Vraylar is one of the newest antipsychotic medications. It was approved for use in the United States by the FDA in 2015. It is mainly used to treat schizophrenia or bipolar disorder I.
Its chemical name is cariprazine. As a newer medication, it is not available in generic form.
How does Vraylar work?
Vraylar helps balance the levels of neurotransmitters in your brain. Neurotransmitters are chemicals that help your brain cells communicate with each other.
The main neurotransmitters affected by Vraylar are dopamine and serotonin. Dopamine plays a role in causing hallucinations, delusions, and thought disorders. Serotonin affects mood—low serotonin levels are associated with depression. By balancing the levels of dopamine and serotonin in the brain, Vraylar can help treat both bipolar disorder and schizophrenia.
Like most antipsychotic medicines, Vraylar works gradually, so it may take some time to notice improvements in symptoms.
The most common side effects of taking Vraylar are:
- difficulty moving or slow movements
- uncontrolled body movements
- weight gain
In rare cases, antipsychotic medications like Vraylar can cause tardive dyskinesia (TD), a movement disorder that can become permanent. TD is treatable, especially if you notice it early.
Vraylar for bipolar disorder
In bipolar disorder, antipsychotics like Vraylar act as mood stabilizers. Most mood stabilizers are effective at treating mania, but less effective in treating depression. Because Vraylar has a greater effect on serotonin levels, it is more effective for treating depression than many alternatives. It is also effective at treating mixed episodes, where a person experiences both mania and depression at the same time. 
Vraylar for negative symptoms of schizophrenia
Symptoms of schizophrenia are divided into “positive symptoms”, like hallucinations or delusions, and “negative symptoms”, which include:
- social withdrawal
- loss of emotion or pleasure
- difficulty speaking
- difficulty functioning in daily life
Most antipsychotic medications only help with positive symptoms. While Vraylar has not specifically been approved by the FDA for negative symptoms, it does seem to be much more effective for negative symptoms than other antipsychotic medications. 
- Citrome. (2013). Cariprazine: chemistry, pharmacodynamics, pharmacokinetics, and metabolism, clinical efficacy, safety, and tolerability. Expert Opinion on Drug Metabolism & Toxicology 9(2), pp. 193-206. Retrieved from https://www.tandfonline.com/doi/abs/10.1517/17425255.2013.759211
- Stahl et al. (2020). Cariprazine as a treatment across the bipolar I spectrum from depression to mania: mechanism of action and review of clinical data. Therapeutic Advances in Psychopharmacology 10. Retrieved from https://journals.sagepub.com/doi/full/10.1177/2045125320905752
- Earley et al. (2019). Efficacy of cariprazine on negative symptoms in patients with acute schizophrenia: A post hoc analysis of pooled data. Schizophrenia Research
204, pp. 282-288. Retrieved from https://www.sciencedirect.com/science/article/pii/S0920996418305127