Jump to content
CrazyBoards.org

Recommended Posts

Does anyone else have experience with Rexulti completely destroying their depression? For me, Rexulti almost had a same day anti-depressant effect and controls depressive episodes acutely and astoundingly fast. I literally feel anti-depressant effects in as little as 3 hours after I take it. When I look back to when I was on it, I now realize that I didn't have a single bout of depression during that time, it just was not super effective in controlling mania. I think Rexulti is a hell of an anti-depressant, a way improved drug than abilify with less than half the side effects, no lethargy or cognitive impairment either which is always surprising to find in an antipsychotic. I know it has an indication for adjunctive therapy in adults with MDD but none for bipolar depression... maybe Lundbeck is just waiting for close to the expiration of the patent before the release new clinical trial data and extend their patent after they get the bipolar depression indication approved, but that's just a thought.

Anyone else have a similar experience with Rexulti, brexpiprazole? Please let me know about your time on the medication and if it sat well with you or not so much. Interested in if others are also getting this rapid and significant anti-depressant effect from this drug or if it's just me

  • Like 1

Share this post


Link to post
Share on other sites

Never tried Rexulti, but once it goes generic I'd be curious to try, especially if it really helps with depression and doesn't cause same side effects as Abilify (namely weight gain/increased appetite). How long were you on it? Did you go onto Lamictal instead, for more help with mania?

Share this post


Link to post
Share on other sites

@mmaryland same experience except it took a little longer to kick in. Was going well at 2mg but then mania started and the rexulti just couldn't keep up. Shame - I really liked it 

Share this post


Link to post
Share on other sites
5 hours ago, Blahblah said:

Never tried Rexulti, but once it goes generic I'd be curious to try, especially if it really helps with depression and doesn't cause same side effects as Abilify (namely weight gain/increased appetite). How long were you on it? Did you go onto Lamictal instead, for more help with mania?

You'll be waiting a long time for generic Rexulti to come out. You could always try to get a prior authorization approved through your insurance and then it would be covered under your formulary. I was on it from May 2017 to November 2017, so 6 months, starting at 2mg, then going back down to 0.5mg because of akathisia and then 1mg for a month, 2mg for a 2 months, then upped to 3mg for a month, and increased to the max dose of 4mg for the last 2 months. It wasn't controlling my mania, despite being on 1,350mg of Lithium daily. I was still having to take Seroquel to help me sleep so being on two AAPs was not something my psychiatrist wanted to continue for too long. Rexulti was amazing with respect to having literally no cognitive impairment or memory problems, hyperglycemia, no extreme elevated appetite like the other AAPs I had been on. If anything, I found it improved my outlook on life and helped me gather my thoughts, become more insightful, didn't induce any anxiety, never caused oversedation, basically felt nothing like any AAP I have ever taken. If only Rexulti had the capability to control mania or hypomania it would be the perfect medication for bipolar disorder.

My psych. took me off it because I was still taking Seroquel 100mg to sleep at night in addition to Rexulti 4mg during the day, and switched me to Latuda about a week before Thanksgiving 2017. I was given 7 day free samples of 20mg, 40mg, and 60mg. I believe I started out with 40mg, and made sure to always eat with it. My psych. thought the Latuda would be sedating enough to help with my sleep, but it wasn't and I still was taking Seroquel 50-100mg at bedtime. All the while I had been on Lithium 1,350mg since February 2017, which didn't help with sleep either. I decided to take myself off Lithium and decreased my dose during my Winter break. I was off it completely by late December/early January 2018. Then we tried just Seroquel 100mg at bedtime and wow how stable I was, only I had no personality, emotions, feelings, empathy, or interest in communicating or participating in everyday activities/interactions.

So I got switched to Saphris while introducing Lamictal in January 2018. I am now on 100mg of Lamictal, but only stayed on Saphris 5mg for maybe a week? I just really thought hard about if I honestly needed to also be treated with an AAP. This is when I proposed to my psych. to stop it, upon my agreement to take Seroquel or Saphris when I felt hypomania or manic episodes coming on. We also agreed to discontinue Valium 20mg at bedtime, which had been used since July 2017 to prevent benzo withdrawal seizures from Xanax and was successful in that aspect, and try to replace the Saphris and Valium at bedtime with Ativan 2mg or Halcion 0.25, I was given a small prescription for each and was to see which one I felt was better for helping get my sleep schedule on track. Well, Halcion took the win, but during this time I was also out of Xanax for 1.5-2 weeks and without the Valium being in my system I suffered a benzodiazepine withdrawal complication seizure. So now back on the Valium while tapering the Xanax, Halcion at night, with 100mg Lamictal every morning

Lamictal has surprised me. I've been having really good control of my moods. I have infrequent acute depressive moods but haven't had really any highs or lows since being on it actually. 

