Nausea, Insomnia, and More: 9 Exxua Side Effects

Exxua (gepirone) is an antidepressant that’s FDA approved to treat depression in adults. It’s the only medication in its class, and it works differently from other antidepressants. Exxua helps balance the activity of serotonin in the brain. Serotonin is a chemical that plays a role in mood and sleep, among other bodily functions.

Because Exxua works differently from other antidepressants, its side effects are distinct. For instance, Exxua doesn’t seem to cause sexual side effects, unlike many other antidepressants. But what side effects can it cause?

Exxua side effects at a glance

Many Exxua side effects are mild. And they typically get better or go away as your body gets used to the medication. If you have side effects that don’t go away or get worse, contact your healthcare team immediately.

Common or mild Exxua side effects include:

• Dizziness

• Nausea

• Vomiting

• Headaches

• Fatigue or drowsiness

• Trouble sleeping

• Diarrhea

• Dry mouth

• Stomach pain

• Upset stomach

• Constipation

• Excessive sweating

Rare but serious Exxua side effects include:

• Heart rhythm changes

• Serotonin syndrome

• Suicidal thoughts

• Manic, hypomanic, or mixed episodes in people with bipolar disorder

This medication also carries a boxed warning for suicidal thoughts and behavior. (A boxed warning is the FDA’s strictest warning for medications.) This Exxua side effect is very rare. But if you experience worsening depression or thoughts of harming yourself, seek immediate help.

We’ll go into more detail about nine Exxua side effects below. Keep in mind this isn’t a complete list of the possible side effects. If you experience any side effects that are bothersome or feel excessive, contact your healthcare team.

1. Dizziness

Dizziness is the most common Exxua side effect. It may be more noticeable when you first start taking Exxua or after dosage changes. But it should go away after your body adjusts to the medication.

EXPERT PICKS: WHAT TO READ NEXT

• What antidepressants are available? Exxua (gepirone) is one of several antidepressants currently available. Read about different types of antidepressants and when they’re recommended.

• How Exxua and Viibryd compare: Find out how Exxua differs from Viibryd (vilazodone), another type of antidepressant.

• Exxua vs. SSRIs: See how Exxua compares to selective serotonin reuptake inhibitors (SSRIs).

If you feel dizzy, find a place to sit or lie down. And be careful when changing positions, such as going from sitting to standing. Drinking extra fluids may help limit dizziness.

If your dizziness seems severe, contact your prescriber. You may need a lower Exxua dosage. Or you may need a different antidepressant altogether.

2. Nausea or vomiting

Like other antidepressants, Exxua can cause nausea or vomiting. This side effect may be worse when you first start taking Exxua. But it generally improves or goes away after your body adjusts to the medication.

Even if you’re feeling nauseated, it’s important to take Exxua with food. Food helps your body absorb the medication.

Other things you can do to ease nausea or vomiting include:

• Staying hydrated

• Drinking ginger or peppermint tea

• Avoiding spicy or fried foods

If you throw up shortly after taking Exxua, contact your prescriber or pharmacist. They may suggest taking another dose. But don’t take extra Exxua without a healthcare professional’s OK. If your nausea or vomiting doesn’t improve or gets worse, contact your prescriber.

3. Headaches

Many medications cause headaches as a side effect. And Exxua is no exception. Headaches from an antidepressant are more likely when you first start taking the medication. But they usually go away over time.

There are a number of simple ways to manage headaches:

• Drink plenty of water and other fluids.

• Exercise regularly, or find other ways to add more movement to your routine.

• Optimize your sleep hygiene to help you get enough rest.

• Limit caffeine and alcohol, which can trigger headaches.

• Ask a healthcare professional if you can safely take over-the-counter (OTC) pain relievers, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin).

If your headaches seem severe or excessive, contact your prescriber. This isn’t typical with Exxua. And there may be another cause for your headaches.

Good to know: Exxua interacts with some medications used for migraine headaches. These include triptan medications, such as sumatriptan (Imitrex). Talk to your prescriber about how to safely manage migraines while taking Exxua.

