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Understanding Vraylar Withdrawal Symptoms

Antipsychotic withdrawal symptoms are notoriously difficult to tolerate. Therefore, without constant and careful assistance, the process often results in repeated hospitalizations. This is due to the extreme reactions and impacts on the person. Drugmakers state they don’t know how these drugs work, beyond ambiguous statements and theories, but sell them anyway after a few very short drug trials.19

vraylar withdrawal symptomsHowever, studies have shown that antipsychotics like Vraylar likely target certain key receptors in the CNS. These are the areas that transport (or block) essential hormones and neurotransmitters needed for life to function. The effects that a person experiences on a Vraylar withdrawal program come about, at least in part, due to the deficient and dysfunctional state of the CNS that the drug has left in its wake.19,20,21

There are other factors, if unresolved, that can contribute to the severity of Vraylar withdrawal symptoms. There may be a history of lifestyle considerations, or poor diet, where the affected neurochemistry seems to be nutritionally or emotionally starved and shows signs of degrading. A massive review of medical literature published in the World Journal of Psychiatry showed the extraordinarily positive effects of dietary and psycho-social interventions in successfully treating schizophrenia patients.22 In contrast, a person taking antipsychotics commonly relies on stimulants to feel any pleasure and interest in life. This can create a whole other dependence issue. Ignoring whatever underlying factors were present when mania or other mental health events occurred could unnecessarily complicate antipsychotic drug withdrawal. However, this investigative work is always done at Alternative to Meds Center, and a person’s program consists of treatments for these underlying conditions before, during, and even after Vraylar withdrawal. You can learn more about the many withdrawal protocols used at Alternative to Meds by reviewing our antipsychotic withdrawal page.

Common Vraylar Withdrawal Symptoms

The FDA drug label contains zero information on Vraylar withdrawal symptoms except regarding withdrawals for an infant after birth, where the mother took Vraylar. Studies and clinical trials can help fill in some of this vital information, as well as researching antipsychotic medications generally for common antipsychotic withdrawal adverse effects.2 For your info, below you will find some important data to know.

  • Abruptly stopping antipsychotic drugs often results in “rebound psychosis”, often more intense than what was experienced before treatment began. This can include hallucinations, delusions, mania, hearing voices, catatonia. Abrupt withdrawal from Vraylar can cause NMS or Tardive Dyskinesia or other movement disorders to suddenly emerge. 2,30,31
  • Common antipsychotic withdrawal symptoms include physical, emotional, and psychiatric adverse effects: nausea, vomiting, headache, insomnia, nightmares, anxiety, tension, restlessness, hyperkinesia, sweating, numbness, and many others at varying degrees of intensity.23
  • An Infant can experience Vraylar withdrawal symptoms, extrapyramidal symptoms and “fetal harm” (unspecified) where the mother has taken the medication through the pregnancy. According to the FDA data on the Vraylar label, in rats, the drug was present in the mother’s milk. In rabbits, 1st generation pups had cold, pale bodies, and males had sluggish startle-response and other under-developments. These symptoms reappeared in 2nd generation pups.1

While drugmakers use slick ads and demonstrate a disturbingly cavalier attitude toward heavy-hitting drugs like Vraylar (cariprazine), medical school leaves physicians completely in the dark as to how to help someone through Vraylar withdrawal safely.

The atypical antipsychotic drug Vraylar is heavily marketed for the treatment of schizophrenia, as well as manic or mixed forms of bipolar. Antipsychotics are sometimes confused with antidepressants but are far more difficult to taper from, despite a person’s intense desire for relief from the horrific side effects.

Do Your Symptoms Require Vraylar?

vraylar tapering success

Alternative to Meds has helped thousands of clients navigate antipsychotic withdrawal and other drugs for 15+ years. We have published evidence demonstrating our success. In the main, physicians are allowed and even encouraged to ignore testing for underlying issues and medical conditions but to opt for a hasty prescription choice. This commonly hangs the patient in a misdiagnosed condition, followed by years of negative consequences. The Alternative to Meds center designs each program to address these critical issues. Alternative treatments can provide methods to regain your quality of life and attain better mental health naturally.

