Adjunctive Brexpiprazole as a Novel Effective Strategy for Treating Major Depressive Disorder: A Systematic Review and Meta-Analysis

Seoyoung Yoon, Sang Won Jeon, Young-Hoon Ko, Ashwin A. Patkar, Prakash S. Masand, Chi Un Pae, Changsu Han

    Research output: Contribution to journalReview articlepeer-review

    20 Citations (Scopus)


    Purpose/Background Brexpiprazole was approved for adjunctive treatment of major depressive disorder (MDD) in 2015. Because only a small number of randomized controlled trials have investigated the use of brexpiprazole in MDD, we performed a meta-analysis. Methods/Procedures We systematically searched literatures in PubMed, Cochrane Library database, EMBASE, Google Scholar, and up to January 2016. The primary efficacy measure was the mean change in total Montgomery-Åsberg Depression Rating Scale (MADRS) score from baseline. Secondary efficacy measures were the mean change in total Hamilton Rating Scale for Depression (17 items) score from baseline and the response (≥50% reduction in MADRS total score) and remission (MADRS total score ≤ 10 with ≥50% reduction) rates. Findings/Results Four studies fulfilled the inclusion criteria and were included in the analysis. Brexpiprazole showed superior efficacy over placebo with effect sizes (mean differences) of-1.76 (95% confidence interval [CI],-2.45 to-1.07) for MADRS and-1.21 (95% CI,-1.71 to-0.72) for the 17-item Hamilton Rating Scale for Depression. The risk ratios for response and remission were 1.57 (95% CI, 1.29-1.91) and 1.55 (95% CI, 1.22-1.96), respectively. The incidences of discontinuation due to adverse events, akathisia, and weight increase were higher in the brexpiprazole group than in the placebo group, with risk ratios of 3.44 (95% CI, 1.52-7.80), 3.39 (95% CI, 2.08-5.51), and 4.36 (95% CI, 2.45-7.77), respectively, and the incidence of akathisia was related to the brexpiprazole dose. Implications/Conclusions Although our results suggest that brexpiprazole could be an effective adjunctive agent for MDD, they should be cautiously translated into clinical practice because the meta-analysis was based on only a handful of randomized controlled trials.

    Original languageEnglish
    Pages (from-to)46-53
    Number of pages8
    JournalJournal of Clinical Psychopharmacology
    Issue number1
    Publication statusPublished - 2017 Feb 1


    • brexpiprazole
    • efficacy
    • major depressive disorder
    • meta-analysis
    • OPC-34712
    • tolerability

    ASJC Scopus subject areas

    • Psychiatry and Mental health
    • Pharmacology (medical)


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