Vilazodone, also known as Viibryd, is an antidepressant medication primarily used to treat major depressive disorder. Before starting vilazodone treatment, inform your doctor of your mental and physical health history and any other medications you take (prescribed or over the counter), as adverse effects can occur.
Vilazodone brand names
- Viibryd
What is vilazodone prescribed for?
Vilazodone is FDA-approved for the treatment of major depressive disorder (MDD) [1]. It currently is not approved for any other uses. However, as it is a somewhat new medication (having only been approved in 2011), studies and trials of its effectiveness for other conditions are currently limited and may increase over the upcoming years [2].
Due to the similarities between vilazodone and other antidepressants such as SSRIs and SNRIs, and other medications such as buspirone, it is believed that it may have some use in treating the following conditions [2][3]:
- Generalized anxiety disorder (GAD)
- Panic disorder
- Social anxiety disorder (SAD)
- Post-traumatic stress disorder (PTSD)
- Obsessive-compulsive disorder (OCD)
- Premenstrual dysphoric disorder (PMDD)
- Bulimia nervosa
How does vilazodone work?
Vilazodone works in a similar way as the class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs) due to its blocking effect on serotonin receptors. This action helps to increase the level of serotonin in the brain, thus creating an antidepressant effect [3].
However, unlike other SSRIs, vilazodone also has another action, acting as a partial agonist at serotonin receptors, similar to the action of the anti-anxiety medication buspirone. This stimulates receptors and is believed to have a more significant and quicker effect on serotonin than other SSRIs [3][4].
The unique mechanism of action of vilazodone may help to reduce the likelihood of certain side effects commonly seen with SSRIs, such as weight gain and sexual dysfunction. However, it may increase the risk of other side effects, such as nausea and diarrhea [4].
How is vilazodone usually taken?
Vilazodone is available as 10mg, 20mg, and 40mg tablets, which should be swallowed whole without breaking or crushing. Vilazodone is usually taken just once per day [5].
Typically, when starting a new medication, you will begin on a low dose which will be gradually increased. A usual starting dose for the treatment of MDD is 10mg once daily. This will typically be increased to 20mg once daily [6].
The dosage may be increased after one week at the previous dose, and the maximum recommended dose is 40mg once daily. It is recommended to take vilazodone with food [1].
If you forget to take your medication, you can take it when you remember. However, if it is close to the following dosage time, the missed dose should be skipped and the following dose taken at the correct time. Never take double the prescribed amount at once, as this can cause adverse effects.
Always take your medication exactly as it has been prescribed, as missing doses, taking too much, or taking too little, can increase the risk of side effects or limit the effectiveness of your treatment.
How long does vilazodone stay in your system?
When starting vilazodone treatment, you might notice some changes in the first few weeks, although it may take up to three months before the medication takes full effect. It is important to take your medication consistently to receive the full benefits of your treatment [6].
If vilazodone treatment is stopped, the medication may take several days or weeks to leave your system completely following the final dose [2].
You should not stop taking vilazodone suddenly, as this can cause withdrawal symptoms. If it is advised to stop this treatment, your doctor will gradually reduce your dose to prevent adverse effects [1].
Vilazodone side effects
With a new medicinal treatment, it is common to experience side effects within the first few weeks or months. These side effects will typically improve without intervention as the body adjusts to the medication. However, if any side effects continue or cause concern, contact your doctor, as you may need to change your medication or dosage.
Common side effects of vilazodone include [5]:
- Stomach upset, including nausea, vomiting, diarrhea, or constipation
- Headaches
- Dizziness
- Drowsiness
- Fatigue
- Dry mouth
- Changes in appetite
- Shaking
- Insomnia
- Sexual dysfunction, such as reduced libido
In some cases, serious side effects can occur. If you notice any of the following side effects, you should consult your doctor immediately [5][6]:
- Severe or persistent headaches
- Cognitive impairments, such as reduced memory or concentration abilities
- Confusion
- Weakness
- Unsteadiness and falling
- Fainting or loss of consciousness
- Difficulty breathing
- Rapid or irregular heartbeat
- Hallucinations
- Seizures
- Changes in vision or eye pain
- Fever
- Rash or hives
- Muscle stiffness, pain, or tremors
- Unusual bleeding or bruising
Vilazodone precautions
Suicidal ideation
Antidepressant medications, such as vilazodone, have been found to cause or worsen suicidal thoughts, particularly in individuals under the age of 24. This may be more likely to occur at the beginning of a new antidepressant treatment or when the dosage is changed [1].
Doctors will monitor individuals starting a new antidepressant for any concerning changes in their mental state. If you notice any new or worsening thoughts of self-harm or suicide when taking vilazodone, it is essential to contact your doctor or mental health professional for advice and support.
Serotonin syndrome
Medications that affect serotonin levels, such as vilazodone, can cause serotonin syndrome. This occurs when serotonin levels become too high. As such, it is more likely when serotonergic medications are used in combination or high doses, although it can occur with just one medication [1].
Serotonin syndrome can cause symptoms such as irregular blood pressure and heart rate, high body temperature, nausea and vomiting, hallucinations, seizures, and loss of consciousness. If you experience any of these symptoms, you should contact your doctor immediately, who will provide appropriate treatment [6].
Mania
In some cases, antidepressants, such as vilazodone, have been found to cause the onset of a manic episode in individuals with bipolar disorder. As such, you will likely be screened for bipolar prior to commencing vilazodone treatment. If vilazodone is used to treat bipolar depression, it is often prescribed alongside a mood stabilizer to help reduce this risk [6].
Health concerns
You should discuss with your doctor any past or present physical health conditions, as these could affect the safe use of this medication.
Some antidepressants can increase the risk of seizures, glaucoma, and low sodium levels. As such, vilazodone may not be an appropriate treatment for individuals with a history or high risk of these health concerns or should be used with caution in these cases [5].
Similarly, due to the potential side effects, individuals with a history of heart, liver, or kidney conditions may be unable to take this medication safely. If it is deemed necessary for treatment, you may be prescribed a reduced dose, and your doctor will ensure careful monitoring of your physical well-being throughout your treatment.
Vilazodone can increase the risk of unusual bleeding events, so it is not recommended to take this medication alongside NSAIDs, Aspirin, or other blood-thinning medications [1].
Discontinuation syndrome
Abruptly stopping vilazodone can result in withdrawal symptoms, also known as discontinuation syndrome. If it is deemed safe and appropriate to stop vilazodone, your doctor will gradually reduce your dosage to prevent these effects. Withdrawal symptoms of vilazodone can include [1][5]:
- Headaches
- Insomnia
- Nightmares
- Tingling or prickling sensations
- Electric shock sensations in the brain
- Nausea and vomiting
- Depression
- Anxiety
- Suicidal thoughts
- Agitation
- Restlessness
- Irritability
- Confusion
- Dizziness
Pregnancy and breastfeeding
Inform your doctor if you are pregnant or planning to become pregnant before starting vilazodone treatment. There may be some risk to the fetus if vilazodone is taken while pregnant, particularly in the third trimester. It is important to be aware of these risks and the potential risks of untreated depression to make an informed decision about your treatment [6].
Additionally, inform your doctor if you are breastfeeding before starting vilazodone. The medication might be excreted in breast milk, so it may affect the breastfeeding infant. Again, it is essential to be aware of the risks and benefits of this treatment. If medication is used while breastfeeding, it is advised to monitor your baby for any unusual changes in their physical or mental state [1].
Vilazodone interactions
Always inform your doctor of any medications you take before starting a new treatment, as interactions and adverse effects can occur. Vilazodone can interact with other medications and substances, potentially increasing the risk of side effects or impacting the effectiveness of your medication.
Potential interactions include amphetamines, antibiotics, antivirals, antifungals, anti-inflammatories, opioids, blood pressure medications, blood thinners, migraine medications, diuretics, other antidepressants, mood stabilizers, anti-anxiety medications, sedatives, tranquilizers, St. John’s wort, and tryptophan [5][6].
MAOIs, a type of antidepressant, can significantly increase the risk of serious adverse effects if used alongside vilazodone, particularly serotonin syndrome. It is advised to wait two weeks between doses of MAOIs and vilazodone to prevent these risks [1].
It is recommended to avoid or limit the use of alcohol and illicit drugs while taking vilazodone, as these substances may increase the risk of severe side effects and reduce the impact of your medication [6].
Vilazodone storage
Always keep your medication in a safe place where children cannot access it.
Store vilazodone in its original packaging or an airtight container at room temperature.
If you need to dispose of medication that is no longer needed or is out of date, contact a pharmacy or medical professional to ensure it is disposed of safely. Never dispose of medications in the toilet or trash.
What to do if you overdose on vilazodone
If you overdose on vilazodone, call your doctor or Poison Control. In case of an emergency, call 911.
Symptoms of a vilazodone overdose may include [5]:
- Extreme fatigue or weakness
- Feeling confused or disorientated
- Fever
- Hallucination
- Rapid or irregular heartbeat
- Allergan. (Revised 2021). Viibryd (Vilazodone Hydrochloride) Tablets. FDA. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/022567s022lbl.pdf
- Singh, M., & Schwartz, T.L. (2012). Clinical Utility of Vilazodone for the Treatment of Adults with Major Depressive Disorder and Theoretical Implications for Future Clinical Use. Neuropsychiatric Disease and Treatment, 8, 123–130. Retrieved from https://doi.org/10.2147/NDT.S20683
- Cruz, M.P. (2012). Vilazodone HCl (Viibryd): A Serotonin Partial Agonist and Reuptake Inhibitor For the Treatment of Major Depressive Disorder. P & T: A Peer-Reviewed Journal for Formulary Management, 37(1), 28–31. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278186/
- Schwartz, T.L., Siddiqui, U.A., & Stahl, S.M. (2011). Vilazodone: A Brief Pharmacological and Clinical Review of the Novel Serotonin Partial Agonist and Reuptake Inhibitor. Therapeutic Advances in Psychopharmacology, 1(3), 81–87. Retrieved from https://doi.org/10.1177/2045125311409486
- National Library of Medicine. (Revised 2021). Vilazodone. MedlinePlus. Retrieved from https://medlineplus.gov/druginfo/meds/a611020.html
- The American Association of Psychiatric Pharmacists (AAPP) and the National Alliance on Mental Illness (NAMI). (Updated 2016). Vilazodone (Viibryd).NAMI. Retrieved from https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Vilazodone-(Viibryd)
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