Rexulti (brexpiprazole) is an atypical antipsychotic used to treat schizophrenia and major depressive disorder. However, it’s not the only option available. This article explores comparable medications, focusing on Abilify (aripiprazole) as a potential alternative. We’ll delve into the similarities and differences between these two drugs, examining their uses, efficacy, side effects, cost, and other crucial factors to help you understand your options.
Abilify vs. Rexulti: Key Differences and Similarities
Both Abilify and Rexulti belong to the class of atypical antipsychotics, also known as second-generation antipsychotics. These drugs work differently than older, first-generation antipsychotics, generally causing fewer movement-related side effects. While both target dopamine and serotonin receptors in the brain, subtle differences in their mechanisms of action can lead to variations in their effectiveness and side effect profiles.
Key Differences:
- Generic Availability: Abilify is available in a generic form (aripiprazole), making it potentially more affordable. Rexulti is currently only available as a brand-name medication.
- FDA-Approved Uses: While both treat schizophrenia and major depressive disorder as adjunctive therapy, Abilify has broader FDA approval, including for bipolar I disorder, Tourette’s disorder, and irritability associated with autistic disorder in children. Rexulti is only approved for use in adults.
- Dosage Forms: Abilify offers more diverse dosage forms, including tablets, disintegrating tablets, oral solution, and injections (both immediate-release and long-acting). Rexulti is primarily available as tablets.
Similarities:
- Drug Class: Both are atypical antipsychotics.
- Mechanism of Action: Both primarily affect dopamine and serotonin receptors, though their precise interactions differ.
- Target Conditions: Both treat schizophrenia and are used as add-on therapy for major depressive disorder that hasn’t responded to antidepressants alone.
Comparing Efficacy: Which Drug Works Better?
Direct comparison studies between Abilify and Rexulti are limited. Some research suggests Rexulti may cause fewer specific side effects like akathisia (restlessness), insomnia, and weight gain. However, these side effects with Abilify are often manageable with dosage adjustments.
A small study indicated similar efficacy in treating acute schizophrenia, with Rexulti potentially causing fewer extrapyramidal side effects (movement disorders). Another study found comparable weight gain profiles for both drugs over a year. Ultimately, the “better” drug depends on individual responses and tolerability.
Cost and Insurance Coverage
Abilify’s generic availability typically translates to lower out-of-pocket costs compared to Rexulti. Insurance coverage varies for both medications, but generic Abilify is generally more widely covered by insurance plans and Medicare. Utilizing discount programs like SingleCare can further reduce costs for both drugs.
Side Effects: A Comparative Overview
Common side effects for both medications include nausea, constipation, headache, dizziness, and akathisia. However, the frequency and severity of these side effects can differ. For instance, nausea seems more prevalent with Abilify, while weight gain might be slightly more common with Rexulti. Consulting the prescribing information and discussing potential side effects with your doctor is crucial.
Drug Interactions and Warnings
Both Abilify and Rexulti share similar drug interactions and warnings. They should not be combined with alcohol or CNS depressants. Both can interact with certain medications metabolized by the liver, potentially requiring dosage adjustments. Both carry a black box warning regarding increased mortality risk in elderly patients with dementia-related psychosis.
Conclusion: Choosing the Right Medication
Deciding between Abilify and Rexulti requires careful consideration of individual needs and preferences. Factors like cost, side effect profile, and specific treatment goals should be weighed. Consulting with a healthcare provider is essential to determine the most appropriate medication based on your unique medical history and current health status. They can provide personalized guidance and help you make an informed decision.
