Discover the differences between Rexulti and Abilify and how a genetic test can help you choose the right antipsychotic medication for your needs.

Rexulti® vs. Abilify®

Antipsychotics are a group of medications used to treat clinically diagnosed psychotic disorders (also referred to as mental/mood disorders), some of which include schizophrenia, major depressive disorder, and various forms of psychosis. Rexulti and Abilify fall into the classification of antipsychotics; both drugs may help the individuals who need them achieve reduced psychotic symptoms such as hallucinations, major depression, delusions, and manic and depressive episodes. In the United States alone, about 7 million people take antipsychotic medications such as Rexulti and Abilify to help manage their symptoms.1 There are benefits to using each, which we will cover below. Continue reading to learn about what Rexulti and Abilify are, how Rexulti and Abilify differ from one another and how they are similar, and how DNA testing can help you decide whether Rexulti or Abilify would be better for you.

Rexulti vs Abilify: What are They?

The National Institute of Mental Health estimates that three out of every 100 people will experience a form of psychosis at some point in their lives. The term “psychosis” may include hallucinations (such as hearing, seeing, smelling, tasting, or having a sensation about something that is not real or present) but it may also include paranoia, delusions, and disordered thoughts and speech. Medications like Rexulti and Abilify aim to target the parts of the brain associated with hallucinogenic thoughts and psychosis to help reduce or eliminate them. There are various ways to treat psychosis; some people seek talk therapy in the form of cognitive behavioral therapy (CBT) with individual or group therapy. Others layer on antipsychotic medications such as Rexulti or Abilify.

Both Brexpiprazole (Rexulti) and Aripiprazole (Abilify) can be helpful for the aforementioned conditions and the symptoms associated with them, but how they interact with individuals depends on individualized metabolisms, body chemistry makeup, and many other factors.

It is important to understand the differences between Rexulti and Abilify so you can make an educated decision about which one will be best for you. Let’s take a close look at how each of these antipsychotic medications works.

What is Rexulti?

Brexpiprazole (Rexulti) is an atypical antipsychotic medication (also known as a second-generation antipsychotic) that is primarily used for certain mood disorders such as schizophrenia and major depressive disorder. When used for depression, Rexulti should be taken in conjunction with an antidepressant. It works by adjusting the levels of naturally occurring neurotransmitters (including dopamine and serotonin) to help balance them. Rexulti is therefore also classified as a serotonin-dopamine activity modulator (SDAM).

What is Abilify?

Aripiprazole (Abilify) is also a medication for mental wellness that falls under the class of drugs called atypical antipsychotics. The drug is primarily used to treat mood disorders that include, but are not limited to bipolar disorder, schizophrenia, Tourette’s syndrome, and the extreme irritability that may be associated with autism. Some also use Abilify with antidepressant medication to help treat depression. Similar to Rexulti, Abilify targets the neurotransmitters serotonin and dopamine in the brain and works by modulating their levels. Abilify is also recognized as a second-generation antipsychotic (SGA).

Rexulti Vs Abilify: Common Side Effects

Bringing a new medication of any kind into your system comes with a risk of side effects, some of which may be averse to certain individuals. Read on to learn about some of the most common side effects users may experience with Rexulti and Abilify.

Side Effects Common with Rexulti

Some people who take Rexulti experience the following side effects:

  • Weight gain
  • Increased appetite
  • Agitation
  • Congestion
  • Drop in blood pressure
  • Increased blood sugar levels
  • Dizziness or lightheadedness
  • Restlessness
  • Constipation
  • Fatigue
  • Headaches
  • Drowsiness
  • Tremors
  • Uncontrolled movement of the face, lips, and mouth, may be diagnosed as Tardive dyskinesia (TD). This is rare but possible.

Not everyone who takes Rexulti will have these side effects. Additionally, it is important to keep in mind that this is a list of some but not all side effects individuals may experience on Rexulti. For more information and guidance, please speak with your healthcare provider.

Side Effects Common with Abilify

Taking Abilify may come with certain side effects, some of which include:

  • Nausea and vomiting
  • Headaches
  • Insomnia
  • Blurred vision
  • Constipation
  • Compulsive behaviors
  • Trouble swallowing
  • Increased saliva production
  • Weight gain
  • Increased blood sugar levels
  • Uncontrolled movement of the face, lips, and mouth, may be diagnosed as Tardive dyskinesia (TD). This is rare but possible.

How people respond to certain mental wellness medications such as Rexulti and Abilify depends on a variety of factors and varies from individual to individual. Side effects usually lessen over time and dosage may impact the severity of side effects. Please consult your doctor or a healthcare professional if you experience lingering or unwanted side effects from taking any medication.

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Rexulti vs Abilify: Dosage

Rexulti Dosage

Rexulti should always be taken as prescribed by your doctor. This medication is available in oral tablet form in various strengths including 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, and 4 mg. Your doctor will likely start you on a low dosage and adjust after time as needed. When used for depression, Rexulti will usually be used in conjunction with an antidepressant. The maximum recommended dosage of Rexulti that most doctors will prescribe for individuals with depression is 3 mg per day. For patients with schizophrenia, healthcare providers will typically start with a low dose of 1 mg per day and increase up to 4 mg per day as needed. Rexulti is not currently approved as a treatment for anxiety or bipolar disorder. It should not be used in adults aged 65 or older to treat psychosis related to dementia.

Always follow your doctor’s orders and only take Rexulti as directed. Taking more than your prescribed dosage of Rexulti or taking this medication more frequently than prescribed may result in increased side effects, some of which may be dangerous.

Abilify Dosage

Abilify should always be taken as directed by your doctor. This medication may be prescribed in oral tablet form or may be administered as a once-monthly injection by a licensed healthcare provider. When taken in tablet form, Abilify is available in 2 mg, 5 mg, 10 mg, 15 mg, 20 mg, and 30 mg strengths. Abilify is also available in an extended-release form known as Abilify Maintena, which releases the contents of the drug slowly over time. Your doctor will prescribe the dose they feel is appropriate for you and your condition. Do not exceed the recommended dosage or frequency. Doing so may result in increased side effects, some of which could be dangerous.

Rexulti Vs Abilify: How Long Does it Take to Start Working?

How long it takes for Rexulti vs Abilify to start working depends on a variety of factors, some of which include age, weight, metabolism, and condition. Most people begin to see results within 1 to 2 weeks of starting treatment with Rexulti, with the majority of individuals reporting noticeable results after 6 weeks.

Similar to Rexulti, Abilify typically starts to take effect within 1 to 2 weeks of starting treatment, with the most noticeable effects becoming apparent within 4 to 6 weeks. Most people continue to see improvement throughout the first 3 to 4 months of taking Abilify.

Regardless of whether you take Rexulti or Abilify, the time it takes to see effects will vary for all individuals.

Rexulti vs Abilify: How Long Does it Last?

The half-life of a drug indicates how long it takes for about half of the dosage to get metabolized by the body. Rexulti has an estimated half-life of about 91 hours. It takes about 5 half-lives for a drug to be removed from the body. In the case of Rexulti, this means that taking one’s usual dosage would require 18 to 19 days for the drug to exit the body.3

The half-life of Abilify is about 75 hours; injection-based Abilify (Abilify Maintena) has a half-life of between 30 to 45 days. Given this information, it is estimated that Abilify will stay in your system for about 16 days.

The half-life of Rexulti vs. Abilify depends on the dosage as well as various other genetic factors, some of which may be tested for with pharmacogenetics testing.

Can Rexulti and Abilify Be Taken Together?

There are certain medications that are not recommended to be taken with others given the way they may interact. It is always advisable to speak with your doctor and/or pharmacist prior to mixing medications. Taking Rexulti with Abilify may increase unwanted side effects and potentially worsen certain symptoms.

Rexulti or Abilify: Which One Should I Take?

While both Rexulti and Abilify are in the antipsychotic group of drugs, there are unique reasons to take one over the other. Conditions, desired effects, usage, and side effects are often what cause patients to choose Rexulti vs. Abilify, but there are other deciding factors that should be taken into account. After reviewing the features of each and the potential side effects you may experience, it will be up to both you and your healthcare professional to determine whether Rexulti vs. Abilify will be better suited for your needs.

Rexulti vs Abilify: Similarities and Differences

Considerations

Rexulti

Abilify

Drug group

Atypical Antipsychotic/ Second-Generation Antipsychotic (SGA)

Atypical Antipsychotic/ Second-Generation Antipsychotic (SGA)

Use

  • Major Depressive Disorder (MDD)

  • Schizophrenia

  • Schizophrenia

  • Tourette’s Syndrome

  • Bipolar I Disorder (Manic Depression)

  • Major Depressive Disorder (MDD)

  • Irritability associated with autistic disorder

Intended duration of use

Long-term

Long-term

Available in generic form 

No

Yes

May be habit forming?

No, but psychological dependency may occur

No, but psychological dependency may occur

Withdrawal Symptoms?

Possible

Possible

Available forms

Oral tablet

Oral tablet, orally disintegrating tablet, oral solution, injection

Safe for use with alcohol?

No

No


ClarityX: DNA Testing for Medication

The DNA in our bodies contains valuable information that may be useful to determine how we will respond to certain medications. ClarityX examines DNA to uncover this information and provide patients with detailed reports on how they may react to taking certain drugs. We look for variations with the cytochrome 450 enzymes (which metabolize over 70% of drugs). ClarityX offers two testing options with our pharmacogenetic testing:

  • Mindwell test: This focuses on treatments for mental health conditions that include but are not limited to depression, anxiety, ADHD, OCD, and more.
  • Max Rx test: This covers 31 therapeutic areas to test how an individual may respond to more than 265 medications.

Both the Mindwell and Max Rx tests may help determine how you will react to Rexulti and Abilify. This could help you and your healthcare provider make more informed decisions about your treatment plan. Click here to learn more.

1Sandoiu, A. (2017). Antipsychotics: Do they do more harm than good? Medical News Today. Retrieved September 6, 2022, from https://www.medicalnewstoday.com/articles/317296#Benefits-of-antipsychotic-medication-far-outweigh-the-risks-

2U.S. Department of Health and Human Services. (n.d.). Fact sheet: First episode psychosis. National Institute of Mental Health. Retrieved September 6, 2022, from https://www.nimh.nih.gov/health/topics/schizophrenia/raise/fact-sheet-first-episode-psychosis#:~:text=Three%20out%20of%20100%20people,something%20that%20is%20not%20real).

3Rexulti: 7 things you should know. Drugs.com. (n.d.). Retrieved September 6, 2022, from https://www.drugs.com/tips/rexulti-patient-tips#:~:text=Rexulti%20has%20a%20long%20half,to%2019%20days%20for%20Rexulti

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