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I am on Vraylar... Started a couple weeks back.   It's worked wonders.  No more stray thoughts, voices, and everything is calm.  If it is activating, I haven't noticed.

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I've been taking Vraylar for about 3 months now. First 1.5 mg and now 3 mg. First got free samples from my doctor and then instead of paying $1,400 a month signed up for the patient assistance program so I'm getting it for free.

No side effects, but having some very strange dreams. I feel listless and not motivated to do much of anything at all, no weight gain, so I'm not sure if it's working like it's supposed to.

I'm kind of new at this so I'm not sure what else to tell you but if anything else happens I'll update it here.

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I replied earlier but forgot to mention that I also have high blood pressure and believe because of the medication.

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I've had a history with medications since age 6 when I was diagnosed with ADHD. I'm 19 now and discovered I'm actually bipolar. I have no history of taking bipolar medications and have just started on Vraylar. I've experienced nausea, dizziness, fatigue, restlessness, low blood pressure, and have been more irritable. Though, I've only been on it for 5 days.

Edited by Syellow

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I am considering adding this to Prozac for major depression. May I ask folks who are or who have used this medication to comment on effect on libido and orgasm? Grateful for any insights!

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Last night was my first night on Vraylar for MDD. It was terrible. I had trouble falling asleep. Once I fell asleep, I woke up in the middle of the night nauseated and sweating. Had trouble falling back asleep.

My pdoc switched Latuda out for this.

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3 hours ago, rjvfl said:

Last night was my first night on Vraylar for MDD. It was terrible. I had trouble falling asleep. Once I fell asleep, I woke up in the middle of the night nauseated and sweating. Had trouble falling back asleep.

My pdoc switched Latuda out for this.

Would recommend that you talk to your doctor about switching to the morning. Vraylar can be pretty stimulating, and it wouldn't be the first time that I've heard of it disrupting sleep.

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I've been on Vraylar for about a month or so now (as a mood stabilizer, antidepressant, and treatment for obsessive thoughts - it's primarily prescribed because I was having really severe and persistent suicidal thoughts, but my psych thought it might help in some other areas as well due to the rather unique MOA). I wasn't able to tolerate 3 mg at all, but 1.5 mg has been more or less tolerable (there have been some annoying side effects), and it's definitely been helpful so far. After some experimentation I discovered that taking it at night instead of in the morning reduced the severity of the side effects enough for them to be much less of an issue.

This definitely has worse side effects when you initially start it. It has a long half-life (and a active metabolite with a very long half life), so it takes a while for it to stabilize.

The akathisia was more present initially and has reduced to very tolerable levels with time and the switch to night dosing. The insomnia was a significant problem until I switched to night dosing, although it lessened with time prior to that. With regards to the insomnia, I noticed that it generally caused more problems with disrupted sleep quality and too-short sleep duration than with directly falling asleep, although initially it was doing all three of those. There has been some minor weight gain but considering that I am actively trying to gain weight (a very difficult prospect when you're on this dose of Adderall/Fetzima and have other preexisting problems with eating), I don't think this data point has much value. Nausea was a minor issue initially but quickly faded away.

19 hours ago, Disciple said:

I am considering adding this to Prozac for major depression. May I ask folks who are or who have used this medication to comment on effect on libido and orgasm? Grateful for any insights!

Little to no difference. I am on HRT though so I am not the best person to evaluate this.

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On 9/20/2017 at 11:36 AM, browri said:

Would recommend that you talk to your doctor about switching to the morning. Vraylar can be pretty stimulating, and it wouldn't be the first time that I've heard of it disrupting sleep.

The pdoc switched me back to Latuda and increased the dosage.

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I just discovered that my insurer paid a whopping $1085 for 30x 1.5mg Vraylar. Holy fuck. That's makes it by far the most expensive drug I've ever taken at over $36 per dose.

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4 hours ago, JustNuts said:

I just discovered that my insurer paid a whopping $1085 for 30x 1.5mg Vraylar. Holy fuck. That's makes it by far the most expensive drug I've ever taken at over $36 per dose.

You should see how much my HIV PrEP costs (Truvada). $52/day. For a 90-day, Insurance pays $4,606.43 and "I pay" $90 which is actually all covered by the manufacturers savings card. It seems almost criminal really.

Interesting though that Trintellix isn't as expensive as I would expect it to be. For a 90-day, Insurance pays $850.92. I pay $180, of which $160 is covered by the Takeda savings card. $30 copay for 90 days isn't too shabby.

Really interesting, @JustNuts that you can get away with taking Vraylar at night. So many people report having problems with that. It does seem to take 3-6 hours for single-dose administration to reach peak though so I suppose over time it makes sense that sleep initiation would become less of a problem. I suppose temazepam and diazepam help though, yeah?

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Of course now I'm having trouble sleeping again anyway so who the fuck knows. So now I have to take Thorazine to sleep along with clozaril and Vraylar. P.S. Ever need a knock out combo...try Thorazine clozaril, Xanax and Xanax Xr ...I couldn't even talk right. And no lectures please it was doc approved and I take the XR midday so it wasn't totally all at once...unfortunately it wore off too fast and I didn't sleep all night. So yeah idk at all what the Vraylar does with sleep but we don't want to yank it cuz it's probably helping depression

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4 hours ago, browri said:

You should see how much my HIV PrEP costs (Truvada). $52/day. For a 90-day, Insurance pays $4,606.43 and "I pay" $90 which is actually all covered by the manufacturers savings card. It seems almost criminal really.

Interesting though that Trintellix isn't as expensive as I would expect it to be. For a 90-day, Insurance pays $850.92. I pay $180, of which $160 is covered by the Takeda savings card. $30 copay for 90 days isn't too shabby.

Really interesting, @JustNuts that you can get away with taking Vraylar at night. So many people report having problems with that. It does seem to take 3-6 hours for single-dose administration to reach peak though so I suppose over time it makes sense that sleep initiation would become less of a problem. I suppose temazepam and diazepam help though, yeah?

It's crazy, but I guess that's the price we pay for drug development these days... You'd think that long-term meds like antipsychotics or PrEP would cost less money though... I guess it depends on the market size and the value to the healthcare system, but the numbers still seem high.

My insurer paid $318.36 for 30x 20mg Trintellix back when I was on that drug, so that's roughly in line with what yours is paying for 90x (yours seems to have a slightly better price).

Yeah, taking it at night was the only way it was tolerable for me. The benzos probably did help, but I think much of it was just pharmacokinetics. I'm no longer on Vraylar anymore, the new drug is Saphris (asenapine), which is initially heavily sedating (had to take it QD PM instead of the normal BID because of the sedation and because BID dosing caused EPS), but later causes significant akathisia (more than the Vraylar ever caused) — however it seems to be working better than the Vraylar did as an antidepressant, so I guess it's fine for now...

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3 hours ago, JustNuts said:

It's crazy, but I guess that's the price we pay for drug development these days... You'd think that long-term meds like antipsychotics or PrEP would cost less money though... I guess it depends on the market size and the value to the healthcare system, but the numbers still seem high.

My insurer paid $318.36 for 30x 20mg Trintellix back when I was on that drug, so that's roughly in line with what yours is paying for 90x (yours seems to have a slightly better price).

Yeah, taking it at night was the only way it was tolerable for me. The benzos probably did help, but I think much of it was just pharmacokinetics. I'm no longer on Vraylar anymore, the new drug is Saphris (asenapine), which is initially heavily sedating (had to take it QD PM instead of the normal BID because of the sedation and because BID dosing caused EPS), but later causes significant akathisia (more than the Vraylar ever caused) — however it seems to be working better than the Vraylar did as an antidepressant, so I guess it's fine for now...

Saphris was definitely a good one. Decent antidepressant effect. Really calmed the thoughts. Almost TOO much sometimes though. It also caused akathisia for me at 5mg qhs. 2.5mg was tolerable but my pdoc didn't want me to have any akathisia and wasn't willing to make Cogentin the long-term solution.

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Just now, browri said:

Saphris was definitely a good one. Decent antidepressant effect. Really calmed the thoughts. Almost TOO much sometimes though. It also caused akathisia for me at 5mg qhs. 2.5mg was tolerable but my pdoc didn't want me to have any akathisia and wasn't willing to make Cogentin the long-term solution.

I'm on 10mg QHS. My pdoc said to try managing the akathisia with the PRN diazepam for now, and if it's still enough of a problem at the next follow-up, she'll add a low dose of benztropine (Cogentin). I'm not sure if I would want to take benztropine though. I feel like I'm already on a ridiculous enough number of meds as it is.

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15 hours ago, JustNuts said:

I'm on 10mg QHS. My pdoc said to try managing the akathisia with the PRN diazepam for now, and if it's still enough of a problem at the next follow-up, she'll add a low dose of benztropine (Cogentin). I'm not sure if I would want to take benztropine though. I feel like I'm already on a ridiculous enough number of meds as it is.

I've only ever taken Cogentin once at 1mg for an episode of akathisia I was having on 25mg of loxapine. It was pretty sedating. Gave my body a weird hot feeling all over. My vision would easily go out of focus especially reading close up. Also had problems doing basic math. Like I was trying to count something and could barely even count. Definitely not something I would want to make a long-term solution to akathisia. It's good in a pinch to really knock out an episode when you're uncomfortable, but the answer really is to lower the AP dose or find another one that causes less EPS. So far Rexulti hasn't caused any akathisia, but I have noticed some slightly jerky muscles, like minor head twitches at the neck. No facial tics so far like olanzapine though. All-in-all none of it bothers me.

I have to say though, Saphris is one that I would consider trying again. I wasn't taking an antidepressant at the time which really changes my response to APs. It was fairly weight neutral although I may have gained a few pounds but nothing serious. I did notice that about 30-60 mins after taking it I would become RAVENOUSLY hungry for sugars and carbs. That was frustrating because it sometimes led to sedated binge eating which didn't help my weight. However, it's one of those things where if you can resist the food cravings then keeping the weight off shouldn't be a problem. It's not like quetiapine and olanzapine where you gain weight regardless of how well you eat.

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11 hours ago, browri said:

I've only ever taken Cogentin once at 1mg for an episode of akathisia I was having on 25mg of loxapine. It was pretty sedating. Gave my body a weird hot feeling all over. My vision would easily go out of focus especially reading close up. Also had problems doing basic math. Like I was trying to count something and could barely even count. Definitely not something I would want to make a long-term solution to akathisia. It's good in a pinch to really knock out an episode when you're uncomfortable, but the answer really is to lower the AP dose or find another one that causes less EPS. So far Rexulti hasn't caused any akathisia, but I have noticed some slightly jerky muscles, like minor head twitches at the neck. No facial tics so far like olanzapine though. All-in-all none of it bothers me.

I have to say though, Saphris is one that I would consider trying again. I wasn't taking an antidepressant at the time which really changes my response to APs. It was fairly weight neutral although I may have gained a few pounds but nothing serious. I did notice that about 30-60 mins after taking it I would become RAVENOUSLY hungry for sugars and carbs. That was frustrating because it sometimes led to sedated binge eating which didn't help my weight. However, it's one of those things where if you can resist the food cravings then keeping the weight off shouldn't be a problem. It's not like quetiapine and olanzapine where you gain weight regardless of how well you eat.

I've also only taken it once (IM though, not oral) during a nasty little episode of EPS that happened when the inpatient psychiatrist briefly tried putting me on an extra 5mg of Saphris in the morning in addition to the 10mg at night (despite having previously changed me from 5mg BID to 10mg QHS because of intolerable sedation and EPS - I'm not sure WTF he was thinking). It worked pretty well and didn't seem to have any obvious side effects, but I know they only used a small dose, and I'm sure the IM route works differently from the oral route.

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