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Vraylar (Cariprazine) Side Effects & Adverse Reactions

Vraylar (Cariprazine), is an atypical antipsychotic medication approved in 2015 by the FDA for the treatment of schizophrenia and bipolar disorder.  Occasionally, Vraylar is also prescribed as an adjunct for treatment-resistant depression and off-label for anxiety disorders.  Although Vraylar is marketed as an improvement over older atypical antipsychotic medications in terms of efficacy and tolerability, many users will experience unwanted Vraylar side effects and/or adverse reactions throughout treatment.

Vraylar Side Effects (List of Possibilities)

Included below is a comprehensive list of side effects that might occur while using Vraylar (cariprazine).  Understand that side effects reported by Vraylar users may be subject to substantial individual variation, such that the: specific side effects, severities (or intensities) of those side effects, and total number of side effects experienced – will be unique to the specific user.

In other words, the side effects that you experience from Vraylar might be slightly, or perhaps significantly different than those reported by someone else.  Nevertheless, clinical trial data indicate that certain Vraylar side effects are more common than others, including: extrapyramidal symptoms (~21% of users); Parkinsonism (~18% of users); and akathisia (~14% of users).

  • Akathisia (Restlessness): One of the most common Vraylar side effects is akathisia, a movement disorder characterized by inner restlessness and the inability to remain still. Signs of akathisia include: frequent fidgeting, rocking back and forth, swaying, or pacing.  While many speculated that Vraylar might cause lower rates of akathisia than other antipsychotics (based on its mechanism of action), akathisia rates among Vraylar users are relatively high.  It is estimated that approximately 14% of Vraylar users experience akathisia as a side effect.  In fact, some sources suggest that akathisia is a leading cause of Vraylar discontinuation.  The action of Vraylar at dopamine receptor sites (D3 and D2) is thought to be the primary cause of akathisia during treatment.
  • Anxiety: Although many people will find Vraylar helpful in alleviating symptoms of anxiety, others may experience anxiety as a side effect. Data from clinical trials of Vraylar indicate that 3-6% of users will experience anxiety as a side effect.  It’s unclear as to why Vraylar causes anxiety in a subset of users, however, anxiety likely stems from individualized neurochemical incompatibility with the medication.  In other words, preexisting neurochemistry of certain Vraylar users might increase vulnerability to anxiety as a side effect.  Moreover, it’s possible that Vraylar usage may cause relaxation-induced anxiety such that a person becomes paradoxically anxious as a result of excessive physical or mental relaxation.
  • Appetite reduction: While no substantial evidence suggests that Vraylar causes increased appetite, there is evidence indicating that Vraylar causes decreased appetite in a small percentage of users. Clinical reports document appetite reduction or loss in 1-3% of Vraylar users.  It’s possible that this appetite reduction or loss is a byproduct or downstream consequence of other, more common side effects such as: constipation, diarrhea, indigestion, nausea, and/or vomiting.  If you happen to experience appetite reduction while using Vraylar, understand that this reduction could yield a bit of weight loss.
  • Blurred vision: In clinical trials, around 4% of Vraylar recipients experienced blurry vision – compared to just 1% of placebo users. This suggests that Vraylar may affect visual perception in a subset of users.  If you experience blurred vision as a side effect, it is recommended to receive regular eye examinations (from an ophthalmologist) throughout treatment to ensure that the drug isn’t causing or aggravating various eye conditions.  In most cases, blurred vision could be related to eye dryness (decreased tear production), neurotransmitter fluctuations, and/or shifts in activation within visual processing regions of the brain.
  • Cognitive impairment: Although Vraylar often helps treat cognitive symptoms of schizophrenia and/or enhance cognition, certain individuals may experience cognitive deficits as treatment-related side effects. Cognitive deficits and/or “brain fog” might occur as a result of changes in the neurotransmission of dopamine and/or serotonin facilitated by Vraylar – or as a result of downregulated CNS activation.  Examples of cognitive deficits that might occur include: difficulty concentrating; memory lapses; slowed thought speed; and impaired critical thinking.
