Vraylar vs. Eskalith (Lithium)

Vraylar (cariprazine) and Eskalith (Lithium) are used to treat manic episodes associated with bipolar disorder.

Vraylar is also used to treat schizophrenia, and for the acute treatment of mixed episodes associated with bipolar I disorder.

Eskalith (Lithium) is also indicated as a maintenance treatment for individuals with a diagnosis of bipolar disorder.

Vraylar and Eskalith (Lithium) belong to different drug classes. Vraylar is an atypical antipsychotic and Eskalith (Lithium) is an antimanic agent.

Side effects of Vraylar and Eskalith (Lithium) that are similar include vomiting, sleepiness/drowsiness, and diarrhea.

Side effects of Vraylar that are different from Eskalith (Lithium) include extrapyramidal symptoms (muscle spasms, muscle rigidity, tremor, jerking movements), agitation, indigestion, nausea, restlessness, weight gain, headache, insomnia, abdominal pain, constipation, toothache, anxiety, pain in the extremities, dry mouth, loss of appetite, back pain, dizziness, and cough.

Side effects of Eskalith (Lithium) that are different from Vraylar include hand tremors, increased urination, mild thirst, muscle weakness, lack of coordination, giddiness, weakness, blurred vision, and ringing in the ears.

Both Vraylar and Eskalith (Lithium) may interact with carbamazepine.

Vraylar may also interact with CYP3A4 inducers carbamazepine, and inhibitors.

Eskalith (Lithium) may also interact with diuretics, angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), acetazolamide, urea, xanthine preparations, alkalinizing agents such as sodium bicarbonate, iodide preparations, calcium channel blockers, metronidazole, fluoxetine, and nonsteroidal anti-inflammatory drugs (NSAIDs).

Side effects of Vraylar include:

• extrapyramidal symptoms (muscle spasms, muscle rigidity, tremor, jerking movements),
• agitation,
• indigestion,
• nausea,
• vomiting,
• sleepiness,
• restlessness,
• weight gain,
• headache,
• insomnia,
• abdominal pain,
• constipation,
• toothache,
• anxiety,
• diarrhea,
• pain in the extremities,
• dry mouth,
• loss of appetite,
• back pain,
• dizziness, and
• cough.

Common side effects of Eskalith (Lithium) include:

• mild hand tremor,
• weakness,
• lack of coordination,
• dry mouth,
• altered taste perception,
• weight gain,
• increased thirst,
• increased frequency of urination,
• mild nausea or vomiting,
• loss of appetite,
• stomach pain or upset,
• impotence,
• decreased libido,
• diarrhea,
• thinning or drying of the hair,
• itching skin, and
• kidney abnormalities.

Vraylar (cariprazine) is an atypical antipsychotic indicated for the treatment of schizophrenia, and the acute treatment of manic or mixed episodes associated with bipolar I disorder.

Eskaltih (lithium) is an antimanic agent used for treating manic episodes due to bipolar disorder. Eskaltih is also combined with antidepressants to treat depression.

Vraylar may interact with CYP3A4 inducers and inhibitors. Tell your doctor all medications and supplements you use.

Lithium interacts with non-steroidal anti-inflammatory drugs (NSAIDs), hydrochlorothiazide, ACE inhibitors, and methyldopa. Eskaltih can cause harm to a fetus. Do not use Eskaltih without your doctor's consent if you are pregnant. Tell your doctor if you become pregnant during treatment with Eskaltih.

The starting dose of Vraylar is 1.5 mg once daily.

Lithium doses vary widely and are adjusted based on measurements of the levels of lithium in the blood. Most patients require 900-1200 mg daily in 2-3 divided doses.