Do Rexulti and Zoloft Cause Cramps?
Yes, both Rexulti (brexpiprazole) and Zoloft (sertraline) can cause cramps, though through different mechanisms and with varying frequency.
Sertraline (Zoloft) and Cramps
Sertraline is associated with gastrointestinal side effects that can include abdominal cramping, though this is not among its most common adverse effects. 1
Gastrointestinal effects are common with SSRIs, with sertraline showing higher rates of GI side effects compared to some other antidepressants, particularly nausea, diarrhea, and abdominal pain. 1
However, sertraline does not significantly affect gastric sensitivity or compliance in controlled studies, suggesting that cramping when it occurs may be related to other GI mechanisms rather than altered visceral sensation. 2
The gastrointestinal side effects profile varies among SSRIs, with escitalopram and sertraline being among the least tolerated on the GI tract, while mirtazapine shows fewer gut-related side effects. 1
Brexpiprazole (Rexulti) and Cramps
Brexpiprazole is generally well-tolerated with a lower potential for activation-like adverse effects compared to aripiprazole due to its unique receptor binding profile and low intrinsic D2 activity. 3
Brexpiprazole was well tolerated in clinical trials lasting up to 52 weeks, though specific data on muscle cramps or abdominal cramping as adverse effects is not prominently reported in the available evidence. 3
The drug's serotonin-dopamine activity modulating properties suggest a different side effect profile than traditional antipsychotics, with emphasis on lower akathisia rates rather than cramping. 4, 3
Clinical Considerations
When patients on this combination report cramps, consider the anatomical location: abdominal cramps are more likely related to sertraline's GI effects, while muscle cramps in extremities would be less typical for either medication. 1
Monitor for drug interactions when combining these medications, particularly regarding cardiovascular effects and QT prolongation, though cramping itself is not a primary concern from their interaction. 5
If GI cramping is problematic, consider that sertraline's gastrointestinal side effects often improve with continued use as tolerance develops, though this is less predictable than with other SSRI side effects. 1