Frequently asked questions and answers about Rexulti, an antipsychotic drug that may increase the risk of gambling addiction and compulsive behavior side effects.

What does Rexulti treat?

Rexulti is approved for the treatment of adults with schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions). Rexulti is also approved as an add-on treatment to antidepressants for the treatment of adults with major depressive disorder (MDD).

How does Rexulti work?

Rexuti contains brexpiprazole, an antipsychotic medication that works by balancing levels of neurotransmitters in the brain (dopamine and serotonin) to improve thinking, mood, and behavior.

Is Rexulti similar to Abilify?

Yes. Rexulti is nearly identical to the antipsychotic drug Abilify (aripiprazole) and both medications are made by Otsuka Pharmaceutical Company. Rexulti hit the market in July 2015, just 2 months after Abilify lost patent protection from competitors.

What is the problem?

Because Abilify and Rexulti are so similar, experts are concerned about a similar risk of side effects — especially compulsive behavior disorders like gambling addiction. The FDA has already linked Abilify with uncontrollable urges to gamble, eat, shop, and have sex.

What is the risk of gambling addiction from Rexulti?

Patients who are taking Rexulti should talk to their doctor if they have a history of gambling problems because it may trigger this side effect.

The Prescribing Information (PDF) for Rexulti includes the following warning label about the risk of “pathological gambling” from other antipsychotic medications:

“Post-marketing reports of impulse-control disorders including pathological gambling and hypersexuality have been reported in patients treated with another antipsychotic with partial agonist activity at dopamine receptors. Patients with a prior history of impulse-control disorder may be at increased risk and should be monitored carefully.”

What are the Boxed Warnings on Rexulti?

The label on Rexulti also carries “Black Box” warning labels about the risk of increased suicidal thoughts and behaviors for teenagers and young adults who are on antidepressants. Rexulti also increases the risk of stroke and death in adults with dementia-related psychosis.

What are other severe side effects of Rexulti?

  • Stroke in elderly patients with dementia-related psychosis
  • Neuroleptic malignant syndrome
  • Tardive dyskinesia
  • Metabolic changes (hyperglycemia, diabetes, etc.)
  • Leukopenia, neutropenia, and agranulocytosis
  • Orthostatic hypotension
  • Seizures


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