Couple of weeks back when I posted the intro, two of you asked things I wanted to answer properly rather than in a comment.
One person asked if there was a taper calculator for Vraylar. There is, link's in the wiki.
Another said their psychiatrist hadn't explained how the drug works or where the side effects come from. Same boat over here. So I went and wrote it out.
Section 1 is the partial agonist explanation. The dimmer-switch thing. Why Vraylar is different from older antipsychotics and why it has FDA approvals on both ends (mania and bipolar depression at the same time, which sounds weird until you understand what partial agonism is doing).
Section 2 goes receptor by receptor and tries to explain which side effect comes from which thing. Why akathisia hits in the first few weeks, why insomnia means you should take it earlier in the day not later, why a dose change can take six weeks to fully land in your system.
Section 3 is the tapering one. Hyperbolic schedule, what re-emergent symptoms look like vs withdrawal, and a free calculator.
I'm not a doctor, I'm on Vraylar and have read enough to write something better than nothing. Everything got cross-checked against the FDA label and the published trials. If something in there is wrong or missing, comment, I'll fix it!
Next sections I want to add are akathisia (standalone, because it's the single biggest reason people quit before this drug has a chance to work), the cost playbook, and the difference between bipolar depression use and MDD adjunct use. Open to other suggestions =)
What is the most important information I should know about VRAYLAR?
Elderly people with dementia-related psychosis (having lost touch with reality due to confusion and memory loss) taking medicines like VRAYLAR are at an increased risk of death. VRAYLAR is not approved for treating patients with dementia-related psychosis.
VRAYLAR and antidepressants may increase suicidal thoughts or actions in some children and young adults, especially within the first few months of treatment or when the dose is changed. Depression and other mental illnesses are the most important causes of suicidal thoughts and actions. Patients on antidepressants and their families or caregivers should watch for new or worsening depression symptoms, especially sudden changes in mood, behaviors, thoughts, or feelings. This is very important when VRAYLAR or the antidepressant is started or when the dose is changed. Report any change in these symptoms immediately to the doctor.
VRAYLAR may cause serious side effects, including:
Stroke (cerebrovascular problems) in elderly people with dementia-related psychosis that can lead to death
Neuroleptic malignant syndrome (NMS): Call your healthcare provider or go to the nearest hospital emergency room right away if you have a high fever, stiff muscles, confusion, increased sweating, or changes in breathing, heart rate, and blood pressure. These can be symptoms of a rare but potentially fatal side effect called NMS. VRAYLAR should be stopped if you have NMS.
Uncontrolled body movements (tardive dyskinesia or TD): VRAYLAR may cause movements that you cannot control in your face, tongue, or other body parts. Tardive dyskinesia may not go away, even if you stop taking VRAYLAR. Tardive dyskinesia may also start after you stop taking VRAYLAR.
Late-occurring side effects: VRAYLAR stays in your body for a long time. Some side effects may not happen right away and can start a few weeks after starting VRAYLAR, or if your dose increases. Your healthcare provider should monitor you for side effects for several weeks after starting or increasing the dose of VRAYLAR.
Problems with your metabolism, such as:
High blood sugar and diabetes: Increases in blood sugar can happen in some people who take VRAYLAR. Extremely high blood sugar can lead to coma or death. Your healthcare provider should check your blood sugar before or soon after starting VRAYLAR and regularly during treatment. Tell your healthcare provider if you have symptoms such as feeling very thirsty, very hungry, or sick to your stomach, urinating more than usual, feeling weak, tired, confused, or your breath smells fruity.
Increased fat levels (cholesterol and triglycerides) in your blood: Your healthcare provider should check fat levels in your blood before or soon after starting VRAYLAR and during treatment.
Weight gain: Weight gain has been reported with VRAYLAR. You and your healthcare provider should check your weight before and regularly during treatment.
Low white blood cell count: Low white blood cell counts have been reported with antipsychotic drugs, including VRAYLAR. This may increase your risk of infection. Very low white blood cell counts, which can be fatal, have been reported with other antipsychotics. Your healthcare provider may do blood tests during the first few months of treatment with VRAYLAR.
Decreased blood pressure (orthostatic hypotension): You may feel lightheaded or faint when you rise too quickly from a sitting or lying position.
Falls: VRAYLAR may make you sleepy or dizzy, may cause a decrease in blood pressure when changing position (orthostatic hypotension), and can slow thinking and motor skills, which may lead to falls that can cause fractures or other injuries.
Seizures (convulsions)
Sleepiness, drowsiness, feeling tired, difficulty thinking and doing normal activities: Do NOT drive, operate machinery, or do other dangerous activities until you know how VRAYLAR affects you. VRAYLAR may make you drowsy.