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Vraylar Side Effects

vraylar side effectsIn several 3-week trials, the most commonly emerging side effects of Vraylar were akathisia, extrapyramidal disorders, tremor, dyspepsia (stomach pain or discomfort), and vomiting.28 According to the FDA,1 and like virtually all of the antipsychotic drugs, Vraylar comes with a significant load of potential risks and warnings (including the black-box warnings) under the umbrella of Vraylar side effects. The FDA reports that “late-onset” adverse effects can begin well after 3 or 6 weeks. In a 2017 review of research on cariprazine drug trials, Campbell et al point out that some adverse effects may not show up until the drug exposure reaches stability at the 12th week, well beyond the length of trials mentioned on the drug’s label.1,4 One becomes curious as to the absence of long-term testing before giving the green light to market a potentially ruinous drug. Vraylar is thought to suppress certain dopamine receptors’ functionality, possibly leaving the person in an emotionally and mentally bankrupt, numb condition not to mention the physical discomforts that go along with this drug.27

In truth, there are too many Vraylar side effects to list here in anything like a complete form. However, a sample of these Vraylar side effects follows, with a brief description and some medical references for better understanding:

  • NMS, or Neuroleptic Malignant Syndrome that is potentially fatal, linked with all antipsychotic meds or any dopamine agonist. Most often occurs after starting the drug, or after increasing the dosage, or after abrupt withdrawal. The drug impairs or potentially dismantles the autonomic systems in the body. Autonomic systems are the involuntary ones and include breathing, heartbeat, vital organs, digestion, body temperature, etc. that are vital to life. The symptoms include high fever, muscle rigidity, mental status changes, restricted organ function, autonomic rigidity, incontinence, mutism, tremor, high blood pressure, tachycardia, and can be life-threatening.5,30
  • Tremor, extrapyramidal disorder, very common side effects of Vraylar, movement disorders including severe muscle rigidity that can be indistinguishable from NMS symptoms.28,29
  • Tardive Dyskinesia, a condition that is usually irreversible and results in involuntary muscle movements in the face, jaw, mouth, tongue, and other parts of the body.6
  • Diabetes Mellitus, a condition where insulin production is impaired, leading to uncontrolled high blood sugar and other negative consequences, including weight gain, heart disease, stroke, kidney damage, nerve damage.7
  • Leukopenia is a lowering of white blood cells. These are normally the cells that fight off infections and pathogens. Antipsychotics and chemotherapy are two known causes of leukopenia. This can lead to other conditions such as cancers and other diseases. The recommended “cure” for leukopenia is to stop whatever is lowering the white blood count (WBC) levels.8
  • Seizures 9
  • Orthostatic Hypotension, a sudden increase in blood pressure when the person stands up. The stress on the heart can be severe, resulting in a stroke, heart attack, liver failure, and other negative health impacts.10
  • Lowering of cognitive and motor performance, which means a degree of disability in decision-making, problem-solving, remembering, ability to handle machinery, slurred or difficult speech, impaired body movements, blunted expression of emotions.11
  • Death — A Black Box warning informs that dementia patients should not be prescribed Vraylar due to the heightened risk of death.1
  • Akathisia,a relentless urge to move, rock, march, that can lead to suicide in severe cases ,12,28
  • Cardiac disorders, such as tachycardia (racing heartbeat at rest) 1,13,14
  • Musculoskeletal and tissue disorders, pain, neck or other muscle group spasms, stiffness, and involuntary contractions 1,15
  • Pain, abdominal pain, colitis and necrosis, back pain, headache, pain in the extremities 1,16
  • Sleep issues, Insomnia, somnolence (sleepiness during waking hours) 1,17
  • Gastrointestinal disorders:  vomiting, constipation, diarrhea, abdominal pain 1,16,28
  • Numerous others per the drug’s label and research specific to cariprazine’s long-term safety and tolerability.1,18

