Mechansim of Action: vilazodone selectively inhibits serotonin reuptake in the central nervous system as well as acting as a partial agonist of 5HT-1A receptors. The exact mechanism for how these effects translate to its antidepressant effects are not knownLabel, though there is an association between these effects and antidepressive activity. –Drug Bank
…Those who like tracking mechanisms of action are calling vilazodone a “SPARI,” which stands for serotonin partial agonist/reuptake inhibitor. The drug inhibits reuptake of serotonin (like SSRIs) and has partial agonism at 5-HT1A receptors (like buspirone). So, theoretically, giving your patients vilazodone is similar to giving them both an SSRI and buspirone at the same time… –CARLAT
Indications: Major Depressive Disorder (MDD)
Drug Class: SSRI / 5HT1A receptor partial agonist
Some (not all) Interactions: vilazodone should not be taken with or within 2 weeks of taking monoamine oxidase inhibitors (MAOIs). These include phenelzine (Nardil®), tranylcypromine (Parnate®), isocarboxