Vraylar and alcohol: can they be used together?

Medically reviewed by  Jamie Winn, PharmD

Alcohol use can make it extremely challenging to control the symptoms of schizophrenia and bipolar disorder. Studies have shown that people with these medical conditions struggle significantly more with substance abuse. Vraylar can help with schizophrenia and bipolar disorder but when taken with alcohol the side effects are amplified leading to possible life-threatening situations. Medical professionals advise against mixing these two substances. Read on to gain a better understanding of why it’s not a good idea to mix the two.

What is Vraylar?

Vraylar is the brand name of a prescription drug called cariprazine. Cariprazine rebalances dopamine and serotonin to improve thinking, mood, and behavior. It belongs to a class of drugs called atypical antipsychotics and is indicated for the treatment of bipolar disorder. Atypical antipsychotics are used in adults, on their own, or in combination with mood stabilizer drugs such as lithium. Other antipsychotic drugs in this drug class include quetiapine (Seroquel), aripiprazole (Abilify) risperidone, quetiapine, and olanzapine.

Vraylar is an FDA-approved atypical antipsychotic medication used to treat adult mental health conditions such as:

• Schizophrenia
• Short-term episodes of bipolar mania in people with bipolar disorder
• Bipolar depressive episodes in people with bipolar disorder

Vraylar is not approved for use in older adults with dementia-related psychosis due to an increased risk of death. Missing doses of cariprazine may also cause a deterioration in symptoms. Using an app as a reminder may be a good way to prevent this from happening.

What are the side effects of Vraylar?

The most serious side effects of Vraylar include:

• Tardive dyskinesia (uncontrollable slow or jerky movements)
• Low white blood cell count
• Increased prolactin levels causing missed periods in females
• Neuroleptic malignant syndrome
• Changes in your metabolism can lead to high blood sugar levels, high levels of cholesterol or triglycerides, and weight gain

More common side effects of Vraylar include:

• Muscle stiffness
• Drowsiness

Drug interactions and supplements

Vraylar can interact with different types of drugs. Some drugs include:

• CYP3A4 inducers and inhibitors
• Heart medications such as diltiazem (Cardizem) and verapamil (Isoptin) for the treatment of high blood pressure
• Mood stabilizers like carbamazepine (Tegretol) and lithium
• Opioid medication

This is not a complete list of drug interactions for Vraylar. Consult your healthcare provider for medical advice and tell them about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Is Vraylar safe in pregnancy and breastfeeding?

It is not known if Vraylar passes into breast milk. If you are breastfeeding or planning to breastfeed, or are pregnant or planning to become pregnant speak with your doctor about the risks and benefits of using Vraylar.

What can happen if I drink alcohol with Vraylar?

Increase in side effects and symptoms

Alcohol and Vraylar have many common side effects because they are both central nervous system depressants. Alcohol can cause a worsening of symptoms and side effects of bipolar disorder or schizophrenia. You are at an increased risk of some of the following side effects when you combine the two:

• Low blood pressure
• Reduced heart rate
• Reduced rate of breathing
• Sedation
• Lightheadedness
• More likely to fall
• Seizures

You should avoid drinking alcohol as it may worsen the side effects of Vraylar. If you take atypical antipsychotics, talk with your healthcare provider before drinking any alcohol.

Increased risk of substance abuse

When you have depression, you have an increased risk of developing a substance use disorder. Therefore mixing antidepressants with alcohol can lead to alcohol abuse, increasing your potential to become alcohol dependent. If you drink and develop an addiction to alcohol, it will become more difficult for you to control your symptoms of depression and get your alcohol consumption under control. You may need more frequent and long-term treatment if you have both an alcohol use disorder and depression. Vraylar’s prescribing information doesn’t list alcohol as a contraindication or warning but is it strongly discouraged by healthcare professionals.

The combination of alcohol and antidepressants can be very challenging if someone is drinking, binge drinking, heavy drinking, or has an alcohol use disorder prior to taking the antidepressants. Furthermore, if someone decides to stop taking drugs for depression and starts drinking alcohol for symptom management instead, they can worsen their symptoms of depression, in some cases leading to suicidal thoughts.

Get help

The cocktail of symptoms of schizophrenia/bipolar disorder and alcohol withdrawal symptoms can be difficult to cope with, without medical advice and guidance. If you are worried about yourself or a loved one some of the following resources may be of help to you – SAMHSA – Substance Abuse and Mental Health Service or The National Institute of Mental Health. Your doctor or healthcare provider can also help you make decisions about your meds, provide drug information and discuss the adverse effects of combining Vraylar with alcohol.