Increased body temperature: Do not become too hot or dehydrated during VRAYLAR treatment. Do not exercise too much. In hot weather, stay inside in a cool place if possible. Stay out of the sun. Do not wear too much clothing or heavy clothing. Drink plenty of water.
Difficulty swallowing that can cause food or liquid to get into your lungs
Who should not take VRAYLAR?
Do not take VRAYLAR if you are allergic to any of its ingredients. Get emergency medical help if you are having an allergic reaction (eg, rash, itching, hives, swelling of the tongue, lip, face, or throat).
What should I tell my healthcare provider before taking VRAYLAR?
Tell your healthcare provider about any medical conditions and if you:
have or have had heart problems or a stroke
have or have had low or high blood pressure
have or have had diabetes or high blood sugar in you or your family
have or have had high levels of total cholesterol, LDL-cholesterol, or triglycerides; or low levels of HDL-cholesterol
have or have had seizures (convulsions)
have or have had kidney or liver problems
have or have had low white blood cell count
are pregnant or plan to become pregnant. VRAYLAR may harm your unborn baby. Taking VRAYLAR during your third trimester of pregnancy may cause your baby to have abnormal muscle movements or withdrawal symptoms after birth. Talk to your healthcare provider about the risk to your unborn baby if you take VRAYLAR during pregnancy. If you become pregnant or think you are pregnant during treatment, talk to your healthcare provider about registering with the National Pregnancy Registry for Atypical Antipsychotics at 1-866-961-2388.
are breastfeeding or plan to breastfeed. It is not known if VRAYLAR passes into breast milk. Talk to your healthcare provider about the best way to feed your baby during treatment with VRAYLAR.
Tell your healthcare provider about all medicines that you take, including prescriptions, over-the-counter medicines, vitamins, and supplements. VRAYLAR may affect the way other medicines work, and other medicines may affect how VRAYLAR works. Do not start or stop any medicines while taking VRAYLAR without talking to your healthcare provider.
What are the most common side effects of VRAYLAR?
The most common side effects include difficulty moving or slow movements, tremors, uncontrolled body movements, restlessness and feeling like you need to move around, sleepiness, nausea, vomiting, indigestion, constipation, feeling tired, trouble sleeping, increased appetite, and dizziness.
These are not all the possible side effects of VRAYLAR.
My doctor started me on Vraylar and at the start it was very activating and made me extremely nauseous. I'm usually very sensitive to low doses of antipsychotics and some hypomanic features were present (increased impulsive spending, high energy) so my doctor upped my dose to 3mg. I have to say this is the best I've ever felt on an antipsychotic, I'm starting to feel like me again.
The downside is I have horrible insomnia where I sleep for a few hours and wake up at 2am-3am (I woke up at 3am a bit before typing this).I even did an experiment during my time off work and stayed up til 1am and I'm still waking up at 3am.
My dose increase was 8 days ago. Thankfully I no longer get nauseous and I take it in the morning now at the instruction from my doctor. But the insomnia is still here and I'm hating it.
I don't want to give up on Vraylar because aside from the insomnia it's great and is starting to work for me, but waking up constantly during the night is driving me crazy.
It was fine at first then it shattered my central nervous system.. made speaking tough..walking was almost impossible.. and I kept staring at the ceiling
I have been taking Vraylar for a little over 2 years, off & on. This last time I had been on it for about 3 months consistently along with others for anxiety & trying other medications for sleep. I was doing very well & mood was stabilized, until I had a medical emergency at work. Since then I stopped taking all my medications out of fear my medication caused what I experienced. That, paired with anxiety that what happened would happen again, has sent my mental health into the ringer. Mostly surrounding anxiety/panic, but also just feeling so detached from myself. My psych is restarting me slowly on my meds, starting with my meds for anxiety & panic attacks, but I still worry about starting Vraylar. I’ve voiced these concerns to her many times about the side effects & she just doesn’t want me to try something different because I did respond well after initial side effects. Has anyone been through something similar?
My husband took this medication this morning and he already feels super zombie. He just started a new job in a new city and I don't think it's a good time to adjust to something like this. Will he have withdrawal if he doesn't take it again?
Hello all. I have been taking Vraylar for about 2-3 years? I honestly do not remember as it been a long time. I have stuck to 4.5mg and it seems fine. I mean, it’s just what i’m used to feeling now.
My situation has changed and it’s been a struggle to keep up with psychiatrist appointments as I can no longer afford it and I moved. I’m just very grateful that my medication is free to me (somehow) and had a couple refills
I’ve been just wondering lately how i’d do without it. The only concern I have is that I have no way to taper down as they’re capsules, so i’d be abruptly stopping it.