Share this post


Link to post
Share on other sites

I LOVE REXULTI!!!!!  :loved:

Been through Latuda, Saphris, Abilify, Fanapt, Zyprexa, loxapine, and now Rexulti (not necessarily in that order). This really is nothing like my experience with Abilify at all. Not agitating. Much more calming. Definitely a much more profound effect on my depression. I started on 0.5mg, but I found after two weeks that it was too much for me so I dropped down to 0.25mg and I've been here ever since.

No akathisia.

Of all the winters in my memory I have been the least depressed this winter. I think I've been taking Rexulti since September. I've been able to actually get through this winter without falling apart.

On its own not sure it would be a great mood stabilizer but as an adjunct to valproate I find it to be the perfect mix. Just in case my signature changes I'm currently on a mix of Depakote/Trintellix/Rexulti/Vyvanse. I think from a mood stabilizer perspective, Depakote was the single best decision I made. However, from an antipsychotic adjunct to an antidepressant, Rexulti has been the best. Come about mid-March as winter starts coming to a close, my doctor and I will notch down my Trintellix and Vyvanse doses and increase my Rexulti dose to 0.5mg in prep for spring mania. It happens like clockwork.

@Iceberg I think Rexulti has definitely helped to smooth the waves, but I don't see it aborting a manic episode at all. That's what the Depakote is for. 

@mmaryland you have a good point about the patents. And this will be of interest to you @Blahblah. Currently the furthest expiration of patent exclusivity for brexpiprazole is 07/2020. If they didn't get any more indications for this, they would still likely get a pediatric extension for 6 months which would push it to 01/2021. However, as @mmaryland said, they're on track for:

bipolar depression

agitation in autism

manic and mixed episodes in bipolar disorder

agitation in dementia including Alzheimer's (although that last study they did didn't go to well for them, additionally antipsychotic use in the elderly population isn't generally looked on too favorably because of the safety profiles)

treatment-resistant depression indication similar to olanzapine. Some of the trials they're doing are specifically looking at whether brexpiprazole works when 2 or more previous treatments failed (they're trying to cannibalize olanzapine, quetiapine, and aripiprazole here).

Keep in mind of course that while exclusivity may expire, the patents themselves don't expire for a while after that so all the generic companies get to pay royalties to Otsuka and Lundbeck much like they are still paying Otsuka royalties for generic Abilify and will from the looks of it until 2027 specifically because of the patent they got for the MDD adjunct indication in 2014.

Abilify came out in 2002 and they managed to secure royalties until 2027 but the first generic was available in April 2015. The earliest for brexpiprazole appears to be 2015 also expiring in 2027 with exclusivity expiring July 2020. If we use aripiprazole's history to determine what things will be like for brexpiprazole then that means we won't see generic brexpiprazole until like 2028, a year after royalties on aripiprazole stop (funny how that just "works out"), then it will continue to be one of the "non-preferred generics" until 2040 because of the patent royalties.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now


  • Similar Content

    • By Dewey
      I didn't realize this until I was reading another post, but here it is again, the first day of Fall in the US in two days.  Already leaves are turning colors, falling, and the light outside is changing. Usually every change in season, I have one or two manic episodes. Last night had what I believe was my first manic episode in a long time.  But last evening was scarier, all the typical symptoms of mania along with visual disturbances and sensations I had never experienced before.  Left a vmail message on my psych docs line this morning thinking this is the smart thing to do, it usually takes alot for me to bother him in between sessions, but he does encourage this, fortunately. I left him the data and left it up to him if he feels he needs to call me back next week.  I see him in two weeks.
      So, I remember my psych doc telling me once in a mood change, one can take a little extra medicine to help.  I only take Seroquel as needed, so took 1/2 of a 25 mg of Seroquel and nothing happened.  Thirty minutes took the next 1/2 of the 25 mg and finally sleep arrived.  I slept 14 hours straight and when I woke up, I woke up to a totally different person.  That scary weird out of control mood was no longer there (thought I was going to have to call 911 for help), the cycling was almost gone and slowly drifted away throughout the day. 
      I am 67 and finding that my brain is functioning differently lately.  It's beginning to scare me, of course the aging process is very scary.  I have addressed this with my psych doc many times, even my neurologist and they do not seem concerned. I had an MRI and all was normal there for someone my age. These are all new symptoms to me, or maybe the same but more dramatic, I think. 
      I have had more than my share of significant triggers last 9 months.  I tried therapy last two weeks and actually ran out of the therapists room last week due to a panic attack. I warned her not to push. I even had it all written out for her to read, but oh no, she wanted me to verbalize it and then she swung into asking me about bodily feelings, that was when I ran out of her room in a blind panic.  She wanted me to reveal too much stuff too fast and I kept warning her. Will not go back to her.  So, now I have to get up the courage to seek out someone else.  My psych doc will not refer me to anyone, as is his way, which makes it harder on me.  
      Okay, will close for now. 
    • By Dewey
      Last night was scary for me.  I felt a mood suddenly ink in and I think I may have been hallucinating or dissociating due to the anxiety I was experiencing.  I actually saw out of the corner of my right eye a face that was letting out all the angst I was feeling.  It was a tortured hideous expression, and as soon as it appeared, it disappeared and I could feel all those churning emotions inking back into me.  Soo weird !!!  Was this dissociation, am I now BiPolar, what in the heck happened to me?  Never had this, this intense before.  I was afraid of........ me.
      I could tell something seriously was wrong, so what do I do? I go straight to the computer and go to my favorite site to order things I have never been able to afford before as that is one technique to self soothe, only I went overboard.  Yes, I extended my line of credit one late night and now I am buying things that I don't even remember, even two or three of the same item.  I am now busy returning most of them.  However, there are items I have wanted for sooo long that I am now buying, I won't even go into the items I am sending back, way to embarrassing, lol. 
      What scared me the most was the enormous scary mood swing, out of the blue, the mood was bigger than life to me.  I could hear my psych doc telling me what to do as going thru a mood swing like this your body can tolerate extra medication, so I took 1/2 of a 25 mg Seroquel and it did nothing to stop the mood, so 1/2 hour later, I took another half of the 25 mg and it worked, within 30 minutes I was out and I slept 14 hours, woke up in a completely different mood, a completely different person.  I had to say to myself this morning when I woke up, who was that person last night, I didn't even recognize myself and what I went thru.  What a difference a good nights sleep does and strong medicine to help me get to and stay asleep.   Wondering now if I am BiPolar because I heard that only a solid 12 hours of sleep will break cycling and I was definitely cycling last night. 
      I have been coming down from Zyprexa due to extreme vertigo, so wondering if this may have been part of what happened to me.  I also have reduced the Klonopin due to issues with my HMO and have had to stock-pile them, which leaves me wide open for more anxiety.  Lately, my mood and anxiety/panic have rendered me housebound and even sometimes too fearful to get out of my bed. 
      Well, thanks for reading this.  I don't know if anyone can shed any light on this to help me. 
       
    • By Blahblah
      How do you go about most of your days when you're feeling totally ignored, neglected, unloved, lonely, invisible, and useless, like you don't matter to anyone? I can accept that I will always have depression (and the emptiness & struggle that comes with that) that i must (and do) treat, but it is becoming more and more difficult to accept that I don't deeply matter to anyone but the 2 people that gave birth to me (who will soon be gone).
      No one else gives a damn. No one is really truly there for you (especially when the chips are down). This is where much of my suffering comes from and why life often does not seem worth living. Does having "self-love" make up for this pain & isolation? And if so, how do you "love yourself"? I already do millions of "self-care' activities everyday, regular therapy appointments, read too many self-help books, and I still have this crushing pain, emptiness and self-hatred inside.
       
    • By troop111
      Greetings,
      I recently had the initial 6 treatments of Ketamine infusions, and that helped my Bipolar II depression (which is treatment-resistant) for about two weeks. Then I had another booster infusion, and that held for a week, then I had another booster infusion, and that lasted a week. These "boosters" shouldn't have to be given more than once every 1-3 months, yet it seems I need one weekly.
      So the Ketamine failed to provide prolonged relief.
      My only other option now is Electroconvulsive therapy (ECT), which I don't want to do. I know it's gotten better vis-a-vis memory issue side-effects, but I just don't want to do it. I don't like the idea of having my brain electrocuted (however little the electrical charge), and I don't like even the idea of me potentially losing cherished memories.
      My question: If I had such a poor experience with the Ketamine, needing weekly boosters, does that bode poorly for ECT therapy? I know ECT also frequently requires "boosters." I don't want to have to go in weekly for an ECT booster. I'm tired.
      I've been through the ringer for the past 16 years. I'm just tired of trying to get better. I'm tired and worn down.
      Please share your experiences and insights, I'd much appreciate it.
      Thanks!
      Troop
    • By mikl_pls
      Towards the end of August of this year and the beginning of this month, I was a bit manic, and then on 9/5/18, I saw my pdoc, and she put me on divalproex sodium ER (Depakote ER) 500 mg every morning and olanzapine (Zyprexa) 10 mg as needed for mania.
      Since starting the Depakote, I've already noticed that I am feeling rather flat and unmotivated, and that I'm slowly becoming depressed. It's been about four days into taking the Depakote, not long really, but I'm a little alarmed. A good friend of mine who's very knowledgeable with medications said that this is a very small dose, and I deduced that I would not feel much of anything, but I'm wondering if I'm sensitive to the anti-manic effects of it and that it might be putting me "too far on the other side" of euthymia...
      Does anyone maybe have any insight on this, or has anyone maybe even experienced this same thing? Could this possibly be the Depakote this quickly into taking it, or is this maybe just "post-manic depression," or what? 
      I've also been taking the olanzapine (Zyprexa) nightly since it was prescribed to me to make sure I get good sleep, as getting good sleep was one of the things my pdoc instructed me to do since the main thing that precipitated my manic episode was lack of sleep. This probably confounds the clinical picture a bit, but I figured I would mention this.
      Any input would be much appreciated. Thanks!
×