Review ArticlesEfficacy and safety of brexpiprazole in acute management of psychiatric disorders a meta-analysis of randomized controlled trialsAntoun Reyad, Aymana; Girgis, Erinyb; Mishriky, RaafatcAuthor Information aSchool of Pharmacy, Faculty of Science and Engineering, University of Wolverhampton, Wolverhampton bCommunity Dental Service, City of Coventry Health Centre, Coventry and Warwickshire Partnership NHS Trust, Coventry cBirmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK Received 3 December 2019 Accepted 23 January 2020 Correspondence to Ayman Antoun, PhD, Faculty of Science and Engineering, University of Wolverhampton, Wulfruna Street, Wolverhampton, WV1 1LY, UK, Tel: +00441902322291; fax: +00441902321478; e-mail: email@example.com International Clinical Psychopharmacology: May 2020 - Volume 35 - Issue 3 - p 119-128 doi: 10.1097/YIC.0000000000000308 Buy Metrics Abstract Brexpiprazole is a new atypical antipsychotic for schizophrenia management and as adjunct in major depressive disorder (MDD). We searched randomized controlled trials (RCT) to review brexpiprazole efficacy and tolerability in acute management of schizophrenia and MDD using PubMed, EUDRACT, ClinicalTrials.gov and Cochrane Central Register of Controlled Trials. A meta-analysis was conducted using the identified 14 RCT to assess its efficacy using positive and negative syndrome scale (PANSS), clinical global impressions – severity of illness (CGI-S), personal and social performance scale (PSP), Montgomery–Åsberg depression rating scale (MADRS), Sheehan disability scale (SDS) and Hamilton depression rating scale (HDRS17). The mean difference comparing brexpiprazole and placebo were PANSS −4.48, CGI-S −0.23 and PSP 3.24 favoring brexpiprazole. Compared to aripiprazole and quetiapine, brexpiprazole showed similar efficacy. In MDD, brexpiprazole showed efficacy compared to placebo demonstrated by MADRS −1.25, SDS −0.37 and HDRS17 −1.28. Brexpiprazole was associated with side effects including akathisia risk ratio (RR) = 1.72; weight increase RR = 2.74 and somnolence RR = 1.87. Compared to 4 mg, brexpiprazole 2 mg was associated with less risk of akathisia and somnolence. Brexpiprazole demonstrated significant improvements in schizophrenia and MDD and is well-tolerated; however, associated with akathisia and somnolence. These findings will guide psychiatrists and pharmacists in their clinical role for supporting psychiatric patients care. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.