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5- hydroxytryptamine receptor 2A 5- hydroxytryptamine receptor 1A Voltage- dependent P/Q-type calcium channel subunit alpha-1A Voltage- dependent L-type calcium channel subunit beta-1 Voltage- dependent calcium channel subunit alpha-2/delta-2 Synaptic vesicular amine transporter Sodium- dependent serotonin transporter Tryptophan 5-hydroxylase 1 Aromatic-L- amino-acid decarboxylase Ca+ Serotonin Serotonin Brexpiprazole Brexpiprazole Ca+ Serotonin Brexpiprazole Brexpiprazole Brexpiprazole L-Tryptophan Tetrahydrobiopterin O2 5-Hydroxy-L-tryptophan 4a-Hydroxytetrahydrobiopterin CO2 Na+ Na+ Fe2+ Pyridoxal 5'-phosphate Gq signaling cascade Gi signaling cascade Synaptic Vesicle Cytosol Cytosol Presynaptic Neuron Postsynaptic Neuron Synapse ↓ Negative symptoms of schizophrenia Serotonin is synthesized and stored in synaptic vesicles at the nerve terminal Brexpiprazole is an antagonist of 5HT2A receptors. It reduces negative symptoms of schizophrenia Brexpiprazole agonism at 5HT1A receptors are responsible for treating for of the cognitive improvement in schizophrenia ↑Cognitive Improvement Brain Raphei nuclei producing serotonergic neurons Blood vessel - blood brain barrier Brexpiprazole is taken orally and absorbed from the gastrointestinal tract. passive diffusion
HTR2A HTR1A CACNA1A CACNB1 CACNA2D2 SLC18A2 SLC6A4 TPH1 DDC Calcium Serotonin Serotonin Brexpiprazole Brexpiprazole Calcium Serotonin Brexpiprazole Brexpiprazole Brexpiprazole L-Tryptophan Tetrahydrobiopterin Oxygen 5-Hydroxy-L- tryptophan 4a- Hydroxytetrahydrobiopterin Carbon dioxide Sodium Sodium Gq signaling cascade Gi signaling cascade
HTR2A HTR1A CACNA1A CACNB1 CACNA2D2 SLC18A2 SLC6A4 TPH1 DDC Ca+ 5-HT 5-HT Brexp Brexp Ca+ 5-HT Brexp Brexp Brexp Trp BH4 O2 5-HTP 4aHtHbp CO2 Na+ Na+ Fe2+ Pyr-5'P Gq si c Gi si c