Vraylar vs. Latuda for Bipolar Depression and Schizophrenia: 7 Differences to Know About

Bipolar disorders and schizophrenia are complicated mental health conditions. A combination of therapy, lifestyle habits, and medication is usually needed to manage symptoms.

Many medication options exist for these conditions. But there’s no “best” one, and a combination of medications is often needed. Vraylar (cariprazine) and Latuda (lurasidone) are oral antipsychotic medications. If you’re considering these medications, knowing their unique characteristics can help you and your healthcare provider decide what’s best for you. Here, we’ll cover seven important differences between Vraylar versus Latuda.

1. Vraylar is approved to treat more health conditions than Latuda

Both Vraylar and Latuda are antipsychotic medications. They’re part of a group of antipsychotics known as atypical, or second-generation, antipsychotics. Both Vraylar and Latuda are approved to treat:

• Schizophrenia

• Depressive episodes in bipolar type 1 (bipolar depression)

Vraylar is also approved to treat:

• Manic or mixed episodes in bipolar type 1 (a mixed episode is when you feel manic and depressive symptoms at the same time)

• Major depressive disorder (MDD), when added to other depression medications

Some experts consider Latuda a first-choice option for depressive episodes in bipolar type 1. It can be taken alone or in combination with lithium (Lithobid) or Depakote (divalproex sodium). These are two medications that are commonly prescribed to treat bipolar disorder. However, if you’re having a manic or mixed episode, Vraylar may be preferred over Latuda in this situation.

Good to know: Experts think that Vraylar and Latuda work by altering levels of two brain chemicals that are unbalanced in people with mood disorders: dopamine and serotonin. But Vraylar and Latuda have different effects on dopamine. While Latuda generally decreases dopamine levels, Vraylar has mixed effects on dopamine — increasing it in some areas of the brain and decreasing it in others. These mixed effects may be why Vraylar works well for mania and depression in people with bipolar disorder.

2. Unlike Vraylar, Latuda is approved for adolescents and children, in some cases

Vraylar and Latuda are both FDA-approved for adults 18 and over. Latuda is also approved for adolescents and children, in some cases.

Latuda is approved to treat adolescents between the ages of 13 and 17 with schizophrenia. It’s also approved to treat bipolar depression in children ages 10 to 17.

While Vraylar may be effective for children in some cases, we don’t have enough research on this yet.

3. You can take Vraylar with or without food, but you should take Latuda with food

Taking Latuda or Vraylar with food may help with nausea, a possible side effect of both medications. But with Vraylar, it’s up to you whether to take it with food. If it doesn’t typically make you feel nauseated, you may opt to take it without food.

However, Latuda needs to be taken with food no matter what. This helps Latuda get absorbed from your gut. In fact, the presence of food doubles the absorption of each Latuda dose compared with taking it without food. It’s recommended to take Latuda with at least 350 calories.

Head to another GoodRx article for high-calorie snack ideas that are healthy, including nuts, nut butter, and dried fruit.

4. You may need a lower dose of Latuda if you have kidney or liver problems

Usual Latuda doses can build up in the blood if your liver or kidneys aren’t working as expected. Your healthcare provider will likely give you a lower Latuda dose if you have a specified degree of kidney or liver problems. Make sure your provider knows your full medical history before you start Latuda.

Vraylar doses don’t usually need to be adjusted for kidney or liver problems. But it hasn’t been studied in people with severe kidney or liver problems, so it’s usually not recommended if this applies to you.

5. Vraylar and Latuda share some side effects, but there are differences, too

Atypical antipsychotics such as Vraylar and Latuda generally have fewer side effects than typical (first-generation) antipsychotics. These two medications have many common side effects, but there are also some differences.

