In 2002, the first III generation
antipsychotic drug was registered-
aripiprazole. Its partial dopaminergic agonism underlies its unique mechanism of action and the potentially beneficial influence on the positive, negative, or
cognitive symptoms. Due to its relatively high intrinsic activity, the
drug could often cause agitation, anxiety, or
akathisia. For this reason, efforts were made to develop a
drug which would retain the positive favorable actions of
aripiprazole but present a more advantageous clinical profile. This turned out to be
brexpiprazole, which was registered in 2015. Its pharmacodynamic and pharmacokinetic profile (similarly to the other most recent
antipsychotics, i.e.,
lurasidone or
cariprazine) shows promise of increasing the effectiveness of
schizophrenia treatment in the dimensions in which the previous
antipsychotics were not sufficiently effective, including negative, depressive, or
cognitive symptoms. Like other new
antipsychotics, it can also be useful in the treatment of
mood disorders, for instance
drug-resistant depression. Previous reviews focused on the use of
brexpiprazole in specific diagnostic groups. The aim of this article is to provide the readers with an overview of data on the mechanism of action, clinical effectiveness in all studied diagnostic groups, as well as potential drug-food interactions, and the safety of
brexpiprazole.