Drug Comparison
For educational purposes only — a decision-support tool, not a substitute for clinical judgment.
Side-by-side rubric across 96 psychiatric medications. Every rating traces to a verbatim primary-source quote — click any cell to see it.
How to read this tool ▾
Rating scale
– Favorable / lower than class baseline
± Minimal / equivocal
+ Low / uncommon
++ Moderate / common
+++ High / very common
++++ Very high / class-outlier
Frequency vs severity
F = frequency, S = severity. Each gets its own pill colored on the same traffic-light scale: green → blue → yellow → orange → red. Click any cell for incidence percentages and NNH.
Evidence tier
A Network meta-analysis / RCT / FDA label
B Cohort / registry / pooled label data
C Expert review / textbook / case series
Sourcing
Click any cell to see the verbatim source quote and citation. Missing data shows n/a.
Data depth
++ Graded — frequency + severity, primary-source traces
+ FDA label — §6 frequency only (dashed border). Click for sub-types.
Blank — not yet checked (not “absent”)
–±++++++++++ABCF = frequency · S = severity · Dashed border = FDA label only · Click cell for details
1 drug selected — Cariprazine(click to collapse)
1/4 selected
Cariprazine
Vraylar
Second-Generation Antipsychotic (Partial D2/D3 Agonist)
FDA-approved indications
- Schizophrenia (adults; adolescents 13+)
- Acute manic or mixed episodes in Bipolar I (adults; pediatric 10+)
- Bipolar I depression (adults)
- MDD — adjunct to antidepressants (adults)
Off-label uses
- Treatment-resistant depression (adjunct)
- Bipolar depression maintenance
MechanismAtypical Antipsychotic
Half-life2 to 4 days (DDCAR active metabolite: 1 to 3 weeks)
Decision GuideWhen to pick each / when to consider an alternative
Cariprazine
Consider when
- Broad-spectrum bipolar monotherapy — FDA-approved for schizophrenia, acute mania, bipolar depression, and maintenance; rare 4-indication coverage
- Bipolar depression monotherapy — one of few SGAs with bipolar depression FDA approval (with quetiapine, lurasidone, lumateperone)
- Prolactin sensitivity — D3-preferring partial agonist with near-placebo prolactin elevation; avoids endocrine complications
- Lipid/LDL management needed — LDL P-score 0.07 (lowest in Huhn 2019 NMA); most lipid-friendly SGA
- +1 more
Consider an alternative when
- Rapid titration or symptom adjustment required — DDCAR active metabolite t½ 1–3 weeks; steady state takes 4–6 weeks; slow to adjust
- Akathisia is poorly tolerated — partial-agonist class signal; labeled common AE in clinical trials
- Cost or formulary constraint — brand-only with no generic; expensive relative to generic aripiprazole
- Severe hepatic impairment — not recommended per label; limited data in hepatic dysfunction
- +1 more
| Axis | Cariprazine SGA |
|---|---|
| Boxed Warnings | |
Suicidality (boxed warning) | |
Agranulocytosis / severe neutropenia | |
Cerebrovascular events (elderly w/ dementia) | |
Neuroleptic malignant syndrome (NMS) | |
| CNS | |
Sedation / somnolence | |
Activation / insomnia | |
Akathisia / EPS | |
Tardive dyskinesia | |
Seizure risk | |
| Metabolic | |
Weight gain | |
Metabolic (glucose / lipids) | |
| Endocrine | |
Prolactin elevation | |
| Autonomic | |
Anticholinergic burden | |
Orthostatic hypotension | |
| Cardiac | |
QTc prolongation | |
| GI | |
Nausea / GI (general) | |
| Sexual | |
Sexual dysfunction | |
| Interactions | |
CYP interactions / DDI profile | |
| Pregnancy | |
Lactation / breastfeeding safety | |
| Drug-specific / distinctive axes | |
Late-occurring adverse reactions (DISTINCTIVE — CAR-only labeled W&P 5.6) only in Cariprazine | |