Yes, there is emerging but limited research on the use of Rexulti (brexpiprazole) for ADHD and PTSD, though it is not FDA-approved for either condition. Let me summarize what is currently known from research and clinical reports:
1. ADHD (Attention-Deficit/Hyperactivity Disorder)
Current Status:
- Brexpiprazole is not approved for ADHD, and data is scarce.
- However, some clinicians have explored off-label use, especially in adult patients with comorbid mood disorders or aggression.
Rationale for Use:
- As a dopamine D2 partial agonist and 5-HT1A agonist / 5-HT2A antagonist, brexpiprazole may modulate dopamine and serotonin circuits involved in executive function and impulse control.
- This is theoretically helpful in ADHD, but evidence is largely anecdotal or case-based.
Research Data:
- No large-scale RCTs (randomized controlled trials) exist for ADHD.
- A few case reports and small open-label studies have been mentioned in psychopharmacology forums for ADHD with aggression or irritability, particularly in pediatric autism spectrum disorder (where symptoms overlap with ADHD).
2. PTSD (Post-Traumatic Stress Disorder)
Current Status:
- Brexpiprazole is not FDA-approved for PTSD, but there is growing research interest, especially in treatment-resistant PTSD.
Research Highlights:
- Small Open-Label Pilot Study (2020, NCT03039192):
Brexpiprazole was studied as an adjunct in veterans with chronic, treatment-resistant PTSD.
Findings: Some improvements were observed in symptoms like irritability, hypervigilance, and sleep — but the sample size was small, and placebo control was lacking. - Case Reports (e.g., 2019–2023):
Brexpiprazole showed benefits in reducing intrusive thoughts, mood instability, and anxiety in patients who failed SSRI/SNRI treatment. - Mechanistic Basis:
Its 5-HT1A partial agonism and dopamine modulation may help stabilize affect and reduce intrusive symptoms, especially when PTSD is comorbid with depression or borderline features.
Summary Table
|
Condition |
Research Status |
Evidence Level |
Clinical Use (Off-label) |
|
ADHD |
Minimal studies |
Case reports only |
Rare, adjunctive use in complex cases |
|
PTSD |
Early-phase studies, case series |
Low to moderate |
Increasing off-label use, especially with comorbid MDD or insomnia |
Cautions:
- Side effects (e.g., akathisia, weight gain, sedation) may limit tolerability in these populations.
- For PTSD in particular, agitation or sleep disruption can worsen with partial dopamine agonists, depending on dose.
- Always consider primary treatments first (e.g., stimulants for ADHD; SSRIs or trauma therapy for PTSD).
Would you like a curated list of citations from recent clinical case reports or trials? I can generate a PDF or table for your reference.
