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 RisingRayne
      I wish I had never been placed on it adjunctively for depression/anxiety. I was first embarrassed because it is classified as an antipsychotic. I was on the lowest dose for a few months. I gain about 15 pounds. I haven't been able to return to my pre-abilify weight. So frustrating.
    • By rebird77
      Can anyone tell me what you take that has treated bipolar depression. I’m too scared to even touch an antidepressant with my history. I can’t get out of depression. When I think of my life since this illness onset I can only think of a handful of healthy times when I wasn’t at least mildly depressed. I am fighting so dam hard, and this is it. I have time off. I’m about to start getting short term disability and I’ll have at least 6 months to tinker with meds. I’ve already been tinkering with them for over a year and nothing is working for depression.
      i thought lamictal would do it this time but it’s making me worse.
      im desperate. I’m going to seriously look into Latuda with my pdoc but yes I am concerned about anxiety. I do have a goal to get off the .5 klonopin over the next several months. Maybe that is unrealistic or impossible.
    • By cgarcia134
      So far this year, I think I've missed 17 days of work. There was a time I missed four days of work in January. I wasn't on medication at the time. I just had a hard time finding a new psych doctor until a few weeks ago (prescribed 20 mg of Latuda). I would just wake up and sometimes if it was raining, just decide I wasn't going to work. I just didn't care if I got fired or not. There were even days that I didn't get paid for. How about coming home with only $200.00? Despite this, I would continue missing work. I would make every excuse in the book. Thankfully I didn't get fired. The depression started around January after having a period of hypomania. I was diagnosed with bipolar disorder in 2011. I have these episodes generally in the Spring & Fall for some odd reason. Then I'm good to no one, but behave much better, just depressed, have no motivation to get off the couch. 
      I haven't missed a large amount of time from work since 2016 (out of work for longer than a month twice that year). Since taking Latuda, I felt a difference almost immediately, starting sleeping for the full night. I'm hoping this medication works well especially since my co-pay was $175.00. This month, I haven't missed one day of work (knock on wood) and rarely have been late. Trying to become reliable again at work. 
      Anyone else missed work? What worked for you?
       
       
       
       
    • By sming
      Apologies if this sounds a trivial issue but it's something causing me daily anxiety&blame and also something that puzzles the hell out of me. 
      Why is taking a shower so damned hard? I can do other morning "chores" e.g. make breakfast, get dressed, brush my teeth relatively easily. Plus I know that showering :
      feels really good is necessary is actually enjoyable only takes minutes etc. I've tried various CBT techniques e.g. rate perceived v.s. actual difficulty, list pro's and con's and so on to no avail. The best I can come up with is "don't think about it, just do it", which a) is lame and b) doesn't alleviate the procrastination or anxiety much. 
      Anyone else? Any tips?
      Thanks in advance,
      Pete
    • By P Dub 87
      I just turned 30 last November. Seems like all life does anymore is pass me by. I've dealt with severe anxiety and depression for the better part of the last 2 decades, and before that, ADHD as a child. I have tried every medicine under the sun, including experimental ones like ketamine and such. I've done ECT treatments, hundreds of therapy sessions and group therapies. The doctors switched my diagnosis from bipolar, to severe GAD, to borderline personality disorder, back to GAD, many times, and I'm not even sure what the current one thinks I am. I mostly sit there staring into space when I'm in his office. I have no hope or will left in me anymore. I haven't truly felt suicidal since 2009, which is when I had two suicide attempts, but I'm beginning to be okay with dying again. 2 years ago, I lost the love of my life and since then this hole inside me has become larger than ever. We were together for 6.5 years, and it was the most fulfilling, joyous years of my life. Now I'm at the point where feeling sad is a relief, because I mostly feel nothing. I rarely feel anything anymore besides resentment and anger because I know I should be feeling but I'm not. It doesn't matter where I am or what I'm doing, I remain empty inside. I'm so apathetic and detached from the world and the people in it, including friends and family. I isolate myself, turn my phone off for weeks at a time even. I just don't care anymore. I struggled with this beast before I met the love of my life, but she filled me with something that medicines and doctors never could. LOVE. It was like a breath of fresh air, with the sun on my face. Blissful, peaceful. I love her every moment of every day, and I know without her I won't make it. She's the reason I stopped feeling suicidal in 2009. That's the year we met, coincidentally in ECT therapy. We were both in the same waiting room. It's funny, we wouldn't remember each others' names or that we had started making plans to see each other outside of therapy. We were like kids in the recovery room, sitting on our hospital gurneys kicking our feet, sipping on those juice boxes they give you after they electrocute ya, completely nonjudgmental, embracing each others' company. Our mothers had to help us out hahaha. Our memory and attentions spans at the time were hilariously short. My mother would drive me to go see her, and I would forget who I was going to see on the way there. Her mother would remind her to get ready because she had company coming over but she would always forget who was coming to see her. But we would always remember when we saw each other, and we would embrace each other with the biggest hugs. It was like seeing each other for the first time, every time while we were still having ECT treatments, except we knew each other. Hard to explain. I'm simplifying everything but I truly have not ever felt something so strong and amazing, that attraction that soulmates share, if you believe in such things. I've tried dating (if you can even call it that) and talking to girls since I lost her but nothing makes me care. Sex is meaningless, conversations are meaningless...doesn't matter who's talking to me, or how much they're into me, they aren't her. They'll never be her. I just space out and imagine how comfy my sanctuary is where I can lay back with my feet on my soft carpeting and just rest. That's all I ever want to do anymore, just rest. Be as close to 'at peace' as I can. Life never had much sway over me, and now that I'm without 'her'...I'm so close to the final exit. It sucks because this could have all been avoided. I used to drink alcohol, A LOT. I even went to rehab for it, and stayed clean since then with a few hiccups/reminders not to drink. Alcohol never mixed well with me, and caused more problems than she could put up with. I hate myself for not seeing clearly quicker. For not listening to her. And so here I am, a broken being writing on this forum not because I seek help but because I just feel like I should put a brief summary of my story out there. I apologize if any of you were here looking for answers. I see many other souls in pain here too, which inspired me to share. It's nice knowing we aren't completely alone. 
×