I wish we had such a great doctor here

Very informative. This treatment has made immensely improved my therapy for depression. With the pandemic I began to become confused and bipolar. I am safe but this regulator is amazing. Great sleep refreshed in the morning. This is new and I like it. Ty for the information. I understand every word as I am a former medical professional.

Wow- THANK YOU! As a person who has been prescribed a wide range of meds for bipolar- I settled on lamictal which caused horrible hair loss- my dr suggested Rexulti - and I was hesitant because abilify caused 15 lb weight gain in a month- your video has given me a positive attitude toward this- I’m only on day three but I am more relaxed after your explanations. This information is invaluable!

Thank you. You were very clear and answered all my questions

I'm also hearing great things about Cariprazine; its now approved by the FDA in the USA as an add on to antidepressants for depression. It has actions on the D3 receptors that could help a number of conditions, from what i've read. Looking forward to your review on Vraylar/Cariprazine and how it might be unique. Happy 2023!!

Excellent explanation of dopamine modulation. I’d like to hear more opinion from you on the “me too” drugs.for example is brexpiprazole any better than Abilify? Is it sort of an optical isomer of Abilify? Less side effects? What I’m finding is most of my patients are on managed healthcare plans and the lower tiered generic meds are much much cheaper than going into the higher tiered, newer drugs, which many people can’t afford. Maybe do a comparative class on old v new.

Very helpful and informative

It's like voltage gated ion channels, the regulating effect is bliss...

I love ur videos doc!! Thank u so much!!

You're forgetting the sexual side effects. When I was on Brexpiprazole I had uncontrollable sexual desires. Which led me to getting scammed out of $2,000 All I could think was sex. With constant erections. And with the long half life it was not fun. So what's receptor caused that doc I've been bipolar 2 depression for 25 years. The past 5 years treatment resistant until I found trintellix 4 months ago. And got diagnosed ADHD this week. So will ADHD medicines do the same thing as this medicine did to me?...

Great informational video, thank you. You're an excellent speaker. My question is if vortioxetine taken in conjunction with Rexulti would be safe, given that they both go thru gene CYP2D6?

on Wikipedia it says its the opposite of Abilify in terms of dopamine stimulation - would a stronger dose of Rexulti create more stimulation or blockage of dopamine

Is aripiprazole and brexpiprazole effective for treating acute psychosis in the ED compared with other antipsychotics? In my hospital aripiprazole is seen as less effective and more as an augmentation strategy

Is it possible to switch over from Aripiprazole to Brexpiprazole smoothly after being on A for more then a year?

How exactly does the antihistaminic action of certain anti-psychotics like Quetiapine/ Olanzapine and Mirtazepine cause sedation? how does it interact with other activating receptors/neurotransmitters?

I have a question about Rextuli and Abilify. Do they both affect H1 Receptors ? Also I have a bad experience with Serqouel and Zyprexa they made my anxiety way worse. Seems I have a problem with antihistamines has the opposite affect. I was on Abilify and was ok for a while but developed akathisa combined with Pristiq 25mg. My question is will rextuli make my anxiety worse due to its antihistamine properties ?

The doctor prescribed me aripiprazole for an eating disorder. I will use it with zoloft 100. I am very afraid of gaining weight. Will I gain weight with this medicine? Will my metabolism slow down? By the way, I first lost weight and was not eating, then I started eating with zoloft, but now I regularly vomit what I eat. I have bulimia nervosa. Will I benefit from these two drugs? please reply i need your help 🙏🏻

Learning here

Thx doc! How is the comparison between brexipiprazole and cariprazine?

Question: What is your marvelous head doing in front of the blackboard? Could you not move it further to the right?

Hello doc. Have you done a video on vraylar yet by chance? I just got 4 weeks worth of samples and they want me to do it every other day. Currently on Zoloft 100mg so this would be a add on for treatment resistant depression. I really prefer listening to your explanation over anyone else😊

Does abillify cause diabetes and is this reversible on 5mg from 3 months

I certainly hope you can shed light on this: Trialed 1 month lowest 10mg dose Aripiprazole. Upon withdrawal, dystonia for several weeks occurred. Abrupt withdrawal. Quetiapine taken for much longer and tapered, no dystonia upon withdrawal. No EPS on Seroquel however too sedating, not tolerated. Lurasidone at low doses did nothing for depression or side effects. What causes that? and given my reaction, does it mean atypical antipsychotics are very risky for me developing EPS in the short or long term? Is this type of reaction to withdrawal a sign I am at greater risk of developing Parkinson's disease or Alzheimer's (acetylcholine deficiency?)? If it helps to know, when I am on SSRIs they cause tightness jaw which Buspirone reverses too. I would like to try Brexpiprazole and besides the dystonia from withdrawal of Aripiprazole, would it be any less likely to cause what seemed like mixed hypomania on Aripiprazole? I thought all types of APs were safe for bipolar spectrum so was surprised Aripiprazole had that effect. I was not taking any other medicines at the time. Thank you Dr Rege

Perfect 👌

Can I take brexpiprazole 0.5mg with mirtazapine for depression and anxiety I’m currently on 45mg mirtazapine ??

Sir, one of my close relatives, was on Olanzapine 5mg for 6 months but due to weight gain issues her psychiatrist switched her to Lurasidone 20mg abruptly, and now she has become extremely restless, irritable & agitated with insomnia, also probably a bit of tremors. Is it possible that it's due to anticholinergic/antihistaminergic rebound ? How these antipsychotics should be cross titrated ?

Would topical ketoconazole raise levels of the brexpiprazole ? Or would that be more oral route? I’ve just started on brexpiprazole and use keto shampoo for hair loss

What if patient was on risperdal 2 mg daily, and I want to switch to Brexpiprazole ? How can I do the cross tapering between those 2 medications?

How does brexpiprazole compare to paliperidone?

I certainly hope you can shed light on this: Trialed 1 month lowest 10mg dose Aripiprazole. Upon withdrawal, dystonia for several weeks occurred. What causes that? and given my reaction, does it mean atypical antipsychotics are very risky for me developing EPS in the short or long term? Is this type of reaction to withdrawal a sign I am at greater risk of developing Parkinson's disease? I would like to try Brexpiprazole and besides the dystonia from withdrawal of Aripiprazole, would it be any less likely to cause what seemed like mixed hypomania on Aripiprazole? I thought all types of APs were safe for bipolar spectrum so was surprised Aripiprazole had that effect. I was not taking any other medicines at the time. Thank you Dr Rege

how long does it take for a increase from 1-2 mg in rexulti take to work

Just curious-at what doses do you see patients having a response to Rexulti? 0.5mgs? 1mg? Does it take 8 weeks to see a response or a few weeks? Thank you again! Don

Which causes least amount of weight gain

Could you do a video on methylphenidate?

Is Brexpiprazol available as monthly depot or 3 monthly or liquid.

Been on 3mg rexulti for two years but showing high cholesterol, what should I do?

what do you mean by day 8 is 4mg? do you mean 7day +1 day you put the patient on 4 mg? can you please elaborate on that I am confused

If I gained weight with abilify, will I gain weight the same with brex. ?

Is taking Aripiprazole 2.5 mg daily causes weight gain and Diabetes. Plz reply.

I wonder if Rexulti can be helpful with ocd? It’s not sedating, right? Thanks for your videos! Would enjoy working with someone of your caliber in the Washington DC, USA area. Can you recommend any? Best!

If aripiprazole has stopped working as well as it used to, would it be a good idea to switch to brexpiprazole or would it have the same effect of not working after a few months? (I'm a patient but am very curious to know what they will put me on next as my aripiprazole has stopped working as well as it did.)

What differences between Aripiprazole and Brexpiprazole?

why don't you explain what antagonist and agonist mean?

Does this help CFS more than Abilify then?

Y'know, I'm a little annoyed by this 'goldilocks zone,' 'optimization,' and agonists 'raising and lowering the levels of neurotransmitters' language. As you know, the levels of monoamines are not changed by the ligands (directly; excepting effects on autoreceptors, perhaps, it depends on what one means by 'directly'), so it's misleading to talk about them that way; unless we're talking about displacement from another site on the complex, dopamine levels don't really have anything to do with this at all. And the switching of the g-protein is binary, so it's not really about more or less of an effect, it's about the probability of any given GPCR in a population being activated at equilibrium in a sufficiently large population of neurons. The goldilocks bit is wrong in two ways; not only is there no way to know whether the efficacy (depending on the source) of brex or aripiprazole is 'optimal', but the activation of any given receptor is random - it's just that the number of activations in a population changes at equilibrium depending on efficacy of the ligand. So maybe it's a 'goldilocks zone' or 'less dim room' for populations of neurons, but it's not about neurotransmitters or individual synapses at all, which is kind of what your wording suggests. I'm concerned that in the attempt to make things comprehensible to audiences, much of the science gets abandoned in favor of cozy metaphors, which feels kind of patronizing to anyone with a bit of science background, and makes one worry a bit if doctors themselves even know the science.

Perfect 👌