What antidepressants work best with Vraylar?

For those managing conditions like bipolar disorder or schizophrenia, Vraylar (cariprazine) has emerged as a significant player in the realm of atypical antipsychotics. But for many, the journey to mental wellness doesn’t end with just one medication. Depression, a common co-occurring issue, often requires a tandem approach. This leads us to a pertinent question: What antidepressants work best with Vraylar?

Vraylar’s Role in Mental Health Treatment

Before we delve into combinations, let’s understand Vraylar’s role. Cariprazine is designed to treat the manic or depressive episodes associated with bipolar I disorder, as well as schizophrenia. It works on dopamine and serotonin receptors, which are key players in mood regulation. But when depression persists, an antidepressant might be added to the regimen.

Complementary Antidepressants: A Delicate Balance

When considering an antidepressant to pair with Vraylar, healthcare providers often evaluate the following factors:

  • Drug Interaction Profile: Medications should have a low risk of adverse interactions.
  • Symptom Profile: Antidepressants should target the patient’s specific depressive symptoms effectively.
  • Side Effect Tolerance: The combination should minimize the potential for compounded side effects.

SSRIs and SNRIs: Popular Choices

Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) are commonly used alongside antipsychotics due to their efficacy and generally favorable side effect profiles. These could include:

  • Sertraline (Zoloft): Known for its general tolerability and effectiveness in treating depression.
  • Fluoxetine (Prozac): Offers the benefit of long-acting properties, which can be advantageous in maintaining stable blood levels.
  • Venlafaxine (Effexor): As an SNRI, it may be particularly useful for patients who struggle with fatigue or lack of energy, in addition to depression.

Bupropion: A Unique Option

Bupropion (Wellbutrin) is another antidepressant that’s occasionally used with Vraylar. It’s unique because it doesn’t just target serotonin—it also influences norepinephrine and dopamine, which can help with energy and focus.

The Tricyclics and MAOIs: Proceed with Caution

Older classes of antidepressants like tricyclics or monoamine oxidase inhibitors (MAOIs) are generally less favored due to their side effect profiles and potential for interactions. However, they may be considered if other treatments haven’t been successful.

Monitoring Is Key

No matter the antidepressant chosen, it’s essential to monitor for side effects, especially serotonin syndrome—a rare but serious condition that can occur when medications that affect serotonin are combined.

Tailoring Treatment

The “best” antidepressant to combine with Vraylar will vary from person to person. Genetic makeup, lifestyle, symptomatology, and personal medical history all play a part in finding the right match.


The quest for the right antidepressant to pair with Vraylar is a highly personalized one. What works for one individual may not be suitable for another. The key is to work closely with a healthcare provider who can guide you through this process, ensuring that treatment decisions are made with the utmost care for safety and efficacy.

If you’re considering combining medications, it’s imperative to do so under the guidance of a psychiatrist who can closely monitor and adjust your treatment as needed.

Remember, the journey to mental wellness is often a collaborative effort between you and your healthcare team, and finding the right medication combo is a significant step in that journey.

There are various forms of drugs available, such as tablets or liquids, and each may have a separate patient information leaflet (PIL) for different doses. It is important to refer to the PIL for the specific form and dose of the drug that you have been prescribed.

You can search for further information and PILs on websites such as: