Vraylar (Cariprazine) for Depression

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Vraylar (cariprazine) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat depressive episodes associated with bipolar 1 disorder (bipolar depression) in adults. It is also used with other antidepressants to treat major depressive disorder (MDD) in adults.

What Members Say

MHT logo These insights are based on 91 comments about Vraylar from MyDepressionTeam members. These are the experiences of a small number of people and are not meant to be medical advice.

Benefits:

Depression symptoms sometimes improve, including better mood, energy, and daily functioning.
Mood can feel more even or balanced during depressive episodes.
Once-daily capsules can fit easily into a morning or evening routine.

Considerations:

Restlessness, anxiety, insomnia, emotional blunting, and feeling flat can happen and are listed side effects.
Nausea, dizziness, fatigue, and constipation can occur.
Movement-related side effects can happen, including akathisia, dystonia, and tardive dyskinesia.

How Vraylar Works and How It’s Taken

Vraylar is an antipsychotic medicine. It works on brain chemicals called dopamine and serotonin. The exact way it works is not fully known.

In bipolar depression, this helps reduce mood-related brain signaling problems that may worsen depressive symptoms.

Doctors prescribe Vraylar when an adult is being treated for depressive episodes linked to bipolar 1 disorder or for major depressive disorder. By targeting the brain signal pathway, the medication may help manage symptoms.

Vraylar is taken as a capsule by mouth once a day. You can take it with or without food. The medicine stays in your body for a long time, so changes in dose may take a few weeks to fully take effect.

Typical Dosing for Bipolar Depression

The recommended starting dose of Vraylar is 1.5 milligrams taken by mouth once a day.

If needed, the doctor may increase the dose to 3 milligrams once a day on day 15.

The highest recommended dose is 3 milligrams once a day.

This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Typical Dosing for Major Depressive Disorder

The recommended starting dose of Vraylar is 1.5 milligrams taken by mouth once a day.

If needed, the doctor may increase the dose to 3 milligrams once a day on day 15.

Increasing the dose too quickly, in less than 14 days, may raise the chance of side effects. The highest recommended dose is 3 milligrams once a day.

This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Top Advice From Members on Vraylar

These insights are based on 91 comments about Vraylar from MyDepressionTeam members.

Members who use Vraylar often say it helps to stay in close touch with a psychiatrist, especially when starting, changing doses, or dealing with side effects. Many also mention giving it some time to work, watching for movement-related side effects or sleep changes, and asking about cost support if the price is too high.

1

Talk to your doctor if the dose feels off.

“The oversleeping for me was because the dose was too high.”
2

Tell your doctor about side effects right away.

“I took Vraylar for three weeks and developed tardive dyskinesia. Luckily, it stopped when I discontinued the medication.”
3

Ask about help if cost is a problem.

“It cost $2,196. That’s a lot of money for every 30 days. Thank God my insurance covers it.”

Connect with others who understand life with depression. Join MyDepressionTeam for free.

Vraylar Side Effects

In clinical studies of Vraylar used with antidepressants to treat major depressive disorder and depressive episodes associated with bipolar 1 disorder (bipolar depression) in adults, the most common side effects occurred in about 5 percent to 23 percent of people. These include:

Restlessness, including akathisia (feeling like you cannot sit still)
Nausea
Insomnia (trouble sleeping)
Fatigue (feeling tired)
Constipation
Increased appetite
Dizziness
Extrapyramidal symptoms (EPS) — Movement-related side effects, such as stiffness, tremor, or slowed movements

Serious Side Effects and Warnings

Vraylar can cause serious side effects that require immediate medical attention. These include:

Increased risk of death in older adults with dementia-related psychosis — Not approved for this use
Suicidal thoughts and behaviors — Higher risk in people 24 years of age and younger
Cerebrovascular adverse reactions — Stroke and mini-stroke in older adults with dementia-related psychosis
Neuroleptic malignant syndrome (NMS) — A rare, life-threatening reaction with high fever, stiff muscles, confusion, and unstable blood pressure or heart rate
Tardive dyskinesia — Uncontrolled body movements that may not go away
Metabolic changes — High blood sugar or diabetes, high cholesterol or triglycerides, and weight gain
Leukopenia, neutropenia, and agranulocytosis — Low white blood cell counts, including a severe and potentially life-threatening decrease
Orthostatic hypotension and syncope — A drop in blood pressure when standing up and fainting
Falls — Fractures or other injuries
Seizures — Possible seizure episodes
Cognitive and motor impairment — Sleepiness and slowed thinking or reactions that can affect driving or using machinery
Body temperature problems — Trouble cooling down, especially with heat, dehydration, or heavy exercise
Dysphagia — Trouble swallowing that can raise the risk of choking or breathing food or liquid into the lungs
Severe allergic reactions — Rash, itching, hives, or swelling of the face, lips, tongue, or throat
Stevens-Johnson syndrome — A rare, serious skin reaction with blistering or peeling
Cataracts — Clouding of the eye’s lens that can affect vision

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

How To Save on Vraylar

AbbVie, the manufacturer of Vraylar, offers the Vraylar Savings Program. Eligible people with commercial insurance may pay as little as $0.

The Vraylar Savings Program also offers the option to sign up online. To learn more, visit the Vraylar cost and savings page or call 844-487-2952.

What To Know Before Taking Vraylar

Tell your doctor if you have any allergies to cariprazine or any ingredients in Vraylar.

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

Tell your doctor if you have or have had health problems. These include heart problems, stroke, high or low blood pressure, diabetes, seizures, kidney or liver problems, or a low white blood cell count.

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

Vraylar is also FDA approved to treat schizophrenia in adults and in children aged 13 and older. It is also used to treat manic or mixed episodes linked to bipolar 1 disorder in adults and children age 10 and older. In adults, it can be used with antidepressants to treat major depressive disorder.

If you are pregnant, planning to become pregnant, or breastfeeding while taking Vraylar, talk with your doctor about the risks and benefits. There is a pregnancy registry that collects information about people who take this medicine during pregnancy. To learn more, visit the National Pregnancy Registry for Psychiatric Medications or call 866-961-2388.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Vraylar?
In adults with bipolar depression, Vraylar was studied in one eight-week study and two six-week studies. In these studies, the 1.5 milligrams dose improved depression rating scores more than placebo (an inactive treatment) by week 6.

In adults with major depressive disorder, Vraylar used with an antidepressant worked better than placebo used with an antidepressant in one six-week study at 1.5 milligrams and in one eight-week study at 2 to 4.5 milligrams. Because Vraylar stays in the body for a long time, dose changes may take several weeks to fully show their effects.

How long does Vraylar take to work for depression?
In clinical studies of Vraylar in adults with bipolar depression and when added to antidepressants for major depressive disorder, improvement was measured over about six to eight weeks. Because this medicine stays in the body for a long time, changes in dose may take several weeks to fully show their effects. Doctors will monitor you during this time to assess response and side effects.

Can Vraylar cause movement problems when used for depression?
Yes. In clinical studies of Vraylar in adults with bipolar depression and when added to antidepressants for major depressive disorder, some people had movement-related side effects such as restlessness, stiffness, or shaking. A serious condition called tardive dyskinesia can also occur and may cause uncontrolled movements.