4. Fatigue or drowsiness

Fatigue and drowsiness are also common Exxua side effects. These side effects are typically mild. And keep in mind that fatigue is a possible depression symptom. So sometimes, it may be unclear if Exxua is the cause of tiredness.

Exxua is a once-daily medication. So if you’re experiencing sleepiness, try taking your dose with a snack before bedtime. This way, you’re more likely to feel tired when it’s time to go to sleep.

If you’re experiencing drowsiness that’s interfering with your daily routine, contact your healthcare team.

5. Insomnia

Insomnia (trouble sleeping) is another common Exxua side effect. Similar to fatigue, it’s common for people with depression to have trouble sleeping. So this may not be caused by Exxua.

If you’re having trouble sleeping, try taking Exxua with breakfast shortly after you wake up. That way, it’s less likely to cause issues when you’re trying to go to bed.

If you find that your sleep doesn’t improve, tell your prescriber.

6. Diarrhea or constipation

Diarrhea is another common Exxua side effect. Exxua can also cause constipation, but it’s less common than diarrhea.

Below are some tips for managing diarrhea and constipation:

• Drink plenty of water and other fluids.

• For diarrhea, avoid spicy, greasy, or fatty foods.

• For constipation, slowly add more fiber to your diet.

• Discuss safe OTC diarrhea or constipation medications with your prescriber or pharmacist.

If your diarrhea or constipation is bothersome or seems excessive, contact your prescriber. This isn’t typical with Exxua.

7. Heart rhythm changes

In rare cases, Exxua can cause a heart rhythm problem called long QT syndrome. This is a serious side effect and can lead to life-threatening arrhythmias (abnormal heart rhythms).

There are people who may have a higher risk of developing long QT syndrome while taking Exxua. This includes people who:

• Were born with long QT syndrome (congenital long QT syndrome)

• Have abnormal electrolyte levels, such as low potassium

• Have severe liver problems, such as cirrhosis

• Take certain medications that interact with Exxua, such as clarithromycin (Biaxin XL)

• Take other medications that can cause long QT syndrome, such as ziprasidone (Geodon)

Your prescriber will likely check your heart rhythm before you start Exxua and from time to time while you’re taking it. If you experience sudden dizziness, fainting, or a pounding heartbeat, seek medical help. These are possible symptoms of long QT syndrome.

8. Serotonin syndrome

Serotonin syndrome is another rare but serious Exxua side effect. This happens when there is too much serotonin in the brain. Symptoms include sweating, a fast heartbeat, and muscle stiffness.

The risk of serotonin syndrome is higher if you take other medications that increase serotonin levels or activity. Examples include other antidepressants, opioid pain relievers, and triptan migraine medications. Your pharmacist can let you know if you take any other medications that affect serotonin.

Serotonin syndrome can be life-threatening if left untreated. If you’re having symptoms of serotonin syndrome, contact a healthcare professional right away. Depending on your symptoms, they may recommend that you seek emergency care at a hospital.

9. Suicidal thoughts

Exxua carries a boxed warning for suicidal thoughts and behaviors. This serious Exxua is very rare, but you may be at a higher risk if you’re under age 25. It’s also more likely to happen during the first few months of taking Exxua.

If you experience worsening depression or thoughts of harming yourself, get immediate help.

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.

Does Exxua cause sexual side effects?

No, Exxua doesn’t seem to cause sexual side effects such as erectile dysfunction.

Many other antidepressants — particularly selective serotonin reuptake inhibitors (SSRIs) — cause sexual side effects. But research shows that people who take Exxua report these issues much less frequently than those who take SSRIs. In fact, people who took Exxua in studies were no more likely to have sexual side effects than those who didn’t take an antidepressant.

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Written by:

Sarah Morin, RPh

Sarah Morin, RPh, has been a registered pharmacist for over 25 years. She started out as a hospital pharmacist, working at Rhode Island Hospital and then at the University of Connecticut Health Center.

Edited 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.

Reviewed by:

Tegan Smedley, PharmD, APh

Tegan Smedley, PharmD, APh, has 10 years of experience as a pharmacist. She has worked in a variety of settings, including retail, hospital, and ambulatory care.

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