Jump to content

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 Toblerone
      I'm new to the boards and could use some suggestions. 
      15 years ago I was diagnosed by my PCP with generalized anxiety and depression. Although I've been this way as long as I could remember. My anxiety causes my depression. I originally was started on Paxil, which turned me into a zombie. Then I was on Celexa, for a number of years, as it stopped working, my dosage was upped each time until my Dr said I was at the highest dose. So she changed me to Lexapro  w/ Buspar, the Lexapro worked for awhile, but I had to drop the Buspar as it made my bruxism worse when I slept. Eventually the Lexapro stopped working. 
      I switched from my PCP to a Psychiatrist, in hopes of getting more targeted care. The first one misdiagnosed me and was insistent that I was Bipolar and prescribed me Latuda. I took it because I thought, "Well....what If he's right?" Which was a nightmare. Not only was I not able to stay awake during the day, but it put me in a manic state which I had never experienced before.
      I again, switched psychiatrists, this one prescribed me Wellbutrin + Zoloft. I was on it for a month. And was not feeling any relief. So she tapered me off the Zoloft. So now I'm just on the Wellbutrin. And not only is my anxiety through the roof, it makes me jittery and edgy. And the last three weeks, I've cried every day. Although the crying is over a breakup, I'm positive that my meds are not helping. throughout all of this...all of these drugs have zapped my libido. It's a catch 22. Do I want to feel normal and not have any interest in having sex? Or do I want to be anxious and depressed all the time and not feel like having sex? 
      I've taken the GeneSight test in hopes the results would tell me what would work best...But it just breaks the drugs down by categories of Use as directed, Moderate gene-drug interaction, and Significant gene-drug interaction. In which nothing fell into the last category. 
      I hoped that it would narrow it down so I wouldn't have to keep this trial and error up. I don't want to take anything for anxiety that I could become addicted to (Benzos). And as far as antidepressants, I'm running out of options. 
      I've thought of trying Celexa again to see if it would work. It worked last time for 5 years before I had to increase it. It does fall into the moderate gene-drug interaction column on my report for "Genotype may impact drug mechanism of action and result in reduced efficacy."
      As far as antidepressants listed as suggested, I've tried Wellbutrin, which clearly isn't working.
      Then there's Pristiq, Fetzima, Emsam, and Vibryd. Which I have not tried yet. 
      Any suggestions on which one I should try next? Hopefully something that doesn't make me a zombie, cause increased anxiety, or make me cry every day, or zap my entire sex drive? I know. I'm asking a lot. 
      Also noted, I have started DBT in hopes that it will help as well. Hopefully, one day, I can be med free. (A girl can dream.) 
    • By dogsdogsdogs
      Hey there! I've been having a very difficult week. I've been on lexapro and klonopin for depression and anxiety for 3 years and the lexapro has plateaued in the last year or so, so my pdoc decided to put me on Abilify about a week ago and it has SUCKED. I'm not feeling any of the positive effects of the meds yet, which I understand because sometimes it takes a while. BUT i have been feeling a whole bunch of negatives. Theres a general brain slowness, like forming sentences and thoughts takes much longer than usual, like if my train of thought were a real train, there is now a huge parachute on the back slowing it down. 
      The WORST side effect so far has been the derealization. I'm familiar with it as it is a side effect of my anxiety. I can't tell if it is a direct effect of the abilify or if the meds are causing more anxiety which is then causing derealization. The thing is, I haven't been feeling much more anxious than usual recently. It's like the derealization comes over me first and then the anxiety follows. 
      Has anyone experienced this on Abilify? If so, did it go away eventually? Did you switch meds? Nothing seems real and I'm getting very very tired of it. 
    • By dogsdogsdogs
      hey there! 
      I recently started seeing a new psychiatrist since my drug regimen of the last 3 years has plateaued and my old psych was terrible. This new doc seems to know what she's talking about and I like her. Basically my antidepressants have hit a block and feel like they've stopped working. So she suggested adding a little helper on top of what I'm already taking. Her first request was Wellbutrin, BUT when I mentioned that I use an albuterol inhaler for my asthma she said that Wellbutrin and albuterol have a bad interaction and pretty much threw out the idea of trying out Wellbutrin.  She put me on 2mg Abilify instead. It's only been a week but I'm not liking the immediate side effects of Abilify that I've been experiencing and hopefully it will even out eventually. BUT in case it doesn't I want to be able to have other options. 
      I've heard so many good things about Wellbutrin. When I tried looking up Albuterol and Wellbutrin interactions I've come up with NOTHING. even on the drug interactions checker. So my question is, has anyone ever heard of this before?? If so, what exactly is the interaction??? 
      If nothing comes of this, I'll ask the new doc about it when I see her again in a month, but for now it's really killing me to know! 
    • By ReincarnatedCow
      I don’t know really how to talk about this or describe what’s going on but lately I’ve been really depressed and just really low except for a few occasions but after that I slip back down into this depression.  Often I get very stressed or anxious over multiple things or sometimes I’ll just be really upset or sad and I want to cry so bad but I can’t.  I just really want to cry and I’m not trying to hold it back but something is and it’s such a difficult thing and I don’t know why it happens.  I feel weird saying that I want to cry but it just feels so good but whenever I need to I can’t.
    • By Cyclingsarah
      Just started Depakote 200 mg 5 days ago. Started getting really depressed and anxious on it right away and it’s only getting worse.
      Anyone else experienced this? Does it get better with time? Thinking it might be a start-up side effect, but i worry it’s going to continue. 
      A lot of drugs in the same class have made me depressed in the past. Lamotrigine, lyrica, gabapentin, trileptal...