Drug Comparison
For educational purposes only — a decision-support tool, not a substitute for clinical judgment.
Side-by-side rubric across 96 psychiatric medications. Every rating traces to a verbatim primary-source quote — click any cell to see it.
How to read this tool ▾
Rating scale
– Favorable / lower than class baseline
± Minimal / equivocal
+ Low / uncommon
++ Moderate / common
+++ High / very common
++++ Very high / class-outlier
Frequency vs severity
F = frequency, S = severity. Each gets its own pill colored on the same traffic-light scale: green → blue → yellow → orange → red. Click any cell for incidence percentages and NNH.
Evidence tier
A Network meta-analysis / RCT / FDA label
B Cohort / registry / pooled label data
C Expert review / textbook / case series
Sourcing
Click any cell to see the verbatim source quote and citation. Missing data shows n/a.
Data depth
++ Graded — frequency + severity, primary-source traces
+ FDA label — §6 frequency only (dashed border). Click for sub-types.
Blank — not yet checked (not “absent”)
–±++++++++++ABCF = frequency · S = severity · Dashed border = FDA label only · Click cell for details
1 drug selected — Brexpiprazole(click to collapse)
1/4 selected
Brexpiprazole
Rexulti
Second-Generation Antipsychotic (Partial D2 Agonist)
FDA-approved indications
- Schizophrenia (adults; adolescents 13+)
- MDD — adjunct to antidepressants (adults)
- Agitation associated with Alzheimer's dementia (adults)
Off-label uses
- PTSD (adjunct)
- Bipolar disorder
MechanismAtypical Antipsychotic
Half-life91 hours
Decision GuideWhen to pick each / when to consider an alternative
Brexpiprazole
Consider when
- MDD adjunct with akathisia sensitivity — lower akathisia than aripiprazole (RR 1.35 NS vs 1.95); better tolerated as AD augmentation
- Alzheimer's disease agitation — only SGA with FDA approval for agitation in Alzheimer's dementia
- Prolactin sensitivity — partial D2 agonist with near-placebo prolactin elevation; avoids galactorrhea/amenorrhea
- QTc or anticholinergic burden constraint — negative QTc effect (−1.48 ms) and below-placebo anticholinergic profile
- +1 more
Consider an alternative when
- Acute psychosis or severe agitation requiring rapid response — partial agonist with gradual onset; may be insufficient acutely
- Cost or formulary constraint — brand-only with no generic; significant premium over aripiprazole generics
- On potent CYP2D6 or CYP3A4 inhibitors — dose halving required; fluoxetine, paroxetine, or ketoconazole combinations need adjustment
- On strong CYP3A4 inducer (carbamazepine, phenytoin, rifampin) — dose doubling required per label
- +1 more
| Axis | Brexpiprazole SGA |
|---|---|
| Boxed Warnings | |
Suicidality (boxed warning) | |
Agranulocytosis / severe neutropenia | |
Cerebrovascular events (elderly w/ dementia) | |
Neuroleptic malignant syndrome (NMS) | |
| CNS | |
Sedation / somnolence | |
Activation / insomnia | |
Akathisia / EPS | |
Tardive dyskinesia | |
Seizure risk | |
| Metabolic | |
Weight gain | |
Metabolic (glucose / lipids) | |
| Endocrine | |
Prolactin elevation | |
| Autonomic | |
Anticholinergic burden | |
Orthostatic hypotension | |
| Cardiac | |
QTc prolongation | |
| GI | |
Nausea / GI (general) | |
| Sexual | |
Sexual dysfunction | |
| Interactions | |
CYP interactions / DDI profile | |
| Pregnancy | |
Lactation / breastfeeding safety | |