Mitigating Vraylar Withdrawal Symptoms While Tapering

Clearly, each individual is unique and unlike any other complex and beautiful expression of creation. Therefore, there can be no cookie-cutter approach guaranteeing the best results. However, Alternative to Meds Center has devised a palette of comprehensive testing and other assessments before starting any titration program. These test results and of course interviews with the client will inform their best pathway forward.

vraylar dopamine deficiencyNonetheless, we can say that in general, the slow road is the best road when it comes to discontinuing antipsychotics. Research tells us this type of drug is primarily dopaminergic.24 In other words, Vraylar starves the CNS of dopamine. The body responds to this starvation by building more dopamine receptors, just as when the temperature goes up, you get thirsty and seek water. The body gets “thirsty” for dopamine. So, now when you stop the drug, there can be a great surge of dopamine and an increase in the intensity of stimulation effects. And that can cause psychosis and other overstimulation-type reactions that typically are associated with abrupt Vraylar withdrawal. These risks are also associated with so-called “rapid detox” which we do NOT recommend as it carries too much risk, even when comfort drugs temporarily mask the after-effects. Switching medications can be useful in some instances, but must be done extremely cautiously, with absolutely 24/7 monitoring for safety.

The process must be, in a very real sense, micro-managed. Making small and precise tweaks can be much more effective than relying on a mathematical “formula” that just won’t fit every person, on any given day or hour. The center has had great success in softening Vraylar withdrawal symptoms during the tapering process using a strategic and exacting approach tailored to the individual’s needs and their changing conditions.

Other Methods Used In Vraylar Tapering

getting off vraylarCorrecting the diet is also of great importance during tapering from Vraylar, and any drug for that matter.3 Over time, perhaps through bad eating habits and also the quest for stimulants like sugar and caffeine, the body can become depleted of what it needs for normalizing neurochemistry.

Testing shows where the deficiencies are, so they can be corrected with proper diet and food-grade supplements. Also, the presence of neurotoxins can skew a person’s biochemistry to the point where the person is actually symptomatic from accumulated poisons, rather than suffering from some mental disorder. All of these things are checked and corrected. Removal of neurotoxic accumulations in the body provides great relief for many, who report feeling calmer but higher energy, more focused, more interested in life, better mood, better sleep, and many other benefits from this action alone. Much research has been done on the mental health benefits of addressing toxic accumulations in the body.25,26

For More Information on Vraylar Tapering

Please contact us at Alternative to Meds Center for more details on the programs we offer, how we use testing to develop the individual’s treatment plan, and other treatments we offer to soften the process. Vraylar withdrawal does not have to be another nightmare, and we would be happy to discuss how the use of antipsychotic alternatives could benefit your or a loved one’s health, plus answer any questions about insurance coverage or other important information you need when you call.


1. FDA label Vraylar [INTERNET] [cited 2020 May 27]

2. Keks N, Schwartz D, Hope J, “Stopping and switching antipsychotic drugs.” Australian Prescriber [INTERNET] 2019 Oct [cited 2020 May 27]

3. Medline.gov, “Substance use recovery and diet.” US National Library of Medicine, N.D. [cited 2020 May 27]

4. Campbell RH, Diduch M, Gardner KN, Thomas C. Review of cariprazine in management of psychiatric illness. Ment Health Clin. 2018;7(5):221-229. Published 2018 Mar 23. doi:10.9740/mhc.2017.09.221 [cited 2021 Aug 3]

5. Simon LV, Hashmi MF, Callahan AL. Neuroleptic Malignant Syndrome. [Updated 2021 Apr 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482282/ [cited 2021 Aug 3]

6. Boushra M, Nagalli S. Neuroleptic Agent Toxicity. [Updated 2021 Jul 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554608/ [cited 2021 Aug 3]

7. Holt RIG. Association Between Antipsychotic Medication Use and Diabetes. Curr Diab Rep. 2019;19(10):96. Published 2019 Sep 2. doi:10.1007/s11892-019-1220-8 [cited 2021 Aug 3]

8. Qureshi SU, Rubin E. Risperidone- and aripiprazole-induced leukopenia: a case report. Prim Care Companion J Clin Psychiatry. 2008;10(6):482-483. doi:10.4088/pcc.v10n0612c  [cited 2021 Aug 3]

