Table of Contents
Introduction: Understanding the Relationship Between Rexulti and Weight Gain
Rexulti, also known by its generic name brexpiprazole, is a prescription medicine approved by the U.S. Food and Drug Administration (FDA) to treat certain mental health conditions. It is most commonly used to treat major depressive disorder (MDD) when used with an antidepressant, and to treat schizophrenia. Rexulti belongs to a group of medicines called atypical antipsychotics. These medications work by helping to balance certain natural chemicals in the brain, like dopamine and serotonin, which affect mood, behavior, and thoughts.
While Rexulti can help manage symptoms of depression or schizophrenia, some people notice changes in their weight after starting the medicine. Weight gain is a possible side effect, and it is something that often raises concerns for patients, families, and healthcare providers. Gaining too much weight can lead to health problems over time. It may also affect how someone feels about themselves or how well they follow their treatment plan. Because of this, it is important to understand why Rexulti may cause weight gain and what can be done to prevent or manage it.
Not everyone who takes Rexulti will gain weight. However, studies and real-world use show that it is something that can happen. Atypical antipsychotics, including Rexulti, can affect appetite, cravings, and metabolism. Some people may feel hungrier than usual or notice stronger cravings for high-calorie foods. Others may feel more tired or less motivated to be active. These changes can lead to extra calories being stored in the body, which may result in weight gain over time.
Understanding how Rexulti works in the body can help explain why weight gain sometimes occurs. Rexulti acts on receptors in the brain that control mood and emotions. These same receptors also play a role in hunger and how full a person feels after eating. When these signals are changed, it can make someone feel hungrier or less satisfied after meals. Also, Rexulti may slightly change the way the body uses sugar and fat, which can affect metabolism.
There are many questions people have about weight gain and Rexulti. Some of the most common ones include: How much weight do people usually gain on this medication? Can anything be done to stop the weight from going up? What should be done if the weight gain becomes too much? Does everyone gain weight, or is it more likely in certain people? Are there safe ways to lose weight while still taking Rexulti?
This article will answer these questions and more. It will explain how common weight gain is with Rexulti, what causes it, and how to recognize the early signs. It will also give practical tips on how to prevent or reduce weight gain. This includes healthy changes in eating habits, ways to stay active, and when to talk to a healthcare provider. In some cases, medicine may be added to help with weight, but only under medical advice. Stopping Rexulti without medical help can be dangerous, so any changes in treatment should be planned with a doctor.
The goal is to give clear and useful information to help people stay healthy while taking Rexulti. With the right steps, it is often possible to manage or avoid weight gain and continue getting the benefits of mental health treatment. Staying informed can help support both physical health and emotional well-being.
Why Does Rexulti Cause Weight Gain in Some People?
Rexulti (brexpiprazole) is a type of medicine called an atypical antipsychotic. It is used to treat conditions such as major depressive disorder (MDD) and schizophrenia. While Rexulti helps with mood and thinking, it may also lead to weight gain in some people. Understanding how this happens can help with managing or even preventing it.
How Rexulti Affects Brain Chemicals
Rexulti works by changing the levels of certain chemicals in the brain. Two of the most important ones are dopamine and serotonin. These brain chemicals help control mood, behavior, sleep, and appetite.
Rexulti partly blocks dopamine receptors and partly stimulates serotonin receptors. This helps balance the brain’s activity and improves symptoms of depression and psychosis. However, this same effect can also change how the brain handles hunger and fullness.
When dopamine levels are changed, a person may feel more motivated to eat, especially foods high in fat or sugar. Serotonin also plays a role in controlling appetite and cravings. By changing how these chemicals work, Rexulti may make some people feel hungrier, even when they have eaten enough.
Changes in Appetite and Cravings
One of the first signs of possible weight gain with Rexulti is a stronger appetite. Some people may notice they feel hungry more often or crave certain foods like sweets, fried foods, or snacks. These cravings can lead to eating more calories than the body needs.
Even small changes in eating habits, when repeated daily, can add up to extra weight over time. For example, eating just 200 extra calories a day can cause a person to gain about one to two pounds per month.
Some people may also experience changes in how full they feel after eating. The body’s normal signals that say “stop eating” may not be as strong, making it easier to overeat without realizing it.
Impact on Metabolism and Energy Use
Besides changes in appetite, Rexulti can also affect the way the body uses energy. This is called metabolism. Some studies suggest that antipsychotic medications like Rexulti may slow down metabolism, which means the body burns fewer calories at rest.
A slower metabolism makes it easier to gain weight, especially if the person is also eating more or exercising less. Even if eating habits stay the same, weight gain can still happen if the body is burning fewer calories than before.
Rexulti may also cause tiredness or low energy in some people, especially in the beginning of treatment. When a person feels less active or more sleepy, they may move less during the day. This lower activity level can also lead to weight gain over time.
Hormonal and Insulin Effects
Some antipsychotic medications can also affect the body’s hormones, such as insulin. Insulin helps control blood sugar levels. When insulin does not work as well, it can lead to higher blood sugar and fat storage. Although Rexulti is not one of the worst offenders for causing this, there is still a small risk.
Problems with insulin, if they continue, may lead to insulin resistance, which is a risk factor for type 2 diabetes. Insulin resistance is also linked with weight gain, especially around the stomach area.
How Rexulti Compares to Other Antipsychotics
Not all antipsychotic medications cause weight gain the same way. Some drugs, like olanzapine or clozapine, are known to cause more weight gain than Rexulti. Others, like aripiprazole, may cause less. Rexulti is somewhere in the middle.
In clinical trials, some people taking Rexulti gained more than 7% of their starting body weight, especially at higher doses. But many people did not gain significant weight. The amount of weight gain depends on several factors, including dose, length of treatment, individual metabolism, activity level, and genetics.
Rexulti can lead to weight gain through several pathways. It affects the brain’s appetite signals, may slow metabolism, and can increase cravings for high-calorie foods. It may also lead to lower energy and movement, and in some cases, changes in insulin and hormone function. While the risk varies, being aware of these effects can help people make choices that support a healthy weight during treatment.
How Common Is Weight Gain With Rexulti?
Weight gain is a known side effect of many medications used to treat mental health conditions, including antipsychotics like Rexulti. Understanding how often weight gain occurs can help people prepare and make informed decisions. Not everyone will gain weight while taking Rexulti, but some people may notice changes in body weight, especially after taking the medication for several weeks or months.
Rexulti (brexpiprazole) is called an “atypical antipsychotic.” Atypical means it works differently from older antipsychotics and tends to have fewer movement-related side effects. However, weight gain is still a concern with this newer group of medications. Rexulti is approved by the U.S. Food and Drug Administration (FDA) to treat schizophrenia and to be used along with antidepressants in people with major depressive disorder (MDD).
Clinical Trial Data on Weight Gain
Clinical studies provide helpful information about how common weight gain is among people who take Rexulti. In studies on people with major depressive disorder, about 7% to 8% of participants reported gaining weight. For people with schizophrenia, the number was higher—around 10% to 12%. This means that about 1 out of every 10 people with schizophrenia who took Rexulti in these studies gained weight that was considered significant by doctors.
These results come from trials where researchers measured weight at different times while people were taking the medication. The studies often define “significant weight gain” as an increase of at least 7% of a person’s starting body weight. For example, someone who weighs 150 pounds at the beginning of treatment would have to gain about 10.5 pounds for that change to be called significant.
It is important to know that some people in the same studies who were not taking Rexulti also gained weight. This shows that weight gain can sometimes happen for other reasons, such as changes in eating habits, activity levels, or the mental health condition itself.
The Role of Dosage and Duration
The chance of gaining weight may go up depending on how much Rexulti a person takes and how long they use it. In general, higher doses may cause more side effects, including weight gain. Rexulti is usually prescribed in doses ranging from 0.5 mg to 4 mg per day. People taking higher doses (such as 3 mg or 4 mg daily) were more likely to gain weight in clinical studies compared to those on lower doses.
Time also plays a role. Some people do not notice much weight gain during the first few weeks of treatment, but weight may increase slowly over time. Weight gain may become more noticeable after two or three months of use. Long-term studies have found that weight can continue to rise if not managed early. That is why tracking weight regularly is important, especially during the first 12 weeks of treatment.
How Individual Factors Affect Risk
Weight gain with Rexulti is not the same for everyone. Several factors can increase or lower the chance of gaining weight while taking the medication:
- Age: Young adults and teenagers may be more sensitive to medication-related weight gain than older adults.
- Sex: Some studies suggest that females may be more likely to gain weight from antipsychotic medications than males, though results are mixed.
- Baseline weight: People who are already overweight or obese may gain more weight compared to those with lower body weight at the start of treatment.
- Metabolism: Some people naturally burn calories faster than others. Those with slower metabolism may be more affected.
- Other medications: Taking other medications at the same time, especially those that also affect appetite or metabolism (such as mood stabilizers or antidepressants), can increase the risk of weight gain.
- Family history: A family history of obesity or type 2 diabetes may make a person more likely to gain weight with certain medications.
Mental health conditions like depression or schizophrenia can also affect appetite, motivation, and physical activity. Some people eat more when feeling depressed or anxious, while others move less or skip exercise. These behaviors can add to weight gain when combined with a medication like Rexulti.
Weight gain happens in about 7% to 12% of people taking Rexulti, based on clinical studies. The risk is higher with longer treatment, higher doses, and individual factors like age, baseline weight, and metabolism. Although not everyone gains weight, it is a side effect worth watching. Regular weight checks and communication with a healthcare provider can help prevent serious problems. Understanding how common weight gain is with Rexulti is the first step in taking control and managing this side effect.
What Are the Early Signs of Weight Gain on Rexulti?
Weight gain from medications like Rexulti does not usually happen overnight. It often builds up over time. Watching for early signs can help prevent large increases in weight and related health problems.
Common Early Signs to Watch For
One of the first signs is a noticeable increase in appetite. People may begin to feel hungry more often, even after eating full meals. Cravings for high-calorie foods, such as sweets, salty snacks, and processed foods, may also become stronger. These cravings are not always linked to actual hunger but are instead driven by changes in brain chemicals caused by the medication.
Another common early sign is eating larger portions than usual or eating more often during the day. Snacking late at night or eating out of boredom may also increase. This change in eating habits often happens slowly and may not be noticed right away.
Feeling more tired or less motivated to move is another early sign. Rexulti can sometimes lower energy levels. As a result, daily activity may drop without the person realizing it. Less movement means the body burns fewer calories, which can lead to weight gain, even if eating habits do not change much.
Some people may notice swelling in their hands, feet, or face. This swelling, called fluid retention or edema, may not be fat gain but can still increase body weight. Clothes may feel tighter or rings may become harder to remove. Though mild swelling is not always dangerous, it should be checked by a healthcare provider.
Weight gain may also show up through small changes on the scale. Gaining one to two pounds per week over several weeks may not seem serious at first. But if left unaddressed, it can add up over time. A small increase in waist size or feeling less comfortable in clothing are also early signs.
When Does Weight Gain Usually Begin?
Weight gain related to Rexulti often starts during the first few weeks to months of treatment. For some people, weight may start to increase within the first four weeks. Others may not notice changes until after two or three months. Timing can vary based on factors like the dose of Rexulti, diet, physical activity level, and individual body chemistry.
Regular monitoring is important because weight gain might not feel noticeable until it becomes more significant. Checking for early signs each week can help catch changes sooner.
Tools That Help Track Early Changes
Using simple tools can make it easier to catch early weight gain. One helpful method is stepping on a scale once a week and writing down the number. Keeping a weight log can show patterns over time. If the weight increases by more than two pounds in a week, it may be a sign to adjust food choices or activity levels.
Another helpful tool is a food diary. Writing down what is eaten and when it is eaten can show if portions are getting larger or if snacks are becoming more frequent. Some people also find it helpful to take note of feelings during meals. Emotional eating, such as eating when feeling sad, bored, or anxious, can also lead to weight gain.
Using a tape measure to check waist size is another simple way to track body changes. A growing waistline often means fat is building up in the abdominal area, which can increase health risks even if total body weight is not rising quickly.
Fitness trackers or smartphone apps can help track daily steps or time spent being active. A sudden drop in activity level is often linked to slow weight gain. Even small increases in movement, like walking 10–15 minutes a day, can help slow or prevent further weight gain.
When to Talk to a Healthcare Provider
If weight gain becomes noticeable or concerning, it is important to talk to a healthcare provider. Signs like a steady increase in weight, swelling, or increased hunger that does not go away may need medical attention. Providers can check for other causes of weight gain and suggest changes to the treatment plan if needed. Sometimes, changes to diet, exercise, or the dose of Rexulti may help. In some cases, another medication may be added to help manage weight.
Watching for these early signs and tracking small changes can make a big difference in preventing long-term weight problems while taking Rexulti.
Can Weight Gain on Rexulti Be Prevented?
Weight gain is a known side effect of many antipsychotic medications, including Rexulti. However, not everyone who takes Rexulti gains weight. While weight gain is possible, there are steps that can be taken to help prevent it before it becomes a serious concern.
Understanding Risk Before Starting Rexulti
Before beginning treatment, it is helpful to know if a person is at higher risk for gaining weight. Some people are more sensitive to weight changes due to their personal or family history, medical background, or lifestyle. For example, someone with a history of obesity, type 2 diabetes, or slow metabolism may be more likely to gain weight.
Doctors can help by checking a patient’s weight, body mass index (BMI), and waist size before starting Rexulti. Blood tests may also be done to look at cholesterol, blood sugar, and thyroid function. These tests provide a starting point to track any changes once treatment begins.
Discussing personal health history and lifestyle with a healthcare provider before starting Rexulti can help create a plan to reduce the risk of weight gain. When the doctor knows more about a patient’s risks, they may adjust the medication dose or suggest extra support like diet changes, exercise, or referrals to specialists.
The Role of Early Action
Starting healthy habits as soon as Rexulti is prescribed may prevent future problems. It is easier to stop small weight changes early than to try to lose a lot of weight later. People often gain weight slowly over time, and without regular check-ins, the changes can be hard to notice.
Keeping track of body weight on a weekly basis can help detect early signs of weight gain. If a pattern is seen, such as a few pounds gained over several weeks, action can be taken quickly. Writing down daily meals or using an app to track food and activity can also help spot problems early, such as increased snacking or eating larger portions.
Even small changes in eating and activity can make a difference when they are started early. Replacing sugary drinks with water, adding a 20-minute walk after meals, or choosing smaller portions are examples of small but helpful habits.
Talking to a Healthcare Provider About Prevention
Open communication with the healthcare team can make a big difference. If there is concern about weight gain, the doctor or nurse can offer advice or adjust the treatment plan. Sometimes, a lower dose of Rexulti may still be effective but have fewer side effects. In other cases, combining Rexulti with other supports, such as behavioral therapy, nutrition counseling, or physical activity programs, may be recommended.
A referral to a dietitian or a fitness expert may be helpful for someone who has never followed a structured eating or exercise plan. These professionals can provide practical tips that are easy to follow and fit into daily life.
Healthcare providers also play a key role in checking for early warning signs of metabolic changes. At regular checkups, doctors often repeat blood tests to monitor blood sugar, cholesterol, and other markers of health. If any numbers begin to move in an unhealthy direction, changes can be made before serious problems develop.
Personal Habits That Support Prevention
Healthy lifestyle habits are an important part of preventing weight gain. This includes eating a balanced diet, staying active, getting enough sleep, and managing stress.
A balanced diet includes plenty of vegetables, fruits, lean protein, whole grains, and healthy fats. Avoiding processed foods, sugary snacks, and fast food can help reduce extra calorie intake. Meal planning and cooking at home are good ways to take control over ingredients and portion sizes.
Regular physical activity also plays a key role in weight management. Even light to moderate exercise, such as walking, swimming, or biking, can help burn calories and improve energy levels. Exercise also supports mental health and may improve mood, which is especially helpful for people taking Rexulti for depression or schizophrenia.
Getting enough sleep is another helpful habit. Poor sleep can make people feel more hungry and crave unhealthy foods. Stress can have a similar effect, so finding ways to relax—such as deep breathing, listening to music, or spending time outside—can be helpful.
While weight gain is possible with Rexulti, it is not guaranteed. Knowing the risks and taking steps early—such as checking weight regularly, building healthy habits, and staying in touch with a healthcare provider—can help prevent weight gain or reduce its impact. Prevention works best when it starts before major changes happen, and support is available to help keep weight and health on track during treatment.
Lifestyle Changes That Help Prevent or Reduce Weight Gain While Taking Rexulti
Some people gain weight while taking Rexulti, but healthy lifestyle changes can help prevent or reduce it. These changes include eating well, staying active, sleeping better, and managing stress. Making small but steady changes in daily habits can help keep weight under control while continuing treatment.
Healthy Eating Habits
Food choices play a big role in managing weight. Rexulti may increase appetite, especially for high-calorie or sugary foods. Learning how to build a balanced diet can help keep cravings and weight gain under control.
- Choose high-fiber foods: Vegetables, fruits, beans, and whole grains help people feel full longer. Fiber slows digestion, which helps control hunger and blood sugar levels.
- Include lean proteins: Protein builds muscle and helps with fullness. Good sources include chicken, turkey, fish, tofu, eggs, low-fat dairy, and legumes.
- Limit processed foods and sugary snacks: Candy, cookies, soda, chips, and fast food are high in calories and low in nutrients. Eating them too often can lead to fast weight gain.
- Practice portion control: Large portions lead to more calories. Using smaller plates, reading food labels, and measuring snacks can help control how much is eaten without feeling deprived.
- Plan meals ahead: Preparing meals at home helps control ingredients and portion sizes. Planning also reduces the temptation to eat fast food or skip meals.
- Avoid late-night eating: Eating late, especially large meals, can interfere with sleep and may lead to weight gain. A light, healthy snack earlier in the evening is usually enough.
Making smart food choices over time can lead to better weight management, even while taking medications like Rexulti.
Staying Physically Active
Exercise helps burn calories, improves mood, and supports metabolism. Regular movement is one of the best ways to prevent or reverse weight gain.
- Aim for at least 150 minutes of moderate activity each week: This can include brisk walking, swimming, biking, or dancing. Spreading the activity across the week makes it easier to manage.
- Add strength training twice a week: Lifting weights or using resistance bands helps build muscle, which burns more calories at rest. It also supports healthy bones and joints.
- Stay active throughout the day: Taking stairs instead of elevators, walking during phone calls, and stretching during breaks at work all add up. Small steps each day can make a big difference over time.
- Find enjoyable activities: People are more likely to stick to exercise routines they enjoy. Whether it’s a sport, group fitness class, or walking with a friend, enjoyment helps with long-term success.
Physical activity also improves mental health. It can reduce depression symptoms, improve focus, and lower stress, which may help control emotional eating.
Sleep and Weight Management
Poor sleep can lead to weight gain by affecting hormones that control hunger and fullness.
- Get 7 to 9 hours of sleep each night: Sleep helps the body recover, maintain balance, and control appetite.
- Go to bed and wake up at the same time each day: A steady routine supports better sleep quality.
- Avoid screens, caffeine, and large meals before bed: These can interfere with falling asleep and staying asleep.
When people sleep well, they are more likely to make healthy food and activity choices the next day.
Stress and Emotional Eating
Stress can cause emotional eating or cravings for comfort foods that are high in sugar or fat. These habits may lead to fast weight gain.
- Practice relaxation techniques: Deep breathing, stretching, yoga, or spending time in nature can help calm the mind.
- Use healthy ways to cope with stress: Talking to a counselor, journaling, or doing hobbies can help manage emotions without turning to food.
- Know the difference between hunger and stress eating: Real hunger builds slowly and is not linked to feelings. Emotional eating often happens suddenly and may lead to guilt afterward.
Addressing emotional health is just as important as focusing on diet and exercise. Learning to manage stress in healthy ways can prevent weight gain and support overall well-being.
Building Long-Term Habits
Changing habits takes time, but staying consistent helps. Keeping a journal of food, activity, sleep, and mood can show patterns and make it easier to stay on track. Working with a healthcare provider, dietitian, or personal trainer may also help build a plan that works for each person’s lifestyle.
Making steady changes in daily routines—such as eating well, moving more, sleeping better, and lowering stress—can help prevent or reduce weight gain for people taking Rexulti. These changes also support better physical and mental health over the long term.
Are There Medications or Supplements That Can Help Manage Weight Gain on Rexulti?
Weight gain from Rexulti (brexpiprazole) can be difficult for some people. While healthy eating and regular exercise are always important, these lifestyle changes do not work the same for everyone. In some cases, a doctor may prescribe other medicines or suggest certain supplements to help manage or reduce weight gain linked to Rexulti.
Prescription Medications Sometimes Used to Help With Weight Gain
Doctors may add a second medication to help lower the chances of gaining too much weight while taking Rexulti. These medicines are not officially approved by the FDA for this use, but some have shown helpful results in research and clinical practice. A doctor decides whether to use them based on a person’s health history, current symptoms, and risks.
- Metformin
Metformin is a medication often used to treat type 2 diabetes. It helps lower blood sugar and improve how the body uses insulin. Studies have found that metformin can also help reduce or prevent weight gain caused by antipsychotic medications like Rexulti.
Metformin may work by lowering appetite, improving how fat is stored in the body, and helping muscles use sugar more effectively. Some people taking Rexulti may be prescribed metformin even if they do not have diabetes, especially if they are gaining weight quickly or have signs of insulin resistance.
Metformin is usually well-tolerated. The most common side effects are stomach upset, gas, or diarrhea. These often get better over time. A doctor may start with a low dose and increase it slowly to reduce side effects. It is important to check kidney function regularly while using metformin.
- Topiramate
Topiramate is a medicine often used to treat seizures or prevent migraines. It has also been studied for helping with weight loss. Topiramate can lower appetite and make food less appealing to some people. It may also affect how the body burns calories.
When used along with an antipsychotic like Rexulti, topiramate has helped some people lose weight or prevent further gain. Doctors usually start with a low dose and slowly increase it. Side effects can include tiredness, dizziness, trouble concentrating, or a tingling feeling in the hands or feet. It may not be a good choice for people who already have memory or focus problems.
- Other Medications
In some cases, a doctor might consider other medications such as aripiprazole or bupropion when appropriate. These are not usually added just to manage weight, but in some situations, they may help when used as part of a broader treatment plan.
The decision to add a medication depends on many factors. These include the amount of weight gained, how fast it is happening, other health conditions, and the person’s overall mental health needs. Adding another medicine should only be done under medical supervision to avoid unwanted drug interactions or side effects.
Over-the-Counter Supplements: What Is Known
There are many over-the-counter (OTC) products marketed for weight loss, including vitamins, herbs, and dietary supplements. Some of the most common include:
- Green tea extract
- Garcinia cambogia
- Fiber supplements (such as glucomannan)
- Chromium picolinate
While these products are widely available, most do not have strong scientific proof that they work. Some may cause side effects or interact with prescription drugs. Others may not be safe for people with certain health conditions.
For example, green tea extract in high doses can cause liver problems. Garcinia cambogia has been linked to digestive issues and liver injury in rare cases. Supplements may also not be tested as carefully as prescription medications, so their quality and strength can vary.
Before trying any supplement, it is important to speak with a doctor or pharmacist. Even natural products can affect the way Rexulti or other medications work in the body.
Some prescription medications, like metformin and topiramate, may help manage weight gain caused by Rexulti. These options are usually considered when diet and exercise are not enough and weight gain becomes a health concern. Over-the-counter supplements are not well-studied and may carry risks, so they should only be used after talking to a healthcare provider.
The right choice depends on each person’s health needs. Doctors can help decide if adding a second medication is safe and helpful. Regular follow-up is needed to watch for side effects and make sure treatment goals are met.
How Can Healthcare Providers Help Manage Rexulti-Associated Weight Gain?
Healthcare providers play a key role in helping people manage weight gain that may happen while taking Rexulti. Working with the right team and having regular checkups can lower the chance of serious weight-related problems. Weight gain does not have to be ignored or accepted as normal. There are many ways that doctors, nurses, dietitians, and other health professionals can help prevent or reduce weight gain during treatment.
Psychiatrists and Prescribing Doctors
Psychiatrists are the doctors who most often prescribe Rexulti, especially for depression or schizophrenia. They are responsible for starting the medication, adjusting the dose, and watching for side effects. Since Rexulti can lead to weight gain in some people, psychiatrists need to talk about this risk before starting treatment.
Before prescribing Rexulti, doctors may ask about personal and family history of weight problems, diabetes, or high cholesterol. Knowing these risks can help decide if Rexulti is the right medication or if another option should be considered. If Rexulti is still the best choice, the doctor may recommend extra steps to prevent weight gain, such as changing diet or increasing activity.
Psychiatrists can also adjust the dose of Rexulti if needed. Some people may gain less weight at lower doses, although this is not guaranteed. Changes to dosage must always be done carefully to avoid worsening symptoms of depression or schizophrenia. Regular check-ins with the doctor are important to see how the body is responding and to decide if changes are needed.
Primary Care Providers
Primary care doctors, also called general doctors, help take care of the whole body, not just mental health. These doctors play a big role in checking for signs of weight gain, high blood sugar, or other health problems that may happen while taking Rexulti.
At regular visits, the doctor may check weight, blood pressure, blood sugar levels, and cholesterol. These tests can help catch problems early, when they are easier to manage. If weight gain or other issues are found, the doctor may talk about ways to change eating habits, increase exercise, or even add a medication to help with weight.
Primary care providers may also check the thyroid, liver, or other systems if weight gain is sudden or seems unusual. They help make sure that weight gain is really from the medication and not another hidden health problem.
Dietitians and Nutrition Experts
A dietitian is a trained food and nutrition expert. Some people who take Rexulti may benefit from seeing a dietitian early, before weight gain happens. Others may need help after they start gaining weight.
The dietitian can create a food plan that works with each person’s lifestyle, budget, and health needs. This may include meal timing, portion control, cutting down on sugar or fast food, and increasing vegetables, protein, and fiber. Dietitians often teach practical skills like how to read food labels or plan meals for the week.
If a person has gained weight, the dietitian can track progress and help make safe, slow changes. They can also teach how to deal with cravings or emotional eating, which may be worse when taking psychiatric medications.
Endocrinologists and Weight Specialists
Some people may need more help than general doctors can provide. An endocrinologist is a doctor who treats hormone and metabolism problems, including diabetes and obesity. If Rexulti causes serious weight gain, or if the person develops signs of diabetes, the psychiatrist or family doctor may send them to see an endocrinologist.
The endocrinologist may look deeper into the cause of the weight gain and suggest treatment such as medications that help control blood sugar or reduce appetite. These specialists also monitor for conditions like metabolic syndrome, which can raise the risk of heart disease and stroke.
Team-Based Care and Monitoring
Many health systems now use team-based care to help patients with complex needs. This means the psychiatrist, family doctor, dietitian, and other health workers work together and share information. This can make care more complete and easier to manage.
Good communication between the team helps everyone stay updated about the person’s weight, labs, and treatment goals. For example, if the psychiatrist notices that weight is increasing, they can ask the family doctor to order tests or refer the patient to a nutritionist. Everyone on the team has a role in keeping the person healthy while on Rexulti.
Follow-Up and Long-Term Support
Weight gain from medications can happen slowly, so long-term follow-up is important. Healthcare providers should schedule regular appointments to check body weight, waist size, blood pressure, and lab results. Even small changes in weight or lab values can be early warning signs.
Support over time can make it easier to stick with healthy habits. Healthcare providers may also offer printed guides, mobile apps, or community programs for added support. If weight gain continues even with lifestyle changes, more advanced steps can be taken based on the individual’s needs.
With regular care, open communication, and shared decision-making, healthcare providers can help reduce the impact of Rexulti on weight and protect long-term health.
When to Be Concerned About Weight Gain While Taking Rexulti
Weight gain is a known side effect of Rexulti (brexpiprazole), especially when taken for several weeks or months. While some people may gain a small amount of weight that stays stable, others may experience more rapid or significant weight gain. Understanding when weight gain becomes a problem is important for protecting long-term health and staying on the right treatment plan.
Signs That Weight Gain May Be a Concern
Weight gain can become concerning when it affects health, comfort, or daily life. Some signs that the weight gain should be taken seriously include:
- Gaining more than 5% of starting body weight within a short period, such as within one to three months. For example, a person who weighs 150 pounds at the start of treatment and gains 8 pounds or more may need to speak with a doctor.
- Gaining weight quickly, such as several pounds in just a few weeks. Fast weight gain is more likely to affect blood sugar and cholesterol levels.
- Changes in energy or physical ability, such as becoming tired more often or having difficulty walking, climbing stairs, or doing regular activities.
- New health problems, such as higher blood pressure, elevated blood sugar, or joint pain. These may be linked to extra weight.
- Feeling out of control with eating, especially if there are strong cravings or emotional eating patterns that were not present before starting Rexulti.
Not everyone will experience all of these signs, but even one of them may suggest the need for medical support or changes to the treatment plan.
How Doctors Diagnose Medication-Related Weight Gain
Healthcare providers use several tools to determine whether the weight gain is caused by Rexulti and if it needs treatment. One way to measure this is by looking at the amount of weight gained over time. Most medical professionals become concerned when the weight gain is:
- Unintentional (not related to lifestyle changes alone)
- Greater than 7% of body weight over 3 to 6 months
- Causing physical health issues, like abnormal blood sugar or lipid levels
Another factor doctors look at is body mass index (BMI). If Rexulti causes a person’s BMI to rise into the overweight or obese range, that may increase the risk for health problems and prompt the need for changes.
Doctors may also use lab tests to check for early signs of metabolic syndrome, which includes high blood pressure, high blood sugar, excess belly fat, and abnormal cholesterol. These health issues are more common in people who gain weight quickly while on antipsychotic medications like Rexulti.
What Can Happen If the Weight Gain Is Not Managed
If weight gain continues without being addressed, it can lead to serious long-term health issues. These include:
- Type 2 diabetes
- High blood pressure (hypertension)
- High cholesterol and triglycerides
- Heart disease
- Fatty liver disease
- Joint pain or arthritis
Over time, these problems may increase the risk of heart attack, stroke, or the need for additional medications. This is why it is important not to ignore unwanted weight gain while taking Rexulti.
In addition to physical health risks, weight gain can also affect mental and emotional well-being. Some people may feel sad, frustrated, or embarrassed about their weight. These feelings can make it harder to stay motivated with treatment or make healthy lifestyle changes. In some cases, it can even lead to people stopping their medication without talking to a doctor, which increases the risk of a return of depression, psychosis, or other mental health symptoms.
When to Ask for Help
Medical help should be sought if any of the following occur:
- Gaining more than 5–7% of starting weight
- Gaining weight quickly within a few weeks
- New health problems appear, like high blood sugar or blood pressure
- Feeling unable to control eating or hunger
- Emotional stress linked to weight or appearance
- Difficulty keeping up with regular activities due to extra weight
Doctors may suggest changes to diet or exercise routines, refer to a nutritionist or weight management program, or adjust the dose of Rexulti. In some cases, a different medication may be considered if the weight gain becomes a serious concern.
By noticing these signs early and working closely with a healthcare team, it is possible to manage weight while staying on a treatment that helps improve mental health.
What Are the Long-Term Health Risks of Unmanaged Weight Gain While Taking Rexulti?
Weight gain from medications like Rexulti can seem minor at first. However, when weight continues to increase over time and is not managed properly, it can lead to serious health problems. These issues may develop slowly but can have a big impact on long-term health. People taking Rexulti should be aware of the possible risks and take steps with their healthcare team to lower them. Understanding these risks can help in making informed decisions and taking early action.
Cardiovascular Risks
One of the major concerns with long-term weight gain is its effect on the heart and blood vessels. Gaining extra weight puts more strain on the heart. Over time, this added stress can increase blood pressure, leading to a condition known as hypertension. High blood pressure forces the heart to work harder, which raises the risk of heart disease, stroke, and heart failure.
Weight gain is also linked to high cholesterol levels, especially high levels of LDL (bad cholesterol) and triglycerides. These fats can build up in blood vessels and lead to atherosclerosis, a condition where arteries become narrow and hard. This makes it harder for blood to flow, increasing the chances of a heart attack or stroke.
Metabolic Risks
Another serious concern is the risk of insulin resistance, where the body has trouble using insulin to control blood sugar levels. Over time, this can lead to type 2 diabetes. Diabetes increases the risk of kidney disease, nerve damage, eye problems, and other health complications.
Metabolic syndrome is a group of conditions that often occur together, including high blood pressure, high blood sugar, abnormal cholesterol levels, and excess fat around the waist. This syndrome greatly increases the risk of heart disease, stroke, and type 2 diabetes. Taking Rexulti may raise the chances of developing metabolic syndrome, especially if weight gain is not addressed early.
People who already have prediabetes or a family history of diabetes are at even higher risk. For them, even a small weight gain can lead to larger health problems. Regular monitoring of blood sugar and lipid levels is important to catch changes early and prevent long-term damage.
Mental and Emotional Health Impacts
Weight gain does not only affect physical health. It can also cause emotional and mental stress. Some people may begin to feel unhappy with their body or avoid social situations. This can lead to low self-esteem, depression, or anxiety. In some cases, the fear of gaining weight may cause people to stop taking Rexulti without telling their doctor, which can lead to a return of symptoms like depression or psychosis.
Managing both mental and physical health together is important. Weight gain can make it harder for some people to stay motivated or active, which can increase feelings of hopelessness. That is why early support and healthy routines can make a big difference.
Impact on Daily Function and Quality of Life
Carrying extra weight over time may also make daily tasks harder. Simple actions like walking, climbing stairs, or playing with children can become tiring. Joints, especially in the knees and hips, may start to hurt due to extra pressure. This increases the risk of osteoarthritis, a painful joint condition that can limit movement and lower quality of life.
Increased fatigue, low energy, and reduced physical activity can create a cycle where it becomes harder to lose weight. People may become less active, which causes more weight gain, making the cycle worse. Breaking this pattern takes effort, planning, and often help from a healthcare team.
Importance of Early Action
The longer weight gain continues without action, the harder it becomes to manage. Long-term changes to blood pressure, blood sugar, and cholesterol can happen without clear symptoms. That is why regular health checkups, weight tracking, and lab tests are so important for anyone taking Rexulti. These checks can catch problems early when they are easier to treat.
Doctors may recommend regular blood pressure checks, blood tests for glucose and cholesterol, and waist measurements to monitor for signs of metabolic changes. These steps help in making decisions about medication, diet, and activity levels before serious complications occur.
Unmanaged weight gain while taking Rexulti can lead to major health issues like high blood pressure, heart disease, type 2 diabetes, and metabolic syndrome. It can also affect mental well-being and reduce quality of life. These risks may not appear right away but tend to grow over time. Regular monitoring, healthy lifestyle habits, and early support from healthcare providers are key to lowering these risks and staying healthy while continuing treatment with Rexulti.
Is It Safe to Stop Taking Rexulti Due to Weight Gain?
Some people taking Rexulti may notice weight gain and wonder if stopping the medication is the best way to avoid further changes. It is important to understand that stopping Rexulti suddenly is not safe without medical advice. This can lead to serious problems, including the return of mental health symptoms and withdrawal effects.
Rexulti (brexpiprazole) is a prescription medicine used to treat conditions such as depression and schizophrenia. It works by changing the levels of certain chemicals in the brain, including dopamine and serotonin. These changes help control mood, behavior, and thinking. But if Rexulti is stopped all at once, the brain may react strongly, which can cause new symptoms or make old ones worse.
Stopping Rexulti Suddenly Can Be Risky
Stopping Rexulti without talking to a doctor can lead to withdrawal symptoms. These may include anxiety, trouble sleeping, nausea, dizziness, or mood changes. In some cases, people may feel confused or experience a return of hallucinations or paranoia if they have schizophrenia.
For people using Rexulti as part of treatment for major depressive disorder, stopping the medicine too quickly can cause the return of low mood, sadness, lack of energy, and trouble with thinking clearly. These symptoms may be stronger than before the medication was started. This may increase the risk of emotional distress and can make daily life harder.
Stopping Because of Weight Gain: Weighing the Risks and Benefits
Weight gain is a known side effect of Rexulti. However, not everyone gains weight, and for many people, the weight gain is small. When weight gain does happen, it is important to think about the full picture. If Rexulti is helping manage depression or schizophrenia, stopping it without another plan in place can be harmful. The benefits of feeling mentally stable may still outweigh the risks of weight gain.
Doctors usually do not suggest stopping Rexulti right away because of weight gain. Instead, they may help manage the weight side effects with other tools. These can include a healthy eating plan, exercise, and regular check-ups to track weight and blood pressure. In some cases, doctors may add another medicine to help control weight, or they may lower the Rexulti dose if it is safe to do so.
How to Stop Rexulti Safely, If Needed
If weight gain becomes a serious problem and cannot be managed, the doctor may decide to stop Rexulti. This should always be done slowly and under close medical care. The process of stopping a medicine like Rexulti is called “tapering.” This means lowering the dose little by little over time.
Tapering helps the brain and body adjust without a sudden shock. It lowers the chance of withdrawal symptoms and keeps the person stable. The doctor will create a tapering schedule based on how long Rexulti has been used, what dose was taken, and what condition is being treated.
Sometimes, doctors may switch the person to a different medicine that has a lower risk of weight gain. This decision depends on the person’s health history, current symptoms, and how well other medicines have worked in the past.
Importance of Talking to a Healthcare Provider
Weight gain while taking Rexulti can be upsetting, but stopping the medicine alone is never the right step. A doctor, psychiatrist, or nurse can help find a safe way to manage side effects. This may include changing lifestyle habits, adjusting the dose, or planning a slow and safe stop if needed.
Mental health medicines like Rexulti work best when used as part of a full treatment plan. This plan may also include therapy, support from family or friends, and regular doctor visits. Decisions about changing or stopping medicine should always be made with a medical professional. This helps keep treatment safe and effective.
Taking care of mental health is just as important as managing physical health. With the right support, it is possible to handle side effects like weight gain without losing the progress made in treatment.
Conclusion: Taking Control of Your Health While on Rexulti
Rexulti is an important medication used to treat mental health conditions such as major depressive disorder and schizophrenia. For many people, it helps reduce symptoms and improve daily functioning. However, like many antipsychotic medications, Rexulti can sometimes cause weight gain. This side effect can be frustrating and may feel difficult to manage. But with the right information and support, it is possible to prevent or reduce weight gain while continuing treatment safely.
Gaining weight while taking Rexulti does not happen to everyone. When it does happen, it may be due to changes in appetite, metabolism, or how the body stores fat. The way Rexulti works in the brain can increase hunger or reduce the feeling of fullness after eating. It can also affect energy levels, making it harder to stay active. These effects can lead to gradual or sometimes faster weight gain. Some people may also develop higher blood sugar or cholesterol over time. Because of this, it is important to pay attention to weight and overall health when starting or continuing Rexulti.
Understanding that weight gain is a possible side effect can help people take early steps to manage it. Before starting Rexulti, a healthcare provider may check weight, blood pressure, and blood tests such as blood sugar and cholesterol levels. These checks can help catch changes early. After starting the medication, regular monitoring should continue. Keeping track of body weight, appetite changes, and daily habits can help notice early signs of weight gain. This information can also help doctors give better advice and support.
Lifestyle changes play a major role in managing weight during treatment. Eating balanced meals, getting regular exercise, and keeping a regular sleep schedule can all help. Choosing foods that are high in fiber and protein while avoiding sugary drinks and snacks may reduce overeating. Physical activity such as walking, swimming, or strength training can help burn calories and build muscle. Good sleep and stress control also support healthy weight. Even small changes, such as cooking more meals at home or limiting late-night snacks, can make a difference over time.
In some cases, healthcare providers may recommend medications to help manage weight gain. These may include treatments like metformin, which can help with blood sugar and weight, especially in people with prediabetes. These options are not for everyone and need careful monitoring by a doctor. The decision to use an extra medication should be based on each person’s health needs and treatment goals.
Doctors, nurses, dietitians, and therapists can all work together to help manage side effects. Regular appointments are important to check weight, mood symptoms, and lab results. If weight gain becomes a problem, a doctor might adjust the dose or suggest changes in diet or activity. In rare cases, switching medications may be considered, but this must be done carefully to avoid return of symptoms.
If weight gain is rapid or causes serious health concerns like high blood pressure or diabetes, it is important to act quickly. Doctors may run extra tests or refer patients to specialists, such as endocrinologists. Early action can prevent long-term problems and support better overall health. While it might feel easier to stop the medication, stopping Rexulti without medical advice is not safe. This can cause mood or psychotic symptoms to return suddenly. A doctor can help make a plan if changes are needed, including how to lower the dose safely over time.
Weight gain from Rexulti can be upsetting, but it is possible to manage it with the right approach. Healthy habits, support from healthcare providers, and regular check-ups can all make a big difference. Staying informed and taking early action helps reduce health risks and supports long-term success in treatment. Rexulti can improve quality of life by helping with mental health, and that benefit should not be lost due to concerns about weight. With planning and care, both mental and physical health can be supported together.
Research Citations
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Kane, J. M., Davis, R. E., Weiden, P. J., et al. (2015). Efficacy and safety of brexpiprazole for the treatment of acute schizophrenia: A randomized, double-blind, placebo-controlled trial. American Journal of Psychiatry, 172(1), 11–18. https://doi.org/10.1176/appi.ajp.2015.14101275
Citrome, L., Fleischhacker, W. W., Hough, D., et al. (2016). Efficacy and safety of brexpiprazole as maintenance treatment in adults with schizophrenia. Journal of Clinical Psychopharmacology, 36(3), 284–292. https://doi.org/10.1097/JCP.0000000000000487
McClendon, D. R., Anziano, R., Quirk, S., et al. (2024). A multicenter, open-label study to evaluate the long-term safety and efficacy of adjunctive brexpiprazole 2 mg daily in Japanese patients with major depressive disorder. CNS Drugs. Advance online publication. https://doi.org/10.1007/s40263-024-01124-w
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Questions and Answers: Weight Gain Rexulti
Yes, weight gain is a known side effect of Rexulti. Clinical studies have shown that some people may experience moderate weight gain while taking the medication.
Weight gain occurs in a significant number of patients. In clinical trials, up to 18% of patients reported weight gain, though the extent varies.
On average, patients may gain about 3 to 7 pounds over several weeks, but some may gain more, especially with longer use.
Rexulti may affect appetite, metabolism, and how the body stores fat. It interacts with dopamine and serotonin receptors, which can influence hunger and energy balance.
Not necessarily. Weight gain may plateau or reverse if the medication is stopped or if lifestyle changes are made, but this varies by individual.
Yes, regular exercise, a balanced diet, and monitoring your weight can help manage or prevent weight gain during treatment.
Do not stop taking Rexulti without speaking to your doctor. There may be alternative strategies or medications that minimize weight gain.
Yes, higher doses may increase the likelihood and amount of weight gain, although this can vary between individuals.
In some cases, doctors may prescribe medications like metformin or recommend lifestyle counseling to manage weight gain, but this should only be done under medical supervision.
People with a history of weight gain on antipsychotics, a sedentary lifestyle, or preexisting metabolic issues may be more likely to gain weight on Rexulti.
Dr. Kevin Kargman
Dr. Kevin J. Kargman is a pediatrician in Sewell, New Jersey and is affiliated with multiple hospitals in the area, including Cooper University Health Care-Camden and Jefferson Health-Stratford, Cherry Hill and Washington Township. (Learn More)