Rexuli versus Vraylar versus Abilify side effects

Comparative adverse effects


Tables 3​3​​​–8 list the adverse effects for each agent. The most common adverse effects for aripiprazole were headache (27%), agitation (19%), anxiety (17%), insomnia (16%), akathisia (13%), nausea (13%), vomiting (11%), constipation (10%), dyspepsia (9%), and dizziness (9%).

Psychiatric effects.
Aripiprazole showed the highest rates of the three drugs for fatigue, increased appetite (tied with brexpiprazole), tachycardia, xerostomia, constipation, nausea and vomiting, blurry vision (tied with cariprazine), dizziness, headache, agitation, anxiety, insomnia, and restlessness (tied with cariprazine).

Aripiprazole showed the lowest rate of the three drugs for EPS (excluding akathisia), dystonia, Parkinsonism, and abdominal pain.


For brexpiprazole, the 10 most common adverse effects were headache (9%), agitation (8%), insomnia (8%), akathisia (7%), EPS excluding akathisia (6%), sedation (5%), weight increase (5%), and nausea (4%). Many of these effects are reduced compared with aripiprazole. Notably, akathisia is almost 50% less.

Interestingly, brexpiprazole showed the highest rate of the three drugs for increased appetite (tied with aripiprazole), and weight increase.

Brexpiprazole showed the lowest rate of the three drugs for akathisia, fatigue (tied with cariprazine), constipation, diarrhea, dyspepsia, nausea, dizziness, headache, and somnolence.


Cariprazine’s most common adverse reactions included EPS excluding akathisia (21%), Parkinsonism (18%), akathisia (14%), insomnia (8%), constipation (8%), nausea (8%), somnolence (7%), dyspepsia (6%), and vomiting (6%). Compared with the previous two agents, cariprazine may have the greatest EPS risk.

Cariprazine showed the highest rate of the three drugs for EPS (excluding akathisia), Parkinsonism, akathisia, abdominal pain, somnolence, and restlessness.

Cariprazine showed the lowest rate of the three drugs for fatigue (tied with brexpiprazole), weight gain, tachycardia, xerostomia, vomiting, and insomnia (tied with brexpiprazole).

Discontinuation rates due to adverse effects are shown in Table 9. Cariprazine had the highest rate, followed by aripiprazole, and then brexpiprazole with the lowest rate. The most common adverse effect leading to discontinuation for all three atypicals was akathisia. Among the placebo group, the most common adverse effects were either worsening psychotic or manic symptoms, presumably due to nontreatment.

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I’ve tried Aripiprazole (Abilify) and Cariprazine (Vraylar).

The Anxiety and restlessness was pretty bad on Abilify but it was unbearable on Vraylar.

Might be trying Rexulti soon but I am not expecting much out of it.

I’ll see what my pdoc says.

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