Cariprazine (vraylar) side effects
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Common Side Effects of Cariprazine (Vraylar): Akathisia, Insomnia, and Extrapyramidal Symptoms
Cariprazine (Vraylar) is most commonly associated with side effects such as akathisia (a feeling of inner restlessness), insomnia, and extrapyramidal symptoms (EPS), which include movement disorders like tremors or rigidity. These side effects are generally mild to moderate in intensity and rarely lead to discontinuation of the medication. Akathisia is the most frequently reported side effect, affecting about 14–15% of patients, followed by insomnia and headache. Most cases of akathisia are manageable with dose adjustments or additional medications, and the majority of patients can continue treatment without interruption 2346910.
Other Reported Side Effects: Nausea, Sedation, Dizziness, and Constipation
Other side effects that occur in a smaller percentage of patients include nausea, sedation, dizziness, and constipation. These are typically mild and do not usually require stopping the medication. Sedation and somnolence (sleepiness) are reported in about 3–4% of patients, while constipation and dizziness are less common 346910.
Rare and Unusual Side Effects: Hypersexuality and Retinal Changes
There are rare reports of unusual side effects. For example, a single case report described hypersexuality that resolved after stopping cariprazine, but more research is needed to confirm if this is a true side effect . In animal studies, cariprazine caused retinal changes and cataracts, but these effects have not been observed in humans .
Metabolic, Cardiovascular, and Sexual Side Effects
Cariprazine has a favorable metabolic profile, with minimal impact on weight, blood sugar, or cholesterol levels. Weight gain is generally mild, with an average increase of about 1 kg, and metabolic side effects are rare. The risk of sexual dysfunction and cardiovascular side effects, such as changes in heart rhythm (QT prolongation), is low and occurs in less than 1% of patients 3467910.
Discontinuation and Serious Risks
The risk of discontinuing cariprazine due to side effects is slightly higher than placebo, mainly because of EPS-related symptoms. However, most side effects are manageable, and the overall tolerability is considered good. Like other antipsychotics, cariprazine carries a boxed warning for increased risk of death in elderly patients with dementia-related psychosis, and it is not approved for this use 24810.
Conclusion
Cariprazine (Vraylar) is generally well tolerated, with the most common side effects being akathisia, insomnia, and extrapyramidal symptoms. Most side effects are mild or moderate and can be managed without stopping the medication. Serious or unusual side effects are rare, and cariprazine has a low risk of causing metabolic, cardiovascular, or sexual side effects. Overall, cariprazine offers a favorable safety profile for patients with schizophrenia and bipolar disorder.
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