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Brexpiprazole is a second-generation (atypical) antipsychotic small molecule discovered by Otsuka and jointly developed with Lundbeck. It functions as a serotonin-dopamine activity modulator (SDAM), acting as a partial agonist at the dopamine D2 and D3 receptors and the serotonin 5-HT1A receptor, while also acting as an antagonist at 5-HT2A, 5-HT2B, and 5-HT7 receptors. The orally disintegrating tablet (ODT) formulation is specifically designed to dissolve rapidly in the oral cavity without the need for water, providing an alternative for patients who have difficulty swallowing conventional tablets or for whom adherence is a concern. It is indicated for the treatment of schizophrenia, as an adjunctive therapy for major depressive disorder, and for agitation associated with dementia due to Alzheimer's disease.
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