Latuda vs. Vraylar

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

Key Takeaways

  • Latuda and Vraylar are both once-daily atypical antipsychotics approved for schizophrenia and depressive episodes of bipolar I disorder.

  • Vraylar has two extra approvals Latuda does not: bipolar I mania and add-on treatment for major depressive disorder in adults.

  • Latuda needs to be taken with a substantial meal to absorb properly, while Vraylar can be taken with or without food.

Latuda vs. Vraylar Drug Summary

Latuda

Latuda (lurasidone) is an atypical antipsychotic that blocks dopamine and serotonin receptors in the brain. It's approved for schizophrenia in adults and teens, and for depressive episodes of bipolar I disorder in adults and children 10 and older. It's taken once daily with food, alone or alongside lithium or valproate for bipolar depression.

Vraylar

Vraylar (cariprazine) is an atypical antipsychotic approved for schizophrenia, manic or mixed episodes of bipolar I disorder, bipolar depression, and as an add-on to antidepressants for major depressive disorder in adults. It's taken once daily, with or without food, and dose changes take weeks to fully take effect because of its long-acting metabolites.

Latuda vs. Vraylar Side Effects

Latuda

Most common
Nausea (up to 17%)
Extrapyramidal symptoms (up to 14%)
Somnolence (up to 14%)
Akathisia (up to 13%)

Vraylar

Most common
Nausea (up to 7%)
Extrapyramidal symptoms (up to 17%)
Somnolence (up to 7%)
Akathisia (up to 11%)

Latuda vs. Vraylar Dosage

Latuda

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 40 mg once daily At the start
Maximum dose 20-120 mg/day If needed
Dose changes 3 increases As tolerated

Vraylar

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

Latuda vs. Vraylar Indications

Latuda

Latuda treats schizophrenia in adults and adolescents ages 13 to 17. It also treats depressive episodes of bipolar I disorder in adults and children ages 10 to 17, either on its own or added to lithium or valproate.

  • Schizophrenia (adults and teens 13-17)

  • Bipolar I depression, alone (adults and kids 10-17)

  • Bipolar I depression, added to lithium or valproate

  • Taken once daily with a meal (at least 350 calories)

Vraylar

Vraylar treats schizophrenia and manic or mixed episodes of bipolar I disorder in adults. It also treats depressive episodes of bipolar I disorder, and is approved as an add-on when antidepressants alone haven't fully worked for major depressive disorder.

  • Schizophrenia (adults)

  • Bipolar I mania or mixed episodes (adults)

  • Bipolar I depression (adults)

  • Add-on for major depressive disorder (adults)

Latuda vs. Vraylar Pros and Cons

Latuda

Latuda's trial data show comparatively modest effects on weight, cholesterol, and blood sugar for an atypical antipsychotic. Its biggest practical hurdle is a strict food requirement needed for the drug to absorb properly.

Pros

  • Smaller effects on weight, cholesterol, and blood sugar than many atypical antipsychotics

  • Approved for bipolar depression in children as young as 10

  • Single starting dose for schizophrenia, without a multi-step titration

Cons

  • Must be taken with at least 350 calories of food or absorption drops sharply

  • Not FDA-approved for bipolar mania or as an MDD add-on

  • Akathisia and EPS rates climb notably at higher doses, up to 22%

Vraylar

Vraylar covers more approved uses than Latuda, including bipolar mania and adjunctive MDD treatment. Its long half-life means side effects can appear or shift weeks after starting or changing the dose.

Pros

  • Covers four FDA approvals, including bipolar mania and an MDD add-on option

  • Can be taken with or without food

  • Lower reported rates of somnolence and nausea in trials than Latuda

Cons

  • Long half-life means dose changes take weeks to fully show their effect

  • Akathisia and EPS rates run higher in bipolar mania trials, up to 28%

  • Not approved for use in adolescents or children

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