9. Hedges D, Jeppson K, Whitehead P. Antipsychotic medication and seizures: a review. Drugs Today (Barc). 2003 Jul;39(7):551-7. doi: 10.1358/dot.2003.39.7.799445. PMID: 12973403. [cited 2021 Aug 3]  

10. Gugger JJ. Antipsychotic pharmacotherapy and orthostatic hypotension: identification and management. CNS Drugs. 2011 Aug;25(8):659-71. doi: 10.2165/11591710-000000000-00000. PMID: 21790209. [cited 2021 Aug 3]

11. Kasper S, Resinger E. Cognitive effects and antipsychotic treatment. Psychoneuroendocrinology. 2003 Jan;28 Suppl 1:27-38. doi: 10.1016/s0306-4530(02)00115-4. PMID: 12504070. [cited 2021 Aug 3]

12. Demyttenaere K, Detraux J, Racagni G, Vansteelandt K. Medication-Induced Akathisia with Newly Approved Antipsychotics in Patients with a Severe Mental Illness: A Systematic Review and Meta-Analysis. CNS Drugs. 2019 Jun;33(6):549-566. doi: 10.1007/s40263-019-00625-3. PMID: 31065941. [cited 2021 Aug 3]

13. Helton MR. Diagnosis and Management of Common Types of Supraventricular Tachycardia. Am Fam Physician. 2015 Nov 1;92(9):793-800. PMID: 26554472. [cited 2021 Aug 3]

14. Stoner SC. Management of serious cardiac adverse effects of antipsychotic medications. Ment Health Clin. 2018;7(6):246-254. Published 2018 Mar 23. doi:10.9740/mhc.2017.11.246 [cited 2021 Aug 3]

15. Mathews M, Gratz S, Adetunji B, George V, Mathews M, Basil B. Antipsychotic-induced movement disorders: evaluation and treatment. Psychiatry (Edgmont). 2005;2(3):36-41. [cited 2021 Aug 3]

16. Peyrière H, Roux C, Ferard C, Deleau N, Kreft-Jais C, Hillaire-Buys D, Boulenger JP, Blayac JP; French Network of the Pharmacovigilance Centers. Antipsychotics-induced ischaemic colitis and gastrointestinal necrosis: a review of the French pharmacovigilance database. Pharmacoepidemiol Drug Saf. 2009 Oct;18(10):948-55. doi: 10.1002/pds.1801. PMID: 19572384.  [cited 2021 Aug 3]

17. Fang F, Sun H, Wang Z, Ren M, Calabrese JR, Gao K. Antipsychotic Drug-Induced Somnolence: Incidence, Mechanisms, and Management. CNS Drugs. 2016 Sep;30(9):845-67. doi: 10.1007/s40263-016-0352-5. PMID: 27372312. [cited 2021 Aug 3]

18. Nasrallah HA, Earley W, Cutler AJ, et al. The safety and tolerability of cariprazine in long-term treatment of schizophrenia: a post hoc pooled analysis. BMC Psychiatry. 2017;17(1):305. Published 2017 Aug 24. doi:10.1186/s12888-017-1459-z  [cited 2021 Aug 3]

19. Citrome L. Cariprazine for the Treatment of Schizophrenia: A Review of this Dopamine D3-Preferring D3/D2 Receptor Partial Agonist. Clin Schizophr Relat Psychoses. 2016 Summer;10(2):109-19. doi: 10.3371/1935-1232-10.2.109. PMID: 27440212. [cited 2021 Aug 3]

20. Goff DC, Falkai P, Fleischhacker WW, Girgis RR, Kahn RM, Uchida H, Zhao J, Lieberman JA. The Long-Term Effects of Antipsychotic Medication on Clinical Course in Schizophrenia. Am J Psychiatry. 2017 Sep 1;174(9):840-849. doi: 10.1176/appi.ajp.2017.16091016. Epub 2017 May 5. Erratum in: Am J Psychiatry. 2017 Aug 1;174(8):805. PMID: 28472900. [cited 2021 Aug 3]

21. Agius M, Shah S, Ramkisson R, Murphy S, Zaman R. Three year outcomes of an early intervention for psychosis service as compared with treatment as usual for first psychotic episodes in a standard community mental health team. Preliminary results. Psychiatr Danub. 2007 Jun;19(1-2):10-9. PMID: 17603411. [cited 2021 Aug 3]

22. Aucoin M, LaChance L, Clouthier SN, Cooley K. Dietary modification in the treatment of schizophrenia spectrum disorders: A systematic review. World J Psychiatry. 2020 Aug 19;10(8):187-201. doi: 10.5498/wjp.v10.i8.187. PMID: 32874956; PMCID: PMC7439299. [cited 2021 Aug 3]

23. Brandt L, Bschor T, Henssler J, et al. Antipsychotic Withdrawal Symptoms: A Systematic Review and Meta-Analysis. Front Psychiatry. 2020;11:569912. Published 2020 Sep 29. doi:10.3389/fpsyt.2020.569912 [cited 2021 Aug 3]

24. Strange PG. Antipsychotic drugs: importance of dopamine receptors for mechanisms of therapeutic actions and side effects. Pharmacol Rev. 2001 Mar;53(1):119-33. PMID: 11171942. [cited 2021 Aug 3]

25. Brown JS Jr. Psychiatric issues in toxic exposures. Psychiatr Clin North Am. 2007 Dec;30(4):837-54. doi: 10.1016/j.psc.2007.07.004. PMID: 17938048. [cited 2021 Aug 3]

26. Mason LH, Mathews MJ, Han DY. Neuropsychiatric symptom assessments in toxic exposure. Psychiatr Clin North Am. 2013 Jun;36(2):201-8. doi: 10.1016/j.psc.2013.02.001. Epub 2013 Apr 15. PMID: 23688687. [cited 2021 Aug 3]

27. Moritz S, Andreou C, Klingberg S, Thoering T, Peters MJ. Assessment of subjective cognitive and emotional effects of antipsychotic drugs. Effect by defect? Neuropharmacology. 2013 Sep;72:179-86. doi: 10.1016/j.neuropharm.2013.04.039. Epub 2013 May 3. PMID: 23643756. [cited 2021 Aug 3]

28. Sachs GS, Greenberg WM, Starace A, Lu K, Ruth A, Laszlovszky I, Németh G, Durgam S. Cariprazine in the treatment of acute mania in bipolar I disorder: a double-blind, placebo-controlled, phase III trial. J Affect Disord. 2015 Mar 15;174:296-302. doi: 10.1016/j.jad.2014.11.018. Epub 2014 Nov 24. PMID: 25532076. [cited 2021 Aug 3]

29. Blair DT, Dauner A. Extrapyramidal symptoms are serious side-effects of antipsychotic and other drugs. Nurse Pract. 1992 Nov;17(11):56, 62-4, 67. doi: 10.1097/00006205-199211000-00018. PMID: 1359485. [cited 2021 Aug 3]

30. Simon LV, Hashmi MF, Callahan AL. Neuroleptic Malignant Syndrome. [Updated 2021 Apr 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482282/ [cited 2021 Aug 3]

31. Karaş H, Güdük M, Saatcioğlu Ö. Withdrawal-Emergent Dyskinesia and Supersensitivity Psychosis Due to Olanzapine Use. Noro Psikiyatr Ars. 2016;53(2):178-180. doi:10.5152/npa.2015.10122 [cited 2021 Aug 3]


Originally Published May 27, 2020 by Diane Ridaeus


This content has been reviewed and approved by a licensed physician.

Dr. Samuel Lee

Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente.  He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.

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Vraylar Withdrawal Symptoms, Cariprazine Side Effects, Treatment Help
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Nothing on this Website is intended to be taken as medical advice. The information provided on the website is intended to encourage, not replace, direct patient-health professional relationships. Always consult with your doctor before altering your medications. Adding nutritional supplements may alter the effect of medication. Any medication changes should be done only after proper evaluation and under medical supervision.

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