Rexulti (Brexpiprazole) for Major Depressive Disorder

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Rexulti (brexpiprazole) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat major depressive disorder (MDD) in adults.

What Members Say

MHT logo These insights are based on 164 comments about Rexulti from MyDepressionTeam members. These are the experiences of a small number of people and are not meant to be medical advice.

Benefits:

It may help improve depression when added to an antidepressant that is not working well enough.
Some people report improvement in mood, thinking, or energy within days to weeks.
Once-daily dosing can feel simple and easy to manage.

Considerations:

Weight gain and increased appetite are commonly reported concerns.
Sleepiness, fatigue, or low motivation may be hard to manage.
Restlessness, insomnia, or feeling unusually “wired” can occur in some people.

How Rexulti Works and How It’s Taken

Rexulti works on brain chemicals called serotonin and dopamine. It partly turns some signals on and blocks others. The exact way it works is not fully known. These effects may help reduce symptoms of MDD when Rexulti is taken with an antidepressant.

Doctors prescribe Rexulti for adults ages 18 and older with MDD. The medicine is a tablet taken by mouth once a day, with or without food. Treatment usually starts at a low dose. The doctor may slowly raise the dose, often once a week, based on how the person responds.

Top Advice From Members on Rexulti

These insights are based on 164 comments about Rexulti from MyDepressionTeam members.

Members who use Rexulti often say it helps to stay in close contact with their doctor, especially when starting, switching, or adjusting treatment. They also frequently mention watching for side effects, giving the medication some time to work, and speaking up about cost or access problems.

1

Keep track of side effects and tell your doctor.

“Wow, I’ve been experiencing extreme fatigue and weight gain. I thought it was hormonal due to menopause, but then I discussed it with my doctor. I’m on Rexulti for depression, and it states that it can cause fatigue, weight gain, and hormonal changes.”
2

Ask for help right away if your mood gets much worse.

“Started Rexulti about two weeks ago. Sunday, I started feeling more depressed. Yesterday and today are unbearable to the point that I called Crisis Intervention and my doctor to see if I should be admitted.”
3

Let your doctor know if cost or insurance is a problem.

“I was given a sample of Rexulti by a psych one time, and it worked very well. I took the prescription to my pharmacy, and it was $1,100. That is more than my house payment. My doctor hooked me up with a Rexulti Savings Card.”

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Rexulti Side Effects

In clinical studies of Rexulti taken with antidepressants to treat MDD in adults, the most common side effects occurred in about 2 percent to 9 percent of people. These included:

Constipation
Fatigue (feeling unusually tired)
Common cold symptoms
Weight gain
Increased appetite
Akathisia (restlessness or feeling like you need to move)
Headache
Sleepiness
Tremor (shaking)
Dizziness
Anxiety
Restlessness

Serious Side Effects and Warnings

Rexulti can cause serious side effects that need immediate medical attention. These include:

Suicidal thoughts and behaviors — The risk is higher in people ages 24 and younger taking antidepressants. Watch for new or worsening mood or behavior changes.
Neuroleptic malignant syndrome, or NMS — This is a rare, life-threatening reaction that can cause high fever, muscle stiffness, confusion, and unstable blood pressure or heart rate.
Tardive dyskinesia — This condition causes uncontrolled body movements that may not go away.
Metabolic changes — These include high blood sugar or diabetes, unhealthy cholesterol or triglyceride levels, and weight gain.
Compulsive urges — These may include gambling, shopping, sex, eating, or binge eating that you cannot control.
Low white blood cell count — This can raise the risk of infection.
Orthostatic hypotension and fainting — This is a drop in blood pressure when standing that can cause dizziness or passing out.
Falls — These can lead to fractures or other injuries.
Seizures — These can occur during treatment.
Body temperature problems — These may include trouble cooling down, especially with heat, dehydration, or heavy exercise.
Trouble swallowing — This can raise the risk of choking or breathing food or liquid into the lungs.
Cognitive and motor impairment — This may include sleepiness or slowed thinking that can affect driving or other activities.
Severe allergic reaction — This may include hypersensitivity, with symptoms such as rash, facial swelling, hives, or anaphylaxis.

Get medical help right away if you think you are having a serious reaction.

How To Save on Rexulti

Otsuka America Pharmaceutical offers the Rexulti Savings Card. People with commercial insurance may be able to pay as little as $0.

The Rexulti Savings Card also offers savings on Rexulti refills, 90-day prescriptions, and a generic antidepressant (if prescribed). To learn more, visit the Rexulti website or call 844-415-0674.

What To Know Before Taking Rexulti

Tell your doctor if you have any allergies to brexpiprazole or any ingredients in Rexulti.

Tell your doctor about all the medications you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.

Do not take Rexulti if you have had a serious allergic reaction to brexpiprazole or any of its ingredients.

Rexulti is also FDA approved to treat schizophrenia in adults and children ages 13 years and older. It is also used to treat agitation associated with dementia due to Alzheimer’s disease.

If you are pregnant, planning to become pregnant, or breastfeeding while taking Rexulti, talk with your doctor about the risks and benefits. Taking Rexulti during the third trimester of pregnancy may cause muscle movement problems or withdrawal symptoms in a newborn.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Rexulti?
Two six-week studies looked at adults with MDD who did not get enough relief from an antidepressant alone. Rexulti taken with an antidepressant reduced depression symptoms more than a placebo (an inactive treatment) plus an antidepressant. In these studies, doses of 2 milligrams and 3 milligrams taken once daily worked better than the placebo, while the 1 milligram dose did not show a clear benefit. Depression symptoms were measured using a standard rating scale called MADRS.

Can Rexulti cause weight gain with depression treatment?
Yes. In adults taking Rexulti with an antidepressant for MDD, weight gain and increased appetite were reported. Rexulti can also cause changes in blood sugar, cholesterol and triglyceride levels, and weight.

What tests or monitoring are needed with Rexulti for depression?
Blood sugar should be checked before starting treatment, or soon after, and then checked from time to time during long-term treatment. Cholesterol and triglyceride levels should be checked at the start and then from time to time during treatment. Weight should be checked at the start and often after that. If a person already has a low white blood cell count or has had drug-related low counts such as neutropenia before, blood count checks are recommended during the first few months.

How long does Rexulti take to work for depression?
The depression studies measured results over six weeks. The studies do not give an exact day or week when people may first notice improvement.

Learn More

On MyDepressionTeam, people share their experiences with depression and other related conditions, get advice, and find support from others who understand.

Learn more about Rexulti and depression care: