Abilify vs. Vraylar

See how Abilify and Vraylar compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Abilify and Vraylar are both atypical antipsychotics used for schizophrenia and bipolar I disorder, but Vraylar is also FDA-approved for bipolar depression, a use Abilify's label doesn't include.

  • Abilify is available as a low-cost generic, while Vraylar has no generic version and typically costs far more out of pocket.

  • Akathisia is a common side effect of both drugs, though rates reported in Vraylar's bipolar mania trials were notably higher than those seen with Abilify in schizophrenia trials.

Abilify vs. Vraylar Drug Summary

Abilify

Abilify (aripiprazole) is an atypical antipsychotic that works as a partial dopamine agonist. It's FDA-approved for schizophrenia, bipolar I disorder, adjunctive treatment of major depressive disorder, irritability linked to autism, and Tourette's disorder. It comes as a tablet or oral solution taken once daily, with or without food.

Vraylar

Vraylar (cariprazine) is an atypical antipsychotic that also acts on dopamine and serotonin receptors. It's FDA-approved for schizophrenia, bipolar I disorder including manic, mixed, and depressive episodes, and as an add-on for major depressive disorder. It's taken as a once-daily capsule, with or without food.

Abilify vs. Vraylar Side Effects

Abilify

Most common
Insomnia (up to 18%)
Nausea (up to 15%)
Akathisia (up to 10%)
Headache (up to 27%)

Vraylar

Most common
Insomnia (up to 9%)
Nausea (up to 8%)
Akathisia (up to 20%)
Movement problems (up to 28%)

Abilify vs. Vraylar Dosage

Abilify

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 10-15 mg/day At the start
Maximum dose 10-30 mg/day If needed
Dose changes 2 increases As tolerated

Vraylar

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 1.5 mg/day Day 1
Maximum dose 1.5-6 mg/day If needed
Dose changes 3 increases Every day

Abilify vs. Vraylar Indications

Abilify

Abilify treats a wide range of psychiatric conditions in both adults and children. It's approved for schizophrenia and bipolar I disorder, and used alongside antidepressants for major depressive disorder that hasn't fully responded to treatment alone. It also has approvals outside psychiatry, for autism-related irritability and Tourette's disorder.

  • Schizophrenia (adults and adolescents 13+)

  • Bipolar I disorder: manic or mixed episodes

  • Adjunct therapy for major depressive disorder

  • Irritability linked to autistic disorder

Vraylar

Vraylar is approved for adults with schizophrenia and for the full range of bipolar I disorder episodes, including depression, which sets it apart from many other antipsychotics. It's also used as an add-on to antidepressants for major depressive disorder in adults. It doesn't carry any pediatric or adolescent approval.

  • Schizophrenia (adults only)

  • Bipolar I disorder: manic or mixed episodes

  • Bipolar I disorder: depressive episodes

  • Adjunct therapy for major depressive disorder

Abilify vs. Vraylar Pros and Cons

Abilify

Abilify has one of the longest track records among atypical antipsychotics and is available as an inexpensive generic. It covers more approved age groups and uses than Vraylar, though it isn't specifically approved for bipolar depression.

Pros

  • Generic aripiprazole often costs $10 to $50 per month without insurance

  • Approved for autism-related irritability and Tourette's disorder

  • Approved for adolescents with schizophrenia or bipolar mania

Cons

  • Not specifically FDA-approved for bipolar depression

  • Requires step-by-step titration for the depression add-on use

  • Shorter half-life means missed doses are felt sooner

Vraylar

Vraylar covers bipolar depression directly, a use Abilify's label doesn't include, and its long half-life makes occasional missed doses less disruptive. It has no generic option, so it typically costs far more out of pocket than aripiprazole.

Pros

  • FDA-approved specifically for bipolar depression

  • Long half-life softens the impact of an occasional missed dose

  • Simple once-daily titration schedule for most uses

Cons

  • No generic; brand-name cost often runs $1,000 to $2,000 per month without insurance

  • Higher reported rates of EPS and akathisia in clinical trials

  • No pediatric or adolescent approval for any condition

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