brexpiprazole + venlafaxine XR

This is a combination therapy consisting of **brexpiprazole**, an atypical antipsychotic, and **venlafaxine XR**, an extended-release serotonin-norepinephrine reuptake inhibitor (SNRI). Brexpiprazole acts as a partial agonist at serotonin 5-HT1A and dopamine D2 receptors, and as an antagonist at serotonin 5-HT2A and noradrenergic α1B/α2C receptors. Venlafaxine XR inhibits the reuptake of serotonin and norepinephrine, enhancing neurotransmission of these monoamines in the CNS. The combined use is investigated as an adjunctive treatment in major depressive disorder, with neurophysiological evidence supporting normalization of serotonin and norepinephrine activity and increased dopamine neuron population activity via AMPA receptor facilitation. This combination is used where monotherapy with an antidepressant is insufficient to produce remission[1][5][7].