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
Vraylar
Abilify vs. Vraylar Dosage
Abilify
Vraylar
| 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 |
| 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
| 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
| 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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