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Brexpiprazole Augmentation on Mirtazapine for Treatment-resistant Depression in an Elderly Patient

Year: 2025

Type: article

Abstract: Treatment-resistant depression (TRD) poses a significant clinical challenge, particularly in elderly patients, due to age-related physiological changes, comorbidities, and reduced medication tolerability. TRD is generally defined as a major depressive disorder (MDD) that fails to respond to at least two adequate antidepressant trials. In this case, a 64-year-old male with no prior psychiatric history presented with a two-month history of depressive symptoms including insomnia, weight loss, paranoid delusions, and social withdrawal. Mirtazapine was initiated with partial improvement. Following the addition of brexpiprazole, the patient demonstrated marked clinical improvement in mood, motivation, and daily functioning.This case underscores the complexity of treating TRD in elderly patients and highlights the potential synergistic effect of combining mirtazapine with brexpiprazole, The pharmacological complementarity of these agents may enhance antidepressant efficacy while minimizing adverse effects in geriatric populations.

Source: International Journal of Advanced Research

DOI: 10.21474/ijar01/21022

Authors: Parinda Parikh, Himani Suthar, Parthiv Pansuriya, Shauryakumar Singh, Arnesh Shukla, Aatish Bhatta, Jeremy Kays, Alisha Arul Alphonse, Arushi Kaushik Chandra B.E, Mahiya Buddhavarapu B.S, Avinash Kesavarapu B.S, Zoe Gellert B.S, Mina Oza, 2ND ARC Associates, White Plains, USA.

Language: English

Topic: Treatment of Major Depression

Subfield: Pharmacology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

OpenAlex ID: W4411433974

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