When You Can't Find Vraylar, What Are Your Options?

If you've been prescribed Vraylar (Cariprazine) and can't get it filled — whether because of stock issues, insurance denials, or cost — you're probably wondering: what else is out there?

The answer is that there are several medications in the same class that treat similar conditions. But switching medications is never a decision you should make on your own. This article is designed to help you have an informed conversation with your doctor about alternatives if Vraylar isn't available to you right now.

Before we get into alternatives, let's make sure you understand what Vraylar is and how it works — because that context matters when evaluating other options.

What Is Vraylar?

Vraylar is the brand name for Cariprazine, an atypical (second-generation) antipsychotic medication made by AbbVie. It's FDA-approved to treat:

• Schizophrenia in adults
• Manic or mixed episodes of bipolar I disorder
• Depressive episodes of bipolar I disorder (bipolar depression)
• Major depressive disorder (MDD) as adjunctive therapy

Vraylar comes as oral capsules in strengths of 1.5 mg, 3 mg, 4.5 mg, and 6 mg. It's taken once daily, with or without food. For a complete overview, see our guide on what Vraylar is, its uses, and dosage.

How Does Vraylar Work?

Vraylar's mechanism of action is what makes it unique among antipsychotics. It's a partial agonist at dopamine D3 and D2 receptors, and also a partial agonist at serotonin 5-HT1A receptors. It acts as an antagonist at 5-HT2A receptors.

In plain English: Vraylar helps balance dopamine activity in the brain. When dopamine is too high (as in mania or psychosis), it turns the signal down. When dopamine is too low (as in depression), it can help turn it up. Its strong preference for D3 receptors is thought to help with motivation, cognition, and the "negative symptoms" of schizophrenia like social withdrawal and flat affect.

For more detail, read our article on how Vraylar works.

Understanding this mechanism helps explain why certain alternatives may work similarly — and why others might not be the right fit.

Alternatives to Vraylar

The following medications are commonly considered as alternatives. Each has its own strengths, limitations, and FDA-approved uses. Always discuss any medication change with your prescriber.

1. Abilify (Aripiprazole)

Abilify is probably the closest alternative to Vraylar. Like Vraylar, it's a dopamine D2 partial agonist, which means it works by modulating dopamine activity rather than simply blocking it.

FDA-approved for:

• Schizophrenia (adults and adolescents 13–17)
• Bipolar I disorder (manic and mixed episodes)
• Adjunctive treatment of MDD
• Irritability associated with autism
• Tourette's disorder

Key advantages:

• Generic available — Aripiprazole is significantly cheaper than Vraylar, often $10–$50/month with discount cards
• Well-studied with decades of clinical data
• Available in multiple forms: tablets, oral solution, long-acting injectable (Abilify Maintena, Aristada)

Key differences from Vraylar:

• Less selective for D3 receptors, which may mean less benefit for negative symptoms and depression
• Can cause akathisia (restlessness) similarly to Vraylar
• Different metabolite profile — Vraylar's long-acting metabolites give it a much longer effective half-life

2. Rexulti (Brexpiprazole)

Rexulti is another dopamine D2 partial agonist, sometimes called a "next-generation" version of Aripiprazole.

FDA-approved for:

• Schizophrenia in adults
• Adjunctive treatment of MDD in adults
• Agitation associated with Alzheimer's dementia

Key advantages:

• May cause less akathisia than Aripiprazole or Vraylar
• Generally well-tolerated
• Good option specifically for MDD adjunctive use

Key differences from Vraylar:

• Not approved for bipolar disorder — if you take Vraylar for bipolar depression or mania, Rexulti may not be the right substitute
• Brand-name only, so also expensive (though savings programs exist)
• Different receptor binding profile

3. Latuda (Lurasidone)

Latuda is an atypical antipsychotic that's particularly well-known for treating bipolar depression.

FDA-approved for:

• Schizophrenia in adults and adolescents (13–17)
• Bipolar depression in adults and children (10–17), as monotherapy or with Lithium/Valproate

Key advantages:

• Generic available — Lurasidone generic can cost $30–$80/month
• Strong evidence for bipolar depression
• Relatively lower risk of weight gain and metabolic side effects compared to some antipsychotics

Key differences from Vraylar:

• Must be taken with food (at least 350 calories) for proper absorption
• Not a dopamine partial agonist — works primarily as a dopamine/serotonin antagonist
• Not approved for MDD adjunctive use or bipolar mania

4. Caplyta (Lumateperone)

Caplyta is one of the newer atypical antipsychotics on the market.

FDA-approved for:

• Schizophrenia in adults
• Depressive episodes of bipolar I or II disorder in adults (as monotherapy or adjunctive therapy)

Key advantages:

• Favorable metabolic profile — lower risk of significant weight gain
• Simple dosing: one dose (42 mg) for all approved indications
• May cause less EPS (movement side effects) than some alternatives
• One of the few medications approved for both bipolar I and bipolar II depression

Key differences from Vraylar:

• Brand-name only, so also expensive
• Not approved for schizophrenia maintenance, MDD adjunctive, or bipolar mania
• Relatively new — less long-term data available

How to Choose the Right Alternative

The best alternative depends on several factors:

• What condition you're treating — Bipolar depression? Schizophrenia? MDD? Not all alternatives cover all indications.
• Why you can't get Vraylar — If it's cost, a generic like Aripiprazole or Lurasidone might solve the problem. If it's a temporary stock issue, you may need a short bridge rather than a full switch.
• Your side effect history — If you've tried other antipsychotics before, your experience with them matters.
• Insurance coverage — Your plan may cover one alternative better than another.

This is a conversation to have with your psychiatrist or prescriber. Bring this article along if it helps — they'll appreciate that you've done your research.

Before You Switch: Try to Find Vraylar First

If Vraylar has been working well for you, switching to a different medication should be a last resort. Before considering an alternative:

• Use Medfinder to search for pharmacies with Vraylar in stock
• Try independent or specialty pharmacies
• Ask about mail-order options through your insurance
• Look into savings programs if cost is the issue

For more tips, see our guide on how to find Vraylar in stock near you.

Final Thoughts

Not being able to fill your Vraylar prescription is stressful, especially when your mental health depends on it. The good news is that there are real alternatives — Abilify, Rexulti, Latuda, and Caplyta are all effective medications used to treat overlapping conditions.

But no two medications work exactly the same way, and what works for one person may not work for another. Work closely with your prescriber to find the best path forward, whether that's locating Vraylar, switching to an alternative, or bridging with something temporary.

Your mental health matters, and there is always a next step.