Still Struggling? Why Rexulti Works + Medically Approved Next Steps

If you're still struggling with depression even after trying treatment, you're not alone. Many people don't feel full relief from their first antidepressant. That doesn't mean treatment has failed — it means your brain may need a different approach.

One option doctors often consider is Rexulti (brexpiprazole). Below, we'll explain how Rexulti works, who it may help, what to expect, and what medically approved next steps you can take if you're still not feeling like yourself.

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What Is Rexulti?

Rexulti (brexpiprazole) is a prescription medication approved by the FDA for:

• Major Depressive Disorder (MDD) — used with an antidepressant when antidepressants alone aren't enough
• Schizophrenia

For depression, Rexulti is not usually used by itself. It's added to an existing antidepressant to help improve response. This is called adjunctive treatment.

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Why Some People Still Struggle on Antidepressants

Antidepressants (like SSRIs or SNRIs) mainly work on serotonin and sometimes norepinephrine. While effective for many, they don't fully relieve symptoms for everyone.

You might still experience:

• Low mood
• Lack of motivation
• Fatigue
• Brain fog
• Emotional numbness
• Trouble enjoying things

This is sometimes called incomplete response or treatment-resistant depression.

It's common — and treatable.

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How Rexulti Works Differently

Rexulti works in a unique way compared to traditional antidepressants.

It acts as a serotonin-dopamine activity modulator, which means:

• It partially stimulates certain serotonin receptors
• It balances dopamine activity
• It reduces excessive serotonin activity in other areas

In simpler terms:
Rexulti helps "fine-tune" brain signaling rather than simply increasing one chemical.

Why does that matter?

Depression isn't just about low serotonin. Dopamine — the brain chemical involved in motivation and pleasure — also plays a major role. By affecting both systems, Rexulti may help improve:

• Motivation
• Interest
• Emotional engagement
• Energy
• Mood stability

Clinical trials show that adding Rexulti to an antidepressant can improve depressive symptoms more than an antidepressant alone in people who haven't responded fully.

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Who Might Benefit From Rexulti?

Doctors may consider Rexulti if you:

• Have tried one or more antidepressants without full relief
• Notice persistent lack of motivation or emotional "flatness"
• Have partial improvement but still struggle daily
• Tolerate your current antidepressant but need added support

Rexulti is not usually a first-line treatment for depression. It's typically added when standard therapy hasn't been enough.

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What to Expect If You Start Rexulti

1. Dosing

Rexulti is usually started at a low dose and gradually increased. This helps reduce side effects.

2. Timeline

Some people notice improvements within a few weeks, but full benefits may take 4–8 weeks.

3. Possible Side Effects

Like all medications, Rexulti has potential side effects. The most common include:

• Weight gain
• Restlessness (akathisia)
• Headache
• Fatigue
• Digestive upset

Less common but more serious risks can include:

• Increased blood sugar
• Elevated cholesterol
• Movement disorders
• Rarely, increased suicidal thoughts (especially in younger adults)

Your doctor will monitor for these. Do not stop Rexulti suddenly without medical guidance.

If you experience severe side effects or thoughts of harming yourself, seek medical care immediately.

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Medically Approved Next Steps If You're Still Struggling

If you're not feeling better — or not better enough — here are evidence-based next steps doctors commonly recommend:

✅ 1. Reassess the Diagnosis

Sometimes symptoms overlap with:

• Bipolar disorder
• ADHD
• Anxiety disorders
• Thyroid problems
• Sleep disorders

Accurate diagnosis matters.

If you're unsure whether your symptoms align with major depressive disorder or another condition, Ubie's free AI-powered Depression symptom checker can help you identify what you're experiencing and guide your conversation with a healthcare provider.

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✅ 2. Optimize Your Current Antidepressant

Before adding Rexulti, doctors may:

• Increase the antidepressant dose (if safe)
• Extend the trial to 6–8 weeks
• Switch to a different antidepressant class

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✅ 3. Add Rexulti (Adjunctive Therapy)

If you've had partial response, adding Rexulti is a common next step supported by clinical trials.

This approach is often effective because it targets additional brain pathways beyond serotonin alone.

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✅ 4. Consider Other Augmentation Options

Other medically approved add-on treatments include:

• Aripiprazole
• Quetiapine XR
• Lithium
• Thyroid hormone (in select cases)

Your doctor will tailor treatment to your medical history and symptom pattern.

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✅ 5. Add or Adjust Psychotherapy

Medication works best when combined with therapy.

Evidence-based therapies include:

• Cognitive Behavioral Therapy (CBT)
• Interpersonal Therapy (IPT)
• Behavioral Activation
• Acceptance and Commitment Therapy (ACT)

If you're on medication but not in therapy, adding it may significantly improve results.

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✅ 6. Evaluate Lifestyle Factors

These aren't "quick fixes," but they matter:

• Sleep consistency
• Daily movement
• Nutrition
• Alcohol use
• Social connection
• Sunlight exposure

Lifestyle changes don't replace medication when depression is moderate to severe — but they enhance results.

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When to Seek Immediate Medical Care

Depression can become serious. Speak to a doctor immediately or seek emergency care if you experience:

• Thoughts of suicide or self-harm
• Feeling unable to keep yourself safe
• Severe agitation or restlessness
• Sudden mood changes
• Hallucinations or delusions

These symptoms require urgent medical attention.

Even if symptoms don't feel urgent, it's important to speak to a doctor about ongoing depression. Untreated depression can affect relationships, work, physical health, and long-term well-being.

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Does Rexulti Cure Depression?

No medication "cures" depression. But Rexulti can significantly reduce symptoms when added to an antidepressant.

For many people, the goal is:

• Symptom remission (feeling like yourself again)
• Improved daily functioning
• Reduced relapse risk

Some people need medication short-term. Others may need longer-term treatment. That decision should always be made with your healthcare provider.

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A Realistic but Hopeful Perspective

If you're still struggling, it does not mean:

• You're weak
• You're doing something wrong
• You're beyond help

Depression is a medical condition involving complex brain chemistry and life stressors. Sometimes it takes adjusting treatment to find the right combination.

Rexulti works differently than standard antidepressants, which is why it can help when others haven't fully worked.

But medication is only one part of the solution. Diagnosis review, therapy, medical monitoring, and lifestyle factors all matter.

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Final Thoughts

If your current antidepressant isn't enough, adding Rexulti is a medically approved, evidence-based next step many doctors use successfully.

Here's what you can do today:

• Reflect on whether your symptoms have truly improved
• Use Ubie's free Depression symptom checker to better understand your symptoms and prepare for your doctor's visit
• Schedule a conversation with your healthcare provider
• Ask whether adjunctive treatment like Rexulti may be appropriate

Depression is treatable. But it requires active management.

If anything feels severe, life-threatening, or unsafe, seek emergency care immediately and speak to a doctor right away.

You deserve real relief — not just partial improvement.