Our lawyers are investigating gambling addiction and other uncontrollable behavior side effects of Rexulti (brexpiprazole), a medication that treats depression and schizophrenia.

What is Rexulti?

Rexulti® (brexpiprazole) was approved in July 2015 for the treatment of adults with schizophrenia, and also as an add-on treatment to an antidepressant medication in adults with major depressive disorder. It is manufactured by Tokyo-based Otsuka Pharmaceutical Co. Ltd.

What is the problem?

Rexulti is nearly identical to Abilify (aripiprazole) and it was introduced shortly after Abilify went off-patent. Because the two medications are so similar, lawyers are concerned about a similar risk of gambling side effects.

The Prescribing Information (PDF) for Rexulti warns about the risk of “pathological gambling” from other types of 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.”

Abilify and Compulsive Behaviors

Abilify is associated with impulse-control disorders, such as uncontrollable urges to gamble, eat, shop, and have sex. These behavior problems are believed to be caused by the way Abilify influences the “reward system” in the brain, reinforcing pleasurable behaviors and producing intense cravings to do the behavior again.

Rexulti Boxed Warnings

Rexulti has a “Boxed Warning” label to alert doctors and patients about an increased risk of death when Rexulti is used to treat behavior problems in older adults with dementia-related psychosis.

Rexulti also has a “Boxed Warning” about the increased risk of suicidal thinking and behavior in children, adolescents, and young adults who are taking antidepressants. Patients should be monitored for new or worsening suicidal thoughts and behaviors.

Rexulti Side Effects

In clinical trials, the most common side effects reported by over 5% of people taking Rexulti included weight-gain, and an inner sense of restlessness, such as feeling the need to move (“akathisia”).

The most severe side effects of Rexulti include:

  • 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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