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Efficacy of Adjunctive Brexpiprazole in Patients with Major Depressive Disorder: A Clinical Overview

[ Vol. 12 , Issue. 3 ]


Michael E. Thase, Peter Zhang, Aleksandar Skuban, Mary Hobart, Catherine Weiss, Emmanuelle Weiller and James C. Nelson   Pages 291 - 301 ( 11 )


Objective: To summarize efficacy data from two phase 2 and two phase 3 short-term, multicenter, randomized, double-blind, placebo-controlled studies of brexpiprazole adjunctive to antidepressant treatments (ADTs) in patients with major depressive disorder (MDD) with inadequate response to ADTs.

Methods: Patients with MDD who were inadequate responders to 1–3 prior ADTs entered an 8-week single-blind prospective treatment phase on physician-determined ADT. Patients with inadequate response throughout the prospective treatment phase were randomized to receive either placebo or brexpiprazole (phase 2: flexible dosage 0.15–3.0 mg/day; phase 3: fixed-dosages 1, 2, or 3 mg/day) as adjunctive treatment to their ADT. The primary endpoint was change in Montgomery-Åsberg Depression Rating Scale (MADRS) total score from baseline to week 6.

Results: Phase 2 studies suggested brexpiprazole doses of 1–3 mg/day were effective as an adjunctive therapy. These observations were confirmed across the two phase 3 studies utilizing a pooled placebo group versus brexpiprazole 1, 2, and 3 mg/day and a pooled analysis of all four studies (brexpiprazole 1–3 mg/day). Greater improvements were observed in MADRS total score with brexpiprazole+ADT versus placebo+ADT (1 mg/day, p<0.01; 2 mg/day, p<0.01; 3 mg/day, p<0.001; brexpiprazole 1–3 mg/day, p<0.0001).

Conclusion: Adjunctive brexpiprazole is an efficacious treatment option for patients with MDD and inadequate response to ADT. NCT00797966; NCT01052077; NCT01360632; NCT01360645.


Adjunctive therapy, antipsychotics, brexpiprazole, efficacy, major depressive disorder.


Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Philadelphia, PA 19104, USA.

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