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. 2023 Mar;43(1):112-119.
doi: 10.1002/npr2.12317. Epub 2023 Jan 6.

Analysis of the effect of brexpiprazole on sleep architecture in patients with schizophrenia: A preliminary study

Yusuke Arai  1   2 , Daimei Sasayama  2 , Kazuaki Kuraishi  1 , Shiho Murata  1 , Nobuteru Usuda  1 , Mika Tsuchida  1 , Yuka Nakajima  1 , Shinsuke Washizuka  2
Affiliations

Analysis of the effect of brexpiprazole on sleep architecture in patients with schizophrenia: A preliminary study

Yusuke Arai et al. Neuropsychopharmacol Rep. 2023 Mar.

Abstract

Background: Brexpiprazole is an atypical antipsychotic drug widely used in Japan for the treatment of schizophrenia. Previous studies have investigated the therapeutic effects of some antipsychotics on sleep variables; however, to our knowledge, the effects of brexpiprazole on sleep architecture have not been examined in patients with schizophrenia. Therefore, we aimed to exploratorily investigate the effect of brexpiprazole on sleep variables measured by polysomnography in patients with schizophrenia.

Methods: This study included 10 patients with schizophrenia who were originally treated with haloperidol alone. Sleep variables of the participants were measured using polysomnography. After excluding those who did not meet the study criteria, seven patients (five men and two women; mean age [SD], 59.0 [10.0] years) were eligible for further analysis. Polysomnography was repeated at 4 weeks after the participants were prescribed brexpiprazole in addition to haloperidol. We compared the sleep architecture of the participants, measured using polysomnography, before and after taking brexpiprazole.

Results: Add-on brexpiprazole significantly prolonged rapid eye movement latency, increased the duration and percentage of stage N2 and stage N3 sleep (min, %), and decreased the duration and percentage of stage rapid eye movement sleep (min, %) at a significance level of nominal p < 0.05.

Conclusion: Although not significant after correcting for multiple comparisons, the present results showed that add-on brexpiprazole could alter the sleep architecture of patients with schizophrenia. Future studies are warranted to replicate these findings and to further investigate the beneficial influence of brexpiprazole on sleep.

Keywords: atypical antipsychotic; brexpiprazole; polysomnography; schizophrenia; sleep architecture.

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Conflict of interest statement

Yusuke Arai received speaker honorarium from Otsuka Pharmaceutical, Eisai, and Sumitomo Pharma outside the submitted work in the past 3 years. Daimei Sasayama received speaker honorarium from Otsuka Pharmaceutical, Takeda Pharmaceutical, and Shionogi Pharma outside the submitted work in the past 3 years. Shiho Murata received speaker honorarium from Otsuka Pharmaceutical, Eisai, Sumitomo Pharma, Meiji Seika Pharma, MSD, Janssen Pharmaceutical, and Yoshitomiyakuhin outside the submitted work in the past 3 years. Shinsuke Washizuka received scholarship grants from Otsuka Pharmaceutical, Eisai, Sumitomo Pharma, Takeda Pharmaceutical, Shionogi Pharma, Mochida Pharmaceutical, Tsumura, Daiichi Sankyo, Mitsubishi Tanabe Pharma, Novartis Pharma, and Astellas Pharma outside the submitted work in the past 3 years. Shinsuke Washizuka received speaker honorarium from Otsuka Pharmaceutical, Eisai, Sumitomo Pharma, Takeda Pharmaceutical, Shionogi Pharma, MSD, Janssen Pharmaceutical, Yoshitomiyakuhin, Kyowa Pharmaceutical, Eli Lilly Japan, and Pfizer outside the submitted work in the past 3 years.

Figures

FIGURE 1
FIGURE 1
Study flow chart. Ten participants were recruited for this study. The patients were originally treated with haloperidol alone. Participant sleep variables were measured using PSG. One patient was excluded from the study because he could not tolerate PSG owing to delirium. Two patients were further excluded because the AHI was >15/h. After PSG, seven patients were prescribed add‐on brexpiprazole (1 mg/day for 1 week and 2 mg/day for 3 weeks). PSG was performed again after 4 weeks of add‐on treatment with brexpiprazole. PSG, polysomnography; AHI, apnea–hypopnea index.
See this image and copyright information in PMC

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