  • Constipation: It is estimated that between 6% and 10% of Vraylar users experience constipation as a side effect. Constipation can cause gastrointestinal distress, stomach pain, indigestion, and general discomfort.  If you experience constipation while using Vraylar, it may help to increase your physical activity level, consume more dietary fiber, and/or drink more water (i.e. increase hydration) – as these may help with the passage of stools.  Nevertheless, if constipation is severe or chronic, you may need to ask your doctor about treatments.
  • Diarrhea: In 6-week trials of Vraylar for schizophrenia, and 3-week trials of Vraylar for bipolar disorder, diarrhea was recorded as a side effect in 1% to 6% of users. It appeared as though there might be a dose-dependent effect whereby diarrhea incidence increases at higher doses.  At dosages of 1.5 mg to 3 mg per day, diarrhea was reported in just 1% of users, whereas at dosages of 4.5 mg to 12 mg per day, diarrhea was reported in 4% to 6% of users.  If you experience diarrhea throughout treatment, ask a medical doctor about using an antidiarrheal medication like Imodium to help manage this side effect.
  • Dizziness: Around 3% to 7% of Vraylar users will notice dizziness as a side effect of the medication. It is unclear exactly why dizziness occurs as a side effect, however, some speculate that dizziness may emerge as a result of fluctuations in neurotransmitter levels and cerebral blood flow as facilitated by Vraylar.  Other potential causes of dizziness throughout treatment include blood pressure fluctuations, dehydration, and electrolyte imbalances.  If you feel dizzy, it is recommended to avoid operating heavy machinery and/or motor vehicles – as the dizziness may interfere with motor function.
  • Dry mouth: Though relatively uncommon, dry mouth is a Vraylar side effect that occurs in around 2% to 3% of all users. While dry mouth can be uncomfortable, it’s usually not a reason for discontinuation of Vraylar.  It is believed that modulation of neurotransmitter signaling by Vraylar might lead to decreased secretion of saliva via the salivary glands – hence the dry mouth.  If you experience dry mouth while using Vraylar, it may be helpful to chew sugar-free gum or sip on water more frequently.  Because dry mouth increases risk of cavities, it is strongly recommended to receive dental checkups if you experience severe dry mouth.
  • Dystonia: Dystonia is one of many extrapyramidal symptoms that might occur as a Vraylar side effect, characterized by repetitive muscle contractions that cause twisting or repetitive movements, along with possible fixed abnormal postures. Compared to other extrapyramidal symptoms, dystonia is relatively uncommon such that only around 2% of users exhibit this side effect.  Signs of dystonia include: neck spasms, throat tightness, difficulty breathing or swallowing, and protrusion of the tongue.  While dystonia can occur at any Vraylar dose, dystonia may be more likely to occur and/or become increasingly severe at higher doses.  Moreover, it is thought that younger individuals may be at increased risk of dystonia compared to older users.
  • Extrapyramidal symptoms: The single most common side effect of Vraylar is “extrapyramidal symptoms.” Trial data indicate that extrapyramidal symptoms occur in 15% to 29% of Vraylar users.  Extrapyramidal symptoms are understood to occur as a result of Vraylar’s interaction with D2 and D3 dopamine receptors – each of which decrease dopamine signaling.  As a result, individuals may end up experiencing dysregulation of the extrapyramidal system such that posture and skeletal muscle tone become abnormal.  Examples of extrapyramidal symptoms include: dystonia (muscle spasms and contractions); akathisia (restlessness); parkinsonism (rigid muscle tone); bradykinesia (slowed movement); tremor (involuntary movement); and tardive dyskinesia (jerky movements).
  • Fatigue: Because Vraylar has lower affinity for the H1 histamine receptor than most other antipsychotics, it is less likely to cause fatigue as a side effect. That said, fatigue occurs as a treatment-related side effect in 2% to 5% of users.  The fatigue may be accompanied by drowsiness, sleepiness (or a desire to sleep more than usual), as well as cognitive dysfunction.  In some cases, fatigue may be temporary such that it occurs over a short-term, but fades with longer-term administration of Vraylar.
  • Fever: Fever, also referred to as “pyrexia,” might occur as a side effect of Vraylar. Preliminary data suggest that 1% to 4% of Vraylar users experience pyrexia during 6 weeks of treatment.  Because fever could be the sign of a serious adverse reaction or interaction between Vraylar and another substance, it is recommended to contact a medical professional if you develop fever during treatment.  Fever may be accompanied by increased sweating, chills, or flu-like symptoms.
  • Headache: Between 9% and 18% of Vraylar users reported headache as a side effect in clinical trials, making headache a relatively common side effect. Headache may be caused by a combination of neurotransmitter and cerebral blood flow changes, and possibly by dehydration and/or electrolyte disturbances throughout treatment.  If you develop a headache while taking Vraylar, you may want to evaluate your hydration and consider drinking more water if dehydrated.  Moreover, ask your doctor about using headache relief medication if headaches become frequent and/or severe.
  • High blood pressure: Evidence suggests that some individuals may experience blood pressure increases as a side effect of Vraylar. In 6-week trials of Vraylar for schizophrenia, there weren’t any clinically relevant changes in blood pressure among Vraylar recipients when compared to baseline readings and placebo recipients.  That said, individuals using higher doses of Vraylar between 9 mg and 12 mg per day exhibited increases in supine diastolic blood pressure.  This suggests that there may be a dose-dependent effect of Vraylar on blood pressure.  If you have a history of blood pressure abnormalities or hypertension, be sure to inform your doctor and regularly monitor your blood pressure throughout treatment to ensure that it stays within the normal range.
  • Indigestion (Dyspepsia): It is estimated that between 5% and 9% of Vraylar users will experience indigestion (medically referred to as “dyspepsia”) throughout treatment – making it one of the more common side effects. In some cases, indigestion as a side effect may be accompanied by: bloating, constipation, stomach pain, and/or acid reflux.  If the indigestion becomes severe such that it’s painful or interfering with your appetite, talk to your doctor about management strategies or medications that might help.
  • Insomnia: Insomnia is understood to be a common Vraylar side effect, occurring in 8% to 13% of users. Insomnia is defined as the inability to fall asleep or maintain sleep throughout the night.  If you experience insomnia while using Vraylar, you may want to ask your doctor what he/she recommends to help you manage this reaction.  Sometimes an adjunct sleep aid might prove effective in reversing insomnia as a side effect.
  • Muscle stiffness: A small percentage of Vraylar users may experience muscle stiffness, achiness, or pain. Compared to most extrapyramidal symptoms, nonspecific musculoskeletal stiffness occurred in around 2% of individuals using Vraylar – making it relatively uncommon.  In the event that you experience muscle stiffness throughout treatment, it may be helpful to practice gentle self-massage, take a warm bath, or increase hydration (as dehydration may exacerbate stiffness).
  • Motor impairment: A subset of Vraylar users may experience impaired motor performance as a side effect. Vraylar can sometimes alter the extrapyramidal or motor system within the body as a result of D3 and D2 receptor modulation.  As a result, some users exhibit dysregulated motor function with symptoms such as: shakiness, involuntary movements, twitching, and restlessness.  Additionally, if Vraylar causes drowsiness, sedation, or somnolence (i.e. sleepiness) – this could cause motor impairment as a result of decreased arousal, alertness, and vigilance.  If you experience motor impairment during treatment, avoid operating heavy machinery and/or motor vehicles.
  • Nausea: Trial results indicate that rates of nausea among Vraylar users range from 5% to 13%. Medical literature reports that nausea occurs in around 8% of all users, making it a relatively common side effect.  Nausea may be accompanied by gastrointestinal distress or constipation, and in some cases, might provoke vomiting.  If you recently began using Vraylar, understand that the nausea may be temporary and eventually subside as your body becomes better adjusted to the medication.  Nevertheless, report any nausea that you experience to a medical doctor and ask whether using an antiemetic agent might be helpful in counteracting this side effect.
  • Parkinsonism: Of all extrapyramidal symptoms associated with Vraylar treatment, Parkinsonism is the most common. Some data suggest that between 13% and 26% of all Vraylar users end up with Parkinsonism – making it one of the most common side effects.  Parkinsonism is characterized by symptoms such as: tremor, slowed movement, rigidity, and postural instability.  It is thought that Parkinsonism as a side effect may result from decreases in dopamine signaling via Vraylar-mediated modulation of D3 and D2 receptors.  Moreover, incidence of Parkinsonism appears dose-dependent such that higher doses of Vraylar are more likely to cause Parkinsonism than lower doses.
  • Sleepiness (somnolence): Between 5% and 10% of individuals using Vraylar experience sleepiness (i.e. somnolence) as a side effect. Furthermore, it seems as though likelihood of becoming sleepy while using Vraylar is dose-dependent such that high doses are more likely to induce sleepiness than lower ones.  Because somnolence can interfere with motor function (balance and coordination), it is recommended to abstain from operating a motor vehicle or heavy machinery until the somnolence subsides.  If you constantly feel drowsy or tired while using Vraylar, this side effect could be the reason.
  • Stomach pain: It may be relatively common to experience stomach pain as a side effect of Vraylar. Clinical trial data indicate that abdominal pain occurs in 3% to 8% of Vraylar users, and we know that constipation, diarrhea, indigestion, and vomiting are all relatively common side effects of Vraylar that could lead to stomach pain.  If you develop frequent stomach aches and/or pains on Vraylar, discuss this reaction with a doctor.  Targeting the gastrointestinal distress with over-the-counter medications may prove helpful in alleviating some of the stomach pain you’re experiencing.
  • Tardive dyskinesia: Treatment with Vraylar may cause some individuals to develop tardive dyskinesia as a side effect.  Tardive dyskinesia is a neurological condition characterized by repetitive, involuntary, and/or purposeless movements.  Because tardive dyskinesia can become permanent, it is imperative that anyone who experiences this side effect reports it to a medical doctor as soon as possible.  Signs of tardive dyskinesia include: grimacing, tongue movements or protrusion, smacking of the lips, puckering, rapid blinking of the eyes, and/or rapid movements of the arms, legs or trunk region.  It is thought that tardive dyskinesia risk may increase in accordance with dose such that high doses yield greatest risk.
  • Tremor: Tremor could occur as a Vraylar side effect due to dysregulation of the extrapyramidal or motor system within the body. Extrapyramidal dysregulation as a result of Vraylar treatment is understood to occur primarily from altered dopaminergic signaling within the brain.  Vraylar modulates activity at D3 and D2 receptors which could affect motor function and lead to tremor.  If you end up with tremor or uncontrollable, involuntary movements of the body – report it to your doctor as soon as possible.
  • Weight change: Research suggests that Vraylar causes weight change in up to 62% of users. In most cases, weight gain or loss attributable to Vraylar will be negligible or clinically irrelevant.  That said, up to 27% of Vraylar users might experience clinically significant weight gain and up to 11% of Vraylar users might experience clinically significant weight loss.  Clinically significant weight change is defined as a change in body weight of at least 7% (increase or decrease) compared to pre-treatment (baseline).
  • Vomiting: If you become nauseous while using Vraylar, there’s a chance that you may also end up vomiting. Vomiting occurs in 4% to 10% of all Vraylar users, making it a relatively common side effect.  In some cases, vomiting may only occur in the early stages of treatment and subside as your body becomes better adjusted to Vraylar’s effects.  That said, vomiting could also be the sign of an adverse reaction.  For this reason, any vomiting you experience during treatment should be immediately reported to a medical doctor.