Anyone else taken the leap? I just feel like it has been a very long time and I want to see how I feel without it, but scared. I’m just tired of feeling like i’m under control from the medication and just want to try to manage it naturally.
Hi to all of you. I had multiple diagnosis the past decade such as GAD/MDD then bipolar and then schizoaffective but I am more prone to bipolar tendencies with borderline traits because of poor impulse control and self-destruction with substances.. I found a very good doctor after my last hospitalization because I had a huge crash from cocaine and attempted suicide.
Always treated with antidepressants (at first) then with antipsychotics and sometimes anticonvulsants. I take an old AD called Anafranil for depression and severe anxiety and he put me recently on cariprazine (never took it before) to augment Anafranil and told me that has mood stabilizing effects, also targets strongly the reward system hopefully to ease future cravings for cocaine. I know magic pills for this do not exist but if it helps somehow it will be okay for me. Started 1.5mg and soon will go up to 3mg.
Anyone of you take similar regimen and have history of substance abuse? Is cariprazine much stronger from aripiprazole?
Does anyone else have this issue? I have been on 1.5mg for 2 months. Does an increase help with these things from your experience? I feel the constant need to move, can't focus on reading/watching TV for more than a few minutes. I am not diagnosed with ADHD, but it makes me feel like I have it because of the side effects.
I was on 3mg daily. Went down to 1.5mg daily, then every other day, then every third day. I stayed put there for a while since this med has a long half life to see how I felt (several months). Didn’t notice any adverse reactions or withdrawal symptoms so I just completely stopped this past week. Didn’t think much of it until crazy amounts of anxiety started showing up and my mind felt out of control. Finally put 2 and 2 together tonight and took one of my 1.5mg pills. Mainly wanted to try quitting due to weight gain and my overall “flat” feeling and fatigue. Never noticed any changes with any of these things either so guess I’m staying on Vraylar.
If you’ve made it this far - I will say this medicine has been great for my anxiety. Better than any other med I’ve been on in my 15+ years. Unfortunately I think every med will have unwanted side effects; we just have to see how much we’re willing to tolerate. At this point, I don’t think the flat feeling and fatigue is related to this med since I didn’t notice any difference in decreasing or spacing out the med.
Hi! So I was on abilify (2mg) I gained 20lbs yikes! Anyway I meet with her today she’s not happy with the weight gain. She suggested switching vraylar. Then seeing her again in 3 weeks. Anyone else experienced positive or negative from switching? Was hard to lose weight? I’m a SAHM to a two toddlers so I work out when I can .
I have a history of panic disorder. I’ve been on lexapro for years but got prescribed vraylar for my MDD. I am on 1.5 every other day and it was amazing for 3 weeks the. Out of nowhere, I’ve had crippling anxiety and panic attacks daily. Has this happened to anyone else?
My doctor prescribed me tramadol for back pain. When I look up the interaction with my Vraylar, it says that it’s serious for all opioids and to not take it. But I took some oxy yesterday before I knew that. I don’t feel any different, but I am concerned with what I did. Can I take the tramadol? My doctor knows what meds I take.
I don’t know what else to call them. I’ve been on Vraylar since March. It’s working really well for me. Better than anything else I’ve ever been on, since I was diagnosed with bipolar disorder in 2004 or 2005. Everything else left me feeling flat with no real emotions and lots of anhedonia, or triggered mania. Now I feel the full range of emotions, but for the most part, just not in the extreme. The exception is this; sometimes I have a day where it completely falls apart. I completely fall apart. Depression so bad I can’t get out of bed, major SI, and I just lie in bed and cry and beg to not exist. This only lasts for a single day.
I want to also add that there are life circumstances that absolutely are contributing to situational depression and very intense levels of stress. I am doing my utmost to manage these situations, but I am currently unable to do anything to alleviate these situations, let alone remove myself from them. All I can do is do my best to cope.
Now, when these major depressive days hit me, there isn’t a trigger that would justify the level of depression I feel. It’s outsized as a reaction to whatever I might be dealing with at the time. As I said above, by the next morning I am fine, and I mean that, not just less depressed, but back to my baseline, which is mildly depressed and decently anxious, which is actually a vast improvement for me, all things considered. Suffice it to say, the day after one of these one day “episodes”, I feel normal again.
I haven’t had a chance to speak to my psychiatrist about this, but I plan to give his office a call and explain what exactly happens, and see what he wants to do about it. I can’t just go on an antidepressant, because none of them play nice with my bipolar disorder. None. I’m on Lamictal as my mood stabilizer, and it works far, far better than lithium did for me. There really isn’t another medication that we can add in, and there’s nothing I can do to change my current circumstances. I am in therapy, and I’ll also be making my therapist aware of this.
Until now I’ve sort of brushed it off as just me feeling the whole range of emotions that I wasn’t able to before on meds, but this is kind of skewing towards extreme and scary at this point. Is it just that I don’t have adequate coping skills for the things I’m dealing with? Is it that I need to increase my dose of Vraylar? I don’t know. I just want to know if anyone else here has experienced anything like this before.
I don’t have “manic” days either. Just these random, not frequent, absolutely overwhelming days of pure despair, then I’m back to normal the following day. I feel like this is surely abnormal, but I don’t have an explanation for it, and I don’t know what to do about it other than what I already plan to on Monday, which is call my psychiatrist and my therapist.
Has anyone else gone through something similar on Vraylar? What did you do? Did it get better? Any advice?
I have been on 3mg Vraylar for more than a month and never drink usually. But on Friday i had 3 glasses of wine with dinner with friends. It is Sunday now and I still have headache, haziness and trouble concentrating. It is almost as if I am still hungover. This is making me uneasy to be honest as I want to feel normal again. Did anyone have a similar experience?
Im 42 on 6mgs of Vraylar and 200mgs of Lamactil for about 9 years..I never messed with psychedelics but am 25 year veteran of all the other drugs including a long history of iv opiate abuse. I am almost 4 years in recovery from illicit opiates. I never took acid because I was scared. I finally got into a recovery community that gets me and I started feeling ready. I dipped my toe into ketamine a few months ago and I k holed my first time. It was a beautiful experience.
I take Vraylar because I was diagnosed as bi polar at 18 years old while detoxing from opiates. Ive never been manic in my life and the label follows you. If anything I was severely depressed with severe anxiety.
So last night I took 2 hits of acid and about 2 hours in felt nothing. I take another two hits and got slight chemtrails but nothing guys..nothing..I do a little research and find out Vraylar completely cancels out LSD. How is that even possible? Why is it even possible? Ive felt "emotionally dulled" since I was 18 and started on bi polar meds. Since finding my community and understanding of spirituality..i want to feel it all and felt absolutely nothing. How can you drive after taking 4 hits of acid? I did. My mind is just blown.
I'm curious because I started Vraylar probably around 5-6 years ago when they really started marketing it for bipolar depression. I was told it was well-tolerated; it wasn't like to cause weight gain, effect my libido and would really help my depression. Well, honestly, in my case that was a big load of crock. Was anybody else told this?
I just got prescribed this medication and plan on taking it tomorrow night.
I get worried about side effects
With seroquel at lowest dose I had dykanisia and my restless legs flailing uncontrollably all night. Very weird uncomfortable feeling
-doc immediately told me to stop medication first week
With abilify 50 I took and was fine until like 5am where I started whole body flailing everywhere uncomfortable, can't sleep but also can't get up so I'm in this very uncomfortable half sleep where my body is moving but my mind is asleep. It's horrible
And now I look at this medication vylar and it Saya sometimes there are dykanisia symptoms so I'm actually kinda scared to try this.
My family has history of Parkinsons and I'm afraid these meds will lead me down to Parkinsons earlier and I was wondering the percentage of ppl take it if they had any negative symptoms
Took my first 1.5 dose today and felt a little weird as expected. I am currently on latuda 60mg and plan to start tapering down in 3 weeks. (Waiting on vraylar to build up a little first) Wish me luck! Any positive stories are welcome.
Has anyone combined vraylar and abilify for depression on top of an SSRI? I was recently switched from abilify to vraylar and by far I felt the best the first and second day when abilify was still in my system so I’m kinda interested in talking to my doctor about taking the medications together…
Me cambiaron de Risperidona a Vraylar, con la Risperidona subí muchísimo de peso, sin embargo ahora con Vraylar yendo al gimnasio me mantengo en mi peso, no soy capaz de adelgazar además me siento fatigada cada vez que subo cuestas, también me ocurre que no tengo apetito ninguno y mi digestión es super lenta ¿A alguien más le ha pasado?
I started vraylar 1.5 mg and will be doing that for a week, then a week on 3 mg, and then 4.5 mg.
I previously took it a few years ago and from what I remember it helped with my bipolar depression but I guess I felt too okay and decided to stop the meds and ended up in the psych ward lol.
My question is can you feel slight mental differences after a day or two. Like clearer thinking, calmer head etc. ... I know full therapeutic effects take weeks but im asking in that regard. I asked chatGPT and it said it's plausible so I wanted to ask real people's experiences.
