants can enhance mood, reduce emotional flatness, and improve overall functioning more effectively than antidepressants alone.
Clinical Studies and Efficacy of Rexulti
According to a study documented in the National Library of Medicine, adding brexpiprazole to antidepressant treatment (ADT) can significantly reduce depressive symptoms in individuals with major depressive disorder (MDD), regardless of anxiety status. The study pooled data from three randomized, double-blind trials involving patients who had an inadequate response to ADTs.
Results showed that patients with anxiety-related depression experienced symptom improvements ranging from −2.19 to −3.00, while those without anxiety saw improvements of −1.38 to −2.34 after six weeks. These findings suggest that adjunctive brexpiprazole can enhance the effectiveness of standard antidepressant therapies and was generally well-tolerated by participants.
Who Should Consider Rexulti?
Rexulti may be a good option for individuals experiencing treatment-resistant depression—those who have tried one or more antidepressants without seeing meaningful improvement. It may also benefit people with MDD who experience co-occurring issues like anxiety, irritability, or mood swings.
However, Rexulti isn’t typically prescribed as a first-line treatment for depression. Instead, it’s an adjunctive therapy, meaning it’s used alongside an existing antidepressant when that medication isn’t working well enough on its own.
Potential Side Effects of Rexulti
Like all medications, Rexulti comes with potential side effects. However, many people tolerate it well, especially compared to older antipsychotic drugs. Some of the most common Rexulti side effects include:
- Weight gain
- Fatigue or drowsiness
- Restlessness or agitation (akathisia)
- Dizziness
- Increased appetite
In rarer cases, individuals may experience more severe side effects, such as:
- Tardive dyskinesia (involuntary muscle movements)
- High blood sugar or diabetes symptoms
- Increased cholesterol levels
- Low blood pressure (hypotension)
It’s important to work closely with a healthcare provider to track and monitor for any adverse effects, especially in the early stages of treatment. Regular check-ups will help ensure the medication is both effective and well-tolerated.
Rexulti vs. Other Depression Treatments
How does Rexulti compare to other treatment options for depression? While traditional antidepressants like SSRIs and SNRIs remain the standard treatment, Rexulti offers some distinct advantages as an adjunctive therapy:
- Faster symptom relief: Some patients notice improvements within 2-4 weeks of starting Rexulti, compared to the typical 6-8 weeks required for antidepressants alone to take full effect.
- Broader symptom coverage: Rexulti can address emotional, cognitive, and behavioral symptoms more effectively than medications that focus solely on serotonin.
- Fewer emotional side effects: Rexulti is less likely to cause emotional blunting or apathy compared to higher doses of SSRIs.
However, Rexulti is not without competition. Other adjunctive treatments, such as aripiprazole (Abilify), work similarly and may be prescribed instead. Additionally, some patients respond well to ketamine therapy or transcranial magnetic stimulation (TMS), which are newer treatments for treatment-resistant depression.
Is Rexulti the Right Choice for You?
If you’re struggling with depression that hasn’t improved despite trying traditional antidepressants, Rexulti might be the solution you’ve been waiting for. However, it’s essential to approach treatment holistically and in consultation with a healthcare provider, as each person’s experience with depression is unique.
Rexulti offers a valuable option for individuals with treatment-resistant depression or those needing an extra boost to their existing antidepressant therapy. By targeting multiple brain receptors and addressing a range of emotional and cognitive symptoms, Rexulti for depression may provide the relief many patients have been searching for.
Frequently Asked Questions (FAQs)
How long does it take for Rexulti to start working for depression?
Rexulti can begin improving symptoms within 2 to 4 weeks, though it may take 6 to 8 weeks to see its full effects. Some patients report feeling better sooner when Rexulti is combined with their current antidepressant. It’s important to follow up with your healthcare provider regularly to monitor progress during this period.
Can Rexulti cause weight gain?
Yes, weight gain is a possible side reaction of Rexulti. While not everyone will experience it, studies have shown that some individuals may notice an increase in appetite and mild to moderate weight gain over time. If this is a concern, your doctor can help develop a plan to manage your weight through diet and physical activity.
Is Rexulti addictive or habit-forming?
No, Rexulti is not classified as a controlled substance and does not have addictive properties. However, it’s essential to follow your doctor’s instructions closely and not stop the medication abruptly, as doing so can lead to withdrawal-like symptoms or a return of depressive symptoms. Your healthcare provider will guide you on how to taper off the medication if needed.