Vraylar Adverse Effects & Reactions (List)

Listed below are uncommon, rare and/or adverse reactions that might occur in a small percentage of Vraylar (cariprazine) users.  In the event that you or someone you know develops or exhibits any of the adverse effects listed below, it is necessary to seek emergency medical attention.  Before using Vraylar, it may be helpful to familiarize yourself with all potential adverse reactions so that if one develops, you can easily identify and report it to your doctor.

  • Allergic reaction: While allergic reactions to Vraylar haven’t been reported in the literature, it’s possible that select individuals are allergic to Vraylar and/or its components. Signs of an allergic reaction to Vraylar include: anaphylaxis, swelling (face, lips, tongue, throat), shortness of breath, hives (rash), fever, and/or sweating.  Other signs of an allergic reaction might include: itchiness, nausea, diarrhea, and/or vomiting.
  • Cerebrovascular events: In clinical trials of antipsychotics, increased rates of cerebrovascular events were observed among antipsychotic users compared to placebo users. For this reason, you may be at increased risk of cerebrovascular events such as stroke while using Vraylar.  If you have a history of cerebrovascular events and/or a medical condition that increases risk of cerebrovascular problems, caution and monitoring is necessary while using Vraylar.
  • Depression & suicidal thoughts: While most evidence suggests that Vraylar facilitates an antidepressant effect, it’s possible that some individuals might become depressed and/or experience suicidal thoughts as an adverse reaction to the medication. Not everyone’s preexisting or baseline neurochemistry may react well to the neurochemical modulation exerted by Vraylar.  Simultaneous modulation of various dopaminergic and serotonergic targets with Vraylar might make a subset of individuals experience heightened depression and/or suicidality.  Emergency medical attention is necessary for those who end up increasingly depressed or suicidal while using Vraylar.
  • Difficulty swallowing (Dysphagia): Antipsychotics have been linked to dysphagia (difficulty swallowing) and esophageal dysmotility (irregular contractions in the esophagus). Anyone with a history of breathing problems (e.g. shortness of breath, asthma, etc.) should be regularly monitored for dysphagia while using Vraylar.
  • Dyslipidemia: Treatment with antipsychotic medications like Vraylar can sometimes cause dyslipidemia, or abnormalities in levels of plasma cholesterol, triglycerides, or both. Because changes in levels of plasma cholesterol and triglycerides could increase risk of developing atherosclerosis and various cardiovascular problems, it is advised to cautiously monitor or test lipids prior to using Vraylar – as well as at various intervals throughout treatment.
  • Fainting or Falling: Antipsychotics can increase one’s risk of fainting and falling. Fainting and falling are thought to occur as adverse reactions stemming from: blood pressure changes (and orthostatic hypotension); motor impairment; and/or sensory instability.  Fainting and falling may cause fractures (broken bones) or other severe injuries.  Anyone with a preexisting medical condition and/or using medications that simultaneously increase risk of fainting and falling – might be more likely to faint or fall while using Vraylar.
  • High blood sugar: Though not common, some individuals may experience high blood sugar (hyperglycemia) as an adverse reaction to Vraylar. If you have a history of diabetes, be sure to carefully monitor your blood sugar while using Vraylar.  Moreover, if you notice hyperglycemia during treatment, report it to your doctor as soon as possible.  Certain individuals may need to discontinue Vraylar use if the hyperglycemia becomes severe or puts them at risk of developing Type 2 diabetes.  Signs of hyperglycemia include: blurred vision, increased thirst, fatigue, and frequent urination.
  • Leukopenia, neutropenia, agranulocytosis: It is understood that antipsychotic medications can cause leukopenia, neutropenia, or agranulocytosis as adverse reactions. These conditions are associated with abnormal blood cell counts and increased risk of death.  To decrease chances of developing leukopenia, neutropenia, and agranulocytosis while using Vraylar – it is recommended to receive regular blood work throughout treatment.  A medical doctor will be able to evaluate the blood work and determine whether abnormalities are developing or have developed as a result of Vraylar.
  • Neuroleptic Malignant Syndrome (NMS): Neuroleptic malignant syndrome is a potentially life-threatening adverse reaction that can occur while using antipsychotic medications. Signs of neuroleptic malignant syndrome include: altered mental status, autonomic instability (e.g. dizziness, heart rate fluctuations, etc.), disorientation, fever, and musculoskeletal rigidity.  Individuals with neuroleptic malignant syndrome may also exhibit increased creatine phosphokinase, rhabdomyolysis (myoglobinuria), and/or renal dysfunction.  If neuroleptic malignant syndrome occurs from Vraylar, discontinuation and medical supervision are necessary.
  • Orthostatic hypotension: Orthostatic hypotension refers to a sudden drop in blood pressure when transitioning from being seated or lying down – to a standing position. Signs of orthostatic hypotension might include lightheadedness, dizziness, and blurred or foggy vision.  In some cases, orthostatic hypotension may be severe enough to cause syncope (fainting).  If you experience orthostatic hypotension while using Vraylar, report it to your doctor.  It is understood that risk of orthostatic hypotension and syncope is highest when a person first starts taking Vraylar, as well as after dosage changes – particularly dosage increases.
  • Respiratory disturbances: Vraylar can cause respiratory disturbances in up to 4% of users. Examples of common respiratory disturbances that might occur while using Vraylar include: cough, dysphagia, and shortness of breath.  Report any respiratory disturbances that you experience during treatment to a medical professional as soon as they are noticed.
  • Seizures: Akin to other antipsychotic medications, Vraylar may cause seizures as an adverse reaction in a small percentage of individuals. It is thought that persons with a history of neurological conditions and/or seizures may be at greatest risk of experiencing seizures as an adverse reaction.  In the event that seizures result from usage of Vraylar, the medication will likely necessitate cessation or dosage adjustment.
  • Sweating: Excessive sweating or hyperhidrosis might occur in a small number of Vraylar users as an adverse reaction. In some cases, sweating may be due to dysregulation of body temperature – another side effect that Vraylar can sometimes cause.  If you’re sweating frequently throughout Vraylar treatment, be sure to regularly monitor your body temperature and report any major changes to a medical doctor.
  • Tachycardia: An adverse reaction that occurs in 2% to 3% of Vraylar users is tachycardia, or abnormally rapid heart rate – usually exceeding 100 beats per minute. Tachycardia may also be accompanied by irregular heartbeat or palpitations.  Anyone who experiences tachycardia should contact a medical professional as soon as possible.  Tachycardia may increase risk of serious cerebrovascular events if left unmanaged.

