Clinical experience with the third-generation antipsychotic brexpiprazole in the treatment of schizophrenia spectrum disorders in a psychiatric inpatient settings

Objective: to summarize the clinical experience of the antipsychotic brexpiprazole in the treatment of schizophrenia spectrum disorders in a psychiatric hospital.

Materials and Methods. A group of 26 patients (16 women; 61.5%) aged 19 to 64 years (mean age 35.73±9.33) with leading delusional, hallucinatorydelusional, manic-delusional, depressive-delusional or depressive-paranoid symptomatology constituted the study material. Patients were followed up for 6 weeks after brexpiprazole administration. The severity of psychotic symptomatology was assessed by selected items of the Positive and Negative Syndrome Rating Scale (PANSS). The General Clinical Impression Scale (CGI) was used for objective assessment of the patients' condition: the severity of condition subscale (CGI-S) and the mental status dynamics subscale (CGI–I). Patients' satisfaction with therapy was assessed in the dynamics of treatment and after the end of the follow-up period.

Results. Brexpiprazole was administered both on admission to hospital (65.4%) and after prior antipsychotic therapy (34.6%). The range of maximum doses was 2 to 4 mg per day. Side reactions were registered in 3 cases (11.5%), and only in one case it required withdrawal of the drug. Statistically significant improvement of mental state by the 7th day of therapy was registered for the majority of PANSS items (Delirium, Suspiciousness, Agitation, Anxiety, Tension, Aggressiveness). A statistically significant decrease in the severity of mental state according to CGI was observed from the second week of therapy. A distinct dynamics of change of attitude to therapy towards positive attitude to therapy was established (p=0,029).

Conclusions: clinical experience of brexpiprazole use in psychiatric inpatient settings demonstrated good results both in terms of therapy efficacy and safety, which allows us to evaluate the drug as promising for use in the treatment of psychotic exacerbations and maintenance therapy of patients with schizophrenia and schizophrenia spectrum disorders.

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