Vraylar vs. Abilify for Bipolar 1 Disorder: 7 Differences to Consider
Key takeaways:
Vraylar (cariprazine) and Abilify (aripiprazole) are prescription medications that treat bipolar 1 disorder. Both work well for manic or mixed episodes, but only Vraylar is approved for depressive episodes, too.
Vraylar lasts longer in the body than oral forms of Abilify, so a missed dose now and then is less of an issue. But Abilify has unique dosage forms to prevent missed doses: a long-acting injection and a trackable oral tablet.
Vraylar and Abilify are both available as brand-name medications. But you can also find Abilify as a lower-cost generic. GoodRx can help make your prescription more affordable.
Table of contents
Living with bipolar 1 disorder means dealing with extreme mood swings. And finding the right medication to balance your symptoms can be challenging. Abilify (aripiprazole) and Vraylar (cariprazine) are two common treatment options. But what’s the difference between them? And are they equally effective for bipolar 1 symptoms?
Let’s review seven differences of Abilify versus Vraylar for bipolar 1.
1. Vraylar works better for depression symptoms of bipolar disorder
Bipolar 1 symptoms include shifting from periods of intense energy (bipolar mania) to very low energy (bipolar depression). Mixed episodes, with mania and depression symptoms at the same time, can also happen.
Both Abilify and Vraylar are FDA approved for manic and mixed episodes of bipolar 1. But Vraylar is approved for depressive episodes of bipolar 1, too. Abilify wasn’t effective for bipolar depression symptoms in clinical studies.
This means that Vraylar may be a better option for you if improved depression symptoms are a treatment goal.
2. Unlike Vraylar, Abilify is approved for both children and adults
Abilify is approved for bipolar 1 in adults and children ages 10 and older. It was found safe and effective for children ages 10 to 17 in a clinical study.
Vraylar, on the other hand, is only FDA approved for adults. There haven’t been enough studies in children to know if it’s a safe or effective option. One small study found that Vraylar might be effective for children living with bipolar disorder. But more research is currently underway, with results expected some time in 2025.
For now, only Abilify is an approved option for treating bipolar 1 in children ages 10 and older.
3. Abilify comes in more dosage forms than Vraylar
Vraylar comes as an oral capsule that must be swallowed whole. Abilify, however, comes in several dosage forms:
Oral tablets
Oral tablets with a sensor that tracks your doses (Abilify Mycite)
Orally disintegrating tablets
Oral liquid
Fast-acting injection into the muscle
Long-acting, once-monthly injection (Abilify Maintena)
Long-acting injection given every 2 months (Abilify Asimtufii)
The wide variety of dosage forms makes Abilify a better option if you can’t swallow pills or have trouble remembering to take your medication.
4. Vraylar lasts longer in the body than oral forms of Abilify
Studies show that about half of people living with bipolar disorder don’t take their medication regularly. The condition can make it harder for some people to adhere to treatment. And remembering to take medication every day can be hard for anyone. But missing doses of bipolar medications can cause problems. You may have withdrawal symptoms, or your bipolar symptoms may return. But this is less of an issue with Vraylar.
Vraylar can last for days to weeks in the body. So missing a dose of Vraylar now and then isn’t likely to cause an issue. Oral forms of Abilify don’t last as long in the body, so a missed dose may have more of an impact. That’s why Abilify also comes in long-acting injections and trackable tablets for those who have trouble remembering to take it.
Vraylar may be a better option if you have trouble remembering to take your medication every day. But if you find that you’re missing more than an occasional dose, it’s best to let your healthcare provider know. They can give you tips for remembering your doses or make changes to your medication if needed.
5. Abilify and Vraylar have similar risks and side effects
Abilify and Vraylar are both atypical antipsychotics and have similar risks and side effects. Common side effects of both medications include headache, nausea, and constipation. You may also experience uncontrolled muscle movements or restlessness. Weight gain is possible, but it’s less common with Abilify and Vraylar than some other antipsychotic medications.
Although rare, Abilify and Vraylar can also cause more serious side effects, including:
Suicidal thoughts or behavior
Uncontrollable movements of the face, mouth, or body (tardive dyskinesia)
Seizures
Low white blood cell count
Good to know: Vraylar side effects may not appear until you’ve been taking Vraylar for a few weeks. That’s because it builds up in your body over time. So side effects may not appear until the levels in your body go up.