Note: The list of Vraylar side effects and adverse reactions might be incomplete.  If you know of additional Vraylar side effects that were not reported in this article, be sure to document them in the comments section.

  • Source: https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/204370lbl.pdf
  • Source: https://www.ncbi.nlm.nih.gov/pubmed/28101322
  • Source: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0027009/

Variables that may influence Vraylar side effects

There are a myriad of variables that could influence the side effects that you experience while using Vraylar, as well as the severities of those side effects.  Potentially-influential variables in determining side effects of Vraylar include: Vraylar dosage; duration of Vraylar treatment; use of other substances (e.g. medications) with Vraylar; and individual factors (e.g. lifestyle, genetics, etc.).  For most individuals, a combination of these variables can explain why certain users end up with more debilitating side effects in comparison to others.

  1. Vraylar dose (High vs. Low)

The specific dosage of Vraylar that you’re using might determine the specific side effects that you experience, as well as the severities of those side effects.  Clinical trial data indicate that several side effects may be more common and/or of greater severity among high-dose Vraylar users than lower-dose users.  For example, side effects such as: diarrhea, dystonia, high blood pressure, and Parkinsonism are statistically more likely to occur in recipients of high doses.

In most cases, Vraylar is prescribed at dosages ranging from 1.5 mg to 6 mg per day for the management of schizophrenia, and 3 mg to 6 mg per day for the management of bipolar disorder.  Because higher dosages modulate neurophysiology to a greater extent than lower dosages, persons using 1.5 mg (the lowest dose) will probably experience fewer side effects than if they were using 6 mg (a high dose).

  1. Duration of Vraylar treatment (Short-term vs. Long-term)

The total amount of time over which you’ve consistently used Vraylar could influence the prevalence and severities of your side effects.  It is understood that new or short-term Vraylar users may experience side effects due to lack of neurophysiologic adaptation to the drug.  In other words, because the brain and CNS haven’t fully adapted to the effects of Vraylar, side effects occur due to lack of adaptation.

With longer-term Vraylar use, many side effects experienced in the short-term (due to lack of neurophysiologic adaptation) will subside – the brain and CNS will eventually become better adjusted to Vraylar’s presence.  Nevertheless, while side effects stemming from lack of neurophysiologic adaptation can diminish with a longer-term of treatment, new side effects might also occur with longer-term use.  Long-term use of Vraylar could trigger certain side effects as a result of dosing increases and/or long-term physiologic adaptations.

  1. Administering other substances

It is thought that administering other substances such as medications, illicit drugs, or supplements with Vraylar – might influence the side effects that you experience.  Certain co-administered substances might potentiate or worsen the side effects of Vraylar, yet other substances might offset or attenuate the side effects of Vraylar.  Available data suggest that Vraylar is unlikely to cause clinically-relevant pharmacokinetic interactions, however, there’s a chance Vraylar could interact with another substance pharmacodynamically.

In other words, even if there aren’t any metabolism-related (i.e. pharmacokinetically-mediated) interactions between Vraylar and another substance, there could be interaction effects caused by overlapping neurochemical modulation (e.g. Vraylar and another substance acting synergistically on neurochemistry).  Certain co-ingested substances that act in neurochemical opposition to Vraylar’s effects might decrease its therapeutic efficacy, but also might counteract some of its side effects.

Additionally, there may be substances that don’t interact with Vraylar in any way, but help manage its side effects.  For example, if you’re experiencing a headache while using Vraylar and you’re regularly using a substance that decreases likelihood of headache – this might explain your lack of headache as a side effect.  Lastly, you should consider that side effects you’ve mistakenly attributed to Vraylar might be completely caused by another substance that you’re using along with it.

