Experience with Adjunctive Brexpiprazole Treatment in Patients with Treatment-Resistant Major Depressive Disorder at a University Clinic: A Case Series

Objective: This case series aims to evaluate the efficacy and tolerability of brexpiprazole as an adjunctive treatment in patients with treatment-resistant major depressive disorder (TRD) at a university clinic. Methods: Nine cases diagnosed with TRD, defined as insufficient response to at least two antidepressant therapies, were included. Patients were treated with brexpiprazole (0.5–3 mg/day) in combination with ongoing antidepressants. Treatment responses were assessed based on improvements in depressive symptoms, functionality, and tolerability. Results: Brexpiprazole addition resulted in significant symptomatic improvement in seven cases, with reductions in depressive symptoms such as anhedonia, guilt, and psychomotor agitation. Specific cases highlighted brexpiprazole’s potential in managing complex conditions such as borderline personality disorder and post-traumatic stress disorder. Most patients experienced enhanced daily functionality and social interactions. Mild weight gain and transient dizziness were the only side effects reported, with no treatment discontinuation due to adverse effects. Conclusion: Brexpiprazole demonstrates efficacy and tolerability in managing TRD, particularly as part of a personalized treatment approach. These findings align with existing literature, underscoring brexpiprazole’s role in improving outcomes in resistant and comorbid depressive syndromes. Further studies are needed to confirm these results in larger patient populations.