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Hi everyone,

I will be picking up my rexulti rx soon and wanted to know if I should take it in the evening or the morning? My IOP pdoc has never prescribed it but she looked through the prescribing information sheet and said it is more likely to cause sedation than activation so I should first try taking it at night? But there is a possibility of it causing insomnia(1%). Were the start up effects debilitating? I don't know if I should start it tonight or wait for the weekend. I also am suppose to increase my Lexapro to 20 tomorrow and am wondering if that might be too many changes in a day. It would be okay if I was in the hospital but I am in IOP right now and have to wake up early and drive. Thanks in advance. 

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I don't have any personal experience with Rexulti, but if it were me, I would wait till the weekend to start it, especially since you have to drive, and can't predict with certainty what it's going to do, and you're increasing your Lexapro dose, too.

From what I've read, for some people it's sedating, for others it is activating.

Hopefully, someone with personal experience will reply, and might give more accurate advice.

Edited by CrazyRedhead
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Personally, I have taken it at night, as it caused sedation during the daytime if I took it in the morning. Even when I took it at nighttime, I still felt a little sedated. Just kinda experiment with it if you have the chance to do so.

What dose are you on?

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43 minutes ago, CeremonyNewOrder said:

Pdoc is starting me at just 1mg then 2 mg if I can tolerate it

Ok. I'd personally start taking it at night for sure if it were me. I've always felt better (relatively speaking) when taking it at night (I say relatively speaking because I wasn't a positive responder to it...).

Best of luck to you with Rexulti!

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Good luck starting out at 1mg. There's no way I could tolerate that. I started at 0.5mg and even that was too much. Did 0.5mg for 2 weeks, dropped down to 0.25mg for 4 weeks, then increased back to 0.5mg. Eventually increased to 1mg and that's where I've been since. The startup can be a little strange. It is the opposite of Abilify in that Rexulti's lower doses are sedating and the higher doses are activating. I take my 1mg at night, and it helps wonderfully with sleep in combo with my Depakote. I've been taking it now since ~September 2017 and LOVE it.

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1 hour ago, browri said:

Good luck starting out at 1mg. There's no way I could tolerate that. I started at 0.5mg and even that was too much. Did 0.5mg for 2 weeks, dropped down to 0.25mg for 4 weeks, then increased back to 0.5mg. Eventually increased to 1mg and that's where I've been since. The startup can be a little strange. It is the opposite of Abilify in that Rexulti's lower doses are sedating and the higher doses are activating. I take my 1mg at night, and it helps wonderfully with sleep in combo with my Depakote. I've been taking it now since ~September 2017 and LOVE it.

I thought about starting with 0.5mg but the 1mg tablet is so small. I'll have to see if it can be cut.

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It's a shame that your pdoc didn't give you 0.5mg samples, but it may be worth trying at 1mg. However, if it seems like it's really not treating you well, don't give up on it. Just call your pdoc and see if he has samples of the 0.25mg and 0.5mg tablets so you can very slowly step yourself up. You may find it to be a wonderful medication, but it has a very long half-life, so it takes like 2-3 weeks to reach steady state in your system. In the beginning this build-up process can be kind of uncomfortable.

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1 hour ago, browri said:

It's a shame that your pdoc didn't give you 0.5mg samples, but it may be worth trying at 1mg. However, if it seems like it's really not treating you well, don't give up on it. Just call your pdoc and see if he has samples of the 0.25mg and 0.5mg tablets so you can very slowly step yourself up. You may find it to be a wonderful medication, but it has a very long half-life, so it takes like 2-3 weeks to reach steady state in your system. In the beginning this build-up process can be kind of uncomfortable.

I'm stuck with 1mg tabs because rexulti isn't in stock at my pharmacy and requires a week to order. My pdoc has never prescribed this med so she doesn't know how to titrate it up. Thank you for your info, I'll try to cut the tabs with my pill cutter.

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10 minutes ago, CeremonyNewOrder said:

I'm stuck with 1mg tabs because rexulti isn't in stock at my pharmacy and requires a week to order. My pdoc has never prescribed this med so she doesn't know how to titrate it up. Thank you for your info, I'll try to cut the tabs with my pill cutter.

Yeah, if your pdoc gave you that discretion then I would recommend it. Like I said, 0.5mg even felt like too much all up front, but I took that dip down to 0.25mg for a few weeks and when I increased back up to 0.5mg it felt totally different the second time around.

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