Similarities

Overall, Vraylar and Latuda have similar side effects. Common side effects of Vraylar and Latuda can include:

• Nausea

• Dizziness and drowsiness

• Increase in blood glucose (sugar) or cholesterol

• Weight gain

• Extrapyramidal symptoms (EPS), including restlessness (akathisia), tremors (parkinsonism), or abnormal body stiffening and twisting (dystonia)

Both medications also have the potential to cause more serious side effects, including:

• An increased risk of stroke and death in older adults with dementia (all antipsychotics have this risk)

• Suicidal thoughts and behaviors, especially in people under the age of 25

• Tardive dyskinesia, a severe form of EPS involving uncontrollable body movements

• A life-threatening condition called neuroleptic malignant syndrome

• A drop in white blood cells

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.

Differences

There are some notable differences in their side effects, too:

• Latuda is more likely to cause high prolactin levels, though the risk is low with both Latuda and Vraylar. Symptoms may include sexual dysfunction, menstrual irregularities, and decreased libido.

• Vraylar may be more likely to cause akathisia. Though Vraylar and Latuda can both cause EPS, Vraylar seems to be more likely to cause akathisia.

• Vraylar may be more likely to cause weight gain. People taking Vraylar were more likely to gain weight in clinical studies than those taking Latuda. However, neither medication is as likely to cause weight gain as some other atypical antipsychotics, such as olanzapine (Zyprexa) and quetiapine (Seroquel).

• Latuda may cause manic or hypomanic episodes. Latuda isn’t FDA-approved for bipolar I disorder with mania, but Vraylar is. The product information for Latuda states that it can actually increase your risk of a manic or hypomanic episode. But some research indicates this isn't true and that Latuda may actually help treat mania.

6. Vraylar lasts longer in the body than Latuda

When starting Vraylar (or after a dose increase), it may take longer to see the benefits. This is because blood levels of Vraylar rise slowly. But it also sticks around in the body longer than any of the other oral atypical antipsychotics, including Latuda. So an occasional missed dose may not be as big of a deal as it might be with other antipsychotics. If you take Vraylar, know that side effects can occur weeks after starting it.

7. Latuda comes in a generic form, but Vraylar is brand-only

Vraylar is only available as a brand-name product. Latuda comes in both generic and brand-name versions. Typically, generic medications cost less. But if you have prescription insurance, your out-of-pocket cost for each type depends on your specific plan and coverage.

How do you and your healthcare provider decide between Vraylar versus Latuda?

You and your healthcare provider will consider many factors before deciding whether Vraylar or Latuda is best for you. These include:

• Your age. Since Vraylar is approved for children and adolescents, it may be a better option if you’re under 18.

• Your specific symptoms. Only Vraylar is approved for bipolar I disorder with mania or mixed episodes.

• Your past experiences with bipolar or schizophrenia medications. If you’ve tried another atypical antipsychotic in the past, your healthcare provider will take this into consideration when choosing the next best option.

• Your other medications. Vraylar and Latuda can interact with other medications. This may require a dosage change, as well.

• How well your liver and kidneys function. Your healthcare provider will usually keep your Vraylar dosages the same, even if you have moderate kidney or liver problems. But they will typically lower your Latuda dosages in these situations.

• Whether you have a higher risk for certain side effects. Vraylar and Latuda can cause similar side effects, but there are also some differences. For example, Vraylar may be more likely to cause weight gain.

• Affordability and insurance coverage. Vraylar is brand-name-only, so it may be more expensive. However, this depends on whether you have insurance and what savings opportunities may be available to you.

How to save on Vraylar and Latuda

There are ways to save on Vraylar and Latuda. Both are available as brand-name medications. But you can also find Latuda as a lower-cost generic. Ways to save include:

• Save with GoodRx. GoodRx can help you save over 95% off the average retail price of the generic version of Latuda. Generic Latuda’s price at certain pharmacies may be as low as $16.67 with a free GoodRx discount.

• Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $0 for Latuda using a savings card from the manufacturer. You may also be eligible to pay as little as $0 for your first two 30-day fills of Vraylar. After the first two fills, the cost with the savings card is $5 per 30- or 90-day fill.

• 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 to those who qualify.

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Written by:

Daphne Berryhill, RPh

Daphne Berryhill, RPh, has two decades of experience as a clinical pharmacist. She spent most of her career in the Chicago area practicing in-home infusion.

Edited by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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