Newer antipsychotics: Brexpiprazole, cariprazine, and lumateperone: A pledge or another unkept promise?

Table 1 Characteristics and indications of brexpiprazole, cariprazine, and lumateperone

Name	Characteristics	Dose	Common adverse reactions	FDA indications
Brexpiprazole	Partial agonist of dopamine D2 receptor, a partial agonist of serotonin 1A (5-HT1A) receptors, and a potent antagonist at 5-HT2A, α1B, and α2C adrenergic receptors	2-4 mg/d for schizophrenia; 2 mg/d for MDD	Akathisia, headache, somnolence, tremor, and weight gain	Maintenance treatment of schizophrenia Adjunctive treatment for major depressive disorder in adults
Cariprazine	Dopamine D3/D2 receptor partial agonist with 10-fold higher affinity for D3 receptors than D2 receptors, antagonism at serotonin 5HT2A, 5HT2B with moderate to high binding affinity	1.5 mg/d-6 mg/d for schizophrenia; 3-6 mg/d for bipolar mania	Akathisia, EPS, headaches, weight gain, headache, insomnia, and extrapyramidal side effects	Maintenance treatment of schizophrenia. Mania and mixed episodes related to bipolar mood disorder type I in adults
Lumateperone	Presynaptic partial agonist and postsynaptic antagonist at D2 receptors, an antagonist at serotonin 5-HT2A receptors, and a glutamate modulator	42 mg for schizophrenia	Sedation, somnolence, headache, dryness of mouth, extrapyramidal side effects	Schizophrenia in adults

FDA: Food and Drug Administration; MDD: Major depressive disorder; EPS: Extrapyramidal side effects.