If you or someone you know is having thoughts of suicide, you’re not alone, and help is available. Call the National Suicide Prevention Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line.
6. Abilify and Vraylar have some different drug interactions
Abilify and Vraylar are broken down by your body in slightly different ways. As a result, they have different drug interactions to be aware of.
Both medications can interact with:
Carbamazepine
St. John’s wort
Clarithromycin (Biaxin)
Fluconazole (Diflucan) and other similar antifungals
Grapefruit juice
Abilify also interacts with some antidepressants, such as fluoxetine (Prozac) and paroxetine (Paxil, Brisdelle).
The other medications you’re taking may determine whether Abilify or Vraylar is a better option for you. Be sure to share a list of your medications with your healthcare provider and pharmacist. They can identify any interactions and use them to help determine the best treatment option for your needs.
7. Abilify is available as a lower-cost generic, but Vraylar isn’t
Vraylar is only available as a brand-name medication. But most oral forms of Abilify are available as lower-cost generics. So Abilify may be a more affordable treatment option for some people.
GoodRx can help you navigate many ways to save on your prescription.
Save with GoodRx. GoodRx can help you save over 90% off the average retail price of the generic version of Abilify tablets. Generic Abilify’s price at certain pharmacies may be as low as $9.90 with a free GoodRx discount.
Save with a copay savings card. If you have commercial insurance and meet eligibility requirements, Vraylar’s price is as low as $0 on your first two 30-day fills ($5 per fill thereafter) using a savings card from the manufacturer. And there’s also a savings card for brand-name Abilify which lowers the price to $5 per month.
Save with patient assistance programs. If you’re uninsured or underinsured, you may be eligible for Vraylar’s patient assistance program, which offers the medication free of cost.
The bottom line
Abilify (aripiprazole) and Vraylar (cariprazine) are atypical antipsychotic medications that treat bipolar 1 disorder. Abilify is approved for adults and children ages 10 and older, but Vraylar is only approved for adults. Both medications work well for manic or mixed bipolar episodes, but only Vraylar is approved for depressive episodes. Vraylar comes as an oral capsule, while Abilify comes in several different oral and injectable dosage forms.
Abilify and Vraylar have similar risks and side effects. And they both have interactions to be aware of. Vraylar may be a better option if you forget to take your medication now and again, as it lasts longer in the body than oral forms of Abilify. Your healthcare provider will help determine which medication is best for you based on your medical history and treatment goals.
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References
AbbVie. (2023). A study to assess change in disease activity and adverse events (AEs) with cariprazine in the treatment of depressive episodes in pediatric participants (10 to 17 years of age) with bipolar I disorder. ClinicalTrials.gov.
Chakrabarti, S. (2016). Treatment-adherence in bipolar disorder: A patient-centred approach. World Journal of Psychiatry.
Do, A., et al. (2021). Cariprazine in the treatment of bipolar disorder: Within and beyond clinical trials. Frontiers in Psychiatry.
Findling, R. L., et al. (2009). Acute treatment of pediatric bipolar I disorder, manic or mixed episode, with aripiprazole: A randomized, double-blind, placebo-controlled study. The Journal of Clinical Psychiatry.
Mohr, P., et al. (2021). Dopamine receptor partial agonists: Do they differ in their clinical efficacy? Frontiers in Psychiatry.
Otsuka America Pharmaceutical, Inc. (2022). Abilify - aripiprazole tablet, solution, tablet (orally disintegrating), injection [package insert].
Poweleit, E. A., et al. (2020). Cariprazine in youth with bipolar and psychotic disorders: A retrospective chart review. Journal of Child and Adolescent Psychopharmacology.
Remedy Repack Inc. (2023). Vraylar - cariprazine capsule, gelatin coated [package insert].
U.S. Food and Drug Administration. (2018). FDA approves pill with sensor that digitally tracks if patients have ingested their medication.
For additional resources or to connect with mental health services in your area, call SAMHSA’s National Helpline at 1-800-662-4357. For immediate assistance, call the National Suicide Prevention Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line.
