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Dr. Andrew Rynne

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Is Olanzapine better than Vraylar?

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Dr. Alexander H. Sheppe

Psychiatrist

Practicing since :2014

Answered : 2224 Questions

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Posted on Fri, 20 Jul 2018 in Mental Health
Question: i am shizophrenic. at begining i take abilify and solotic. in searching on net i found that studies demonstrate that onlazapine is more effective than abilify on negative and positive symptoms of shizophrenia.so i talk to my doctor to change medication. and realy i felt a big change on zyprexa. now my question based on studies if after the medication vraylar is available in my country. i can expect more improvement specialy negative symptoms if i take the new medication vraylar?
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Answered by Dr. Alexander H. Sheppe 13 minutes later
Brief Answer:
Consultation

Detailed Answer:
Hello, and thanks for your question.

This is an excellent question.

Generally speaking, Olanzapine is a stronger, more effective, and better-studied medication than Vraylar. There is some evidence that Vraylar may have increased efficacy with regard to negative symptoms, but there are no head-to-head trials comparing Vraylar and Olanzapine.

It does have the advantage of less weight gain than olanzapine, though. If olanzapine is working well for you, I would recommend sticking with it. It would not be wrong to TRY to switch to Vraylar at some point, but olanzapine generally speaking is likely to be more helpful.

Dr. Sheppe


Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Follow up: Dr. Alexander H. Sheppe 35 minutes later
thanks doctor. i read a study on net comparing vraylar(cariprazine) vs risperdone for efficacy on negative symptoms of shizophrenia with 230 patients of each group. at the baseline the mean baseline was approximatly 28 pts for each group. after 26 weeks the score had increase 9 pts for cariprazine group and 7.4 pts for risperdone group for the panss for negative symptoms(panss-fsns). how to calculate the improvement for each drug? the study was published in the lancet journal.
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Answered by Dr. Alexander H. Sheppe 5 hours later
Brief Answer:
Followup

Detailed Answer:
This level of improvement is very very small. An increase of 9 vs 7.4 points is barely significant. I do not think it is worth the risks of trying a different drug (Vraylar) when a drug is already working well for you (olanzapine). There are no direct trials of Vraylar to olanzapine to see which is better, anyway.

Dr. Sheppe
Above answer was peer-reviewed by : Dr. Raju A.T
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