Welcome to the new RxBalance website. Learn more about our Resources.
Lies of Omission: How Pharma Spins Antipsychotics for Depression

When is a lie not quite a lie? When it’s a lie of omission. Case in point: antipsychotic medications to augment depression.
Drug companies rarely lie to us outright. Sometimes, however, they omit or hide critical details to present their medications in the best possible light. Take antipsychotics marketed as an add-on treatment for patients with depression, medications like Rexulti (brexpiprazole) and Abilify (aripiprazole).
Rebranding Antipsychotics: What Patients Aren’t Told
A person with depression might feel differently about taking the antidepressant Rexulti if they knew the medication was initially approved to treat schizophrenia, a point not apparent in the TV ads or on the consumer website.
The tendency of drug companies to hide or minimize specific information helped these second-generation antipsychotics become one of the most popular drug classes in America, not bad for a category of drugs initially developed for schizophrenia. However, only a tiny percentage of Americans have schizophrenia, so pharmaceutical companies looked for ways to expand into another psychiatric market. Their solution? Rebrand antipsychotics for a much larger audience—patients with major depressive disorder—boosting sales by widening the drug’s use beyond its original purpose
Pharmaceutical companies invest heavily in advertising and marketing to shape perceptions of their prescription medications. Lies of omission are a well-established strategy—by controlling what doctors and consumers know, Big Pharma influences what gets prescribed. Key details about drugs are often buried in fine print in physician marketing materials or rushed through in TV ads, drowned out by upbeat music and reassuring imagery.
Seeing a Rexulti ad on TV for depression might prompt you to ask your doctor about the drug. But would you feel the same knowing Rexulti was initially created to treat schizophrenia? This critical fact, along with the severe neurological side effects associated with the drug, is something you’re unlikely to hear from a TV ad. The truth is that antipsychotic medications like Rexulti to augment depression treatment were initially approved for people with schizophrenia and come with significant risks often downplayed in direct-to-consumer advertising.
Compare your reaction to how the Rexulti consumer website explains the drug’s safety profile to an FDA-approved medication guide. The FDA guide highlights a serious neurological side effect, tardive dyskinesia (TD), right in the first sentence, followed by a warning that the condition may be permanent. In contrast, the safety information from a Rexulti educational program for doctors presents the same risk information in a way that feels far more reassuring.
From the FDA Approved Rexulti Package Insert
“Uncontrolled body movements (tardive dyskinesia): REXULTI may cause movements that you cannot control in your face, tongue or other body parts. Tardive dyskinesia may not go away, even if you stop taking REXULTI. Tardive dyskinesia may also start after you stop taking REXULTI.”
From a Sponsored Physician Educational Video Rexulti Website Safety Information
“Tardive dyskinesia (TD): Risk of TD and the potential to become irreversible, appear to increase with duration of treatment and total cumulative dose of antipsychotic drugs. TD can develop after relatively brief treatment periods, at low doses, or after discontinuation of treatment. For chronic treatment, use the lowest dose and shortest duration of REXULTI needed to provide a clinical response. If signs and symptoms of TD appear, drug discontinuation should be considered.”
What’s Left Unsaid: The Power of Selective Framing
A patient reads the FDA-approved Medication Guide after picking up their prescription—and are immediately warned that Rexulti may cause involuntary facial movements that could persist even after stopping the drug. A stark and unsettling message. Meanwhile, doctors may view materials that frame the same risk in a more favorable manner. The sponsored physician video above acknowledges tardive dyskinesia but subtly reassures prescribers by framing TD as dose- and duration-dependent, implying the risk can be managed.
This isn’t just a difference in wording—it’s a deliberate strategy. Would a patient still feel comfortable taking Rexulti if they saw the full warning before filling their prescription? And if not, why is the doctor given a more reassuring version of the same risk? The answer lies in what’s omitted and how the story is spun. The Medication Guide might deter patients, while the marketing video reassures doctors—ultimately leading to more prescriptions. This is the essence of a lie of omission—not an outright falsehood, but a carefully curated version of the truth, designed to influence behavior while keeping the full story just out of reach.
As a former medical advertising writer, I can say with certainty: this is how drugs are marketed in America.
Based on decades of experience in medical advertising, we expose the hidden side of the pharmaceutical industry’s story — empowering patients to make informed decisions about their health.
References
I hope that your information gets very widely distributed. So important for patients to have the true facts. Thank you!