Answers to frequently asked questions about Rexulti (brexpiprazole), a medication similar to Abilify that may also increase the risk of gambling addiction and compulsive behaviors.
Why is Rexulti prescribed?
Rexulti is used to treat the symptoms of schizophrenia, which is a mental illness that causes unusual thinking, loss of interest in life, and strong or inappropriate emotions. Rexulti is also used with an antidepressant to treat depression when the symptoms can’t be controlled by the antidepressant alone.
What type of medication is Rexulti?
Rexulti is in a class of medications called atypical antipsychotics. It works by changing the activity of certain natural substances in the brain that regulate thinking, mood, and behavior.
How should Rexulti be used?
Rexulti comes as a tablet (pill) that is taken by mouth, usually once daily. Take Rexulti at the same time every day and follow the directions on your prescription label carefully. Your doctor may start you on a low dose and gradually increase your dose depending on how well it works and the side effects you experience.
Is Rexulti similar to Abilify?
Yes. Rexulti (brexpiprazole) and Abilify (aripiprazole) are nearly-identical antipsychotic drugs that are both made by Otsuka Pharmaceutical Company. In fact, Otsuka started selling Rexulti in July 2015, just 2 months after Abilify lost patent protection.
What is the problem?
Rexulti and Abilify may have a similar risk of side effects. In May 2016, the FDA strengthened warnings about the risk of compulsive behaviors from Abilify, especially uncontrollable urges to gamble, eat, shop, and have sex.
Does Rexulti cause gambling addiction?
People with a history of gambling problems should talk to their doctor before starting Rexulti. The Prescribing Information (PDF) for Rexulti warns that “pathological gambling” has been reported with similar medications. According to the label on Rexulti:
“Post-marketing reports of impulse-control disorders including pathological gambling and hypersexuality have been reported in patients treated with another antipsychotic with partial agonist activity at dopamine receptors. Patients with a prior history of impulse-control disorder may be at increased risk and should be monitored carefully.”
What are severe side effects of Rexulti?
- Stroke in elderly patients with dementia-related psychosis
- Neuroleptic malignant syndrome
- Tardive dyskinesia
- Metabolic changes (hyperglycemia, diabetes, etc.)
- Leukopenia, neutropenia, and agranulocytosis
- Orthostatic hypotension