  1. Individual factors

A variety of individual factors might determine which side effects a person experiences on Vraylar.  Individual factors that could influence side effect occurrence and severity, include: administration specifics; age; gene expression; lifestyle; and medical conditions.  In other words, a young Vraylar user with an unhealthy lifestyle and numerous medical conditions might be at greater risk of experiencing unwanted side effects than a middle-aged Vraylar user with a healthy lifestyle and a single medical condition.

  • Administration specifics: The time of day at which Vraylar is administered and whether it is administered with food versus on an empty stomach – might determine side effects that occur.  Certain individuals may find side effects to be more extreme and/or numerous when Vraylar is administered in the morning compared to the evening; and vice-versa.  Others might report that side effects are worse when taking Vraylar on an empty stomach versus with food; and vice-versa.  Though administration specifics won’t influence side effects in all users, they should be considered as possible influencers.
  • Age: It is understood that the age of a person using Vraylar might increase or decrease likelihood of side effects.  For example, extrapyramidal symptoms like dystonia tend to be more common in younger users than older users.  On the other hand, adverse reactions like fainting and falls may be more common in older or elderly Vraylar users.
  • Genetics: Genetic and/or epigenetic expression might determine how well a person tolerates Vraylar. Genes that encode for various neurotransmitter receptors (e.g. D3, D2, 5-HT2B, 5-HT1A) might determine how someone reacts to Vraylar in terms of therapeutic effect and side effects.  Though research hasn’t been conducted to determine the impact of gene expression on Vraylar side effect occurrence, it’s reasonable to speculate that there are gene-drug interactions.
  • Lifestyle (diet, sleep, stress): The lifestyle of a Vraylar user could influence the prevalence and/or severity of side effects. Living a healthy lifestyle by consuming a nutrient-dense diet, adhering to a sleep schedule, exercising regularly, and keeping stress levels as low as possible – might prevent side effects or reduce their severities.  Living an unhealthy lifestyle by consuming a diet devoid of adequate nutrition, sleeping poorly, staying sedentary, and/or failing to manage stress – might exacerbate certain Vraylar side effects.
  • Medical conditions: The preexisting medical condition(s) being treated with Vraylar, as well as additional medical diagnoses – might determine the side effects a person experiences throughout treatment. For example, concurrent cerebrovascular conditions, diabetes, epilepsy, and/or hyperlipidemia might substantially increase odds of experiencing adverse reactions while using Vraylar.  If you have no additional medical conditions (besides the condition for which you’re using Vraylar to treat), you may be at lower risk of adverse reactions.

Vraylar (Cariprazine): Do the benefits outweigh the side effects?

Assuming you’re using Vraylar, it is recommended that you regularly assess whether the therapeutic effects provided by the medication outweigh any unwanted side effects that you experience.  It is thought that the majority of individuals taking Vraylar will experience significant therapeutic benefit from the medication in managing symptoms – along with several unwanted side effects.  For person’s attaining significant therapeutic benefit from Vraylar, it’s usually recommended to accept a few unwanted side effects and/or find ways to manage them.

That said, in some cases, the side effects of Vraylar may significantly interfere with a person’s ability to function (at work, school, etc.) or jeopardize their health.  In the event that side effects become severe and/or debilitating enough impair functioning and/or endanger health, it may be necessary to discontinue Vraylar treatment [with the help of a medical doctor] – regardless of whether the medication was effective in controlling symptoms.

If you aren’t quite sure about whether the therapeutic benefits of Vraylar outweigh its side effects, you may want to consider keeping a daily journal throughout treatment.  In the journal, you could document (on a daily basis): how well Vraylar seems to be working, how you feel while using Vraylar, and side effects or adverse reactions that you experience.  Maintaining a journal will help you get a better understanding of whether Vraylar is effective and tolerable for your specific physiology.

Possible ways to reduce Vraylar side effects

Included below is a list of strategies that might prove helpful in decreasing the quantity and/or severities of Vraylar side effects that you experience.  Realize that the efficacies of these side effect mitigation strategies will likely vary among Vraylar users – not everyone will find them helpful.  Additionally, understand that you should never alter aspects of Vraylar treatment without first consulting a medical doctor or psychiatrist to verify safety.

  • Vraylar dosage adjustment: Evidence suggests that high dosages of Vraylar may increase the likelihood of certain side effects. Because larger doses exert a more substantial effect upon neurophysiology, side effect severity may also be greater at high doses.  One potential strategy for reducing the number and/or severity of side effects is to reduce Vraylar dosage.  The aim should be to find the “minimal effective dose” or lowest dosage needed to attenuate neuropsychiatric symptoms.
  • Consider concurrent substances: It may be possible to manage or treat side effects of Vraylar with the use of concurrent substances. For example, if Vraylar is causing headaches, using an over-the-counter headache relief medication may help control them.  Another example might be using a laxative as-needed to help manage a side effect like constipation.  Discuss side effects that you’re experiencing with your doctor to determine whether it’s safe to use concurrent substances for the management of unwanted side effects.
  • Modify administration: For some individuals, modifying the administration of Vraylar might help reduce the number and/or severity of side effects. If you’re currently taking Vraylar in the morning, you might want to try taking it in the afternoon or evening to determine whether different times of day seem to alter your side effects.  Additionally, if you’re taking Vraylar on an empty stomach, you might want to try taking it with food (or vice-versa) and see if your side effects improve.
  • Stop using unnecessary substances: Assuming you take other substances with Vraylar, it is recommended to evaluate whether they are medically necessary. Any substances that are considered medically-unnecessary (by a medical doctor) should be discontinued while using Vraylar.  Discontinuation of medically-unnecessary substances will eliminate the possibility of interaction effects and/or side effects attributable to those substances.
  • Continued Vraylar use: It is common for a subset of individuals to experience side effects in the short-term (first 2 to 8 weeks) of Vraylar treatment due to lack of neurophysiologic adaptation to the medication. In some cases, the short-term side effects may completely abate or diminish in severities with longer-term Vraylar use.  If you’re a new Vraylar user, it may be necessary to continue treatment for a longer duration before side effects will subside.

Note: If none of these strategies seem to help reduce Vraylar side effects and/or make them easier to manage, talk to a medical doctor.  It may be necessary to undergo Vraylar withdrawal and/or transition to a more tolerable medication.

Have you experienced Vraylar side effects?

If you’re using Vraylar and have experienced side effects, document those side effects in the comments section below.  Mention the specific side effects that you’ve experienced, and rate the severities of those side effects on scale from 1 to 10 (with “1” being least severe and “10” being most severe).  To help others best understand your personal situation, share some details in your comment such as: your Vraylar dosage; your age; whether you use other substances with Vraylar (e.g. medications and/or supplements); and how long you’ve been taking Vraylar.

If you’ve tried multiple doses of Vraylar, did you find one dose easier to tolerate than another? (Or was side effect occurrence and severity relatively equal at both doses?).  In the event that you’re using other substances with Vraylar, are you sure that the side effects you’re experiencing aren’t caused by an interaction-related effect (between Vraylar and the other agent) – or that the side effects aren’t completely attributable to the other substance?

If the side effects that you’ve experienced while using Vraylar have been severe, have you tested any of the mitigation strategies discussed in this article?  Are there any specific strategies you’ve found to be helpful in managing Vraylar side effects?

In summary, you should realize that no antipsychotic medication is universally well-tolerated.  Certain individuals may respond favorably to Vraylar, whereas others might find its side effects to be downright debilitating.  If you find Vraylar difficult to tolerate, discuss alternative interventions with a psychiatrist.

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{ 1 comment… add one }
  • Haelan April 29, 2018, 1:20 am

    I’ve been on Vraylar 3 weeks at a dose of 4.5mg. I’m a 44-year-old female with schizoaffective disorder. I also take 5mg of haloperidol twice a day. The only side effect I’ve experienced with Vraylar is a feeling that I want to eat a lot more and more often.

    I crave junk foods all the time and have had to really exercise restraint in order to not gain a lot of weight…although I did gain about 5 lbs in a few weeks. That being said, I feel Vraylar has helped to attenuate some of my symptoms but not all.

    I don’t know if the trade-off is worth this huge increase in appetite, but I’ve been on most of the atypicals and Vraylar has helped the most. If I start gaining a lot more weight I will have to consider ceasing the use of Vraylar. No other side effects have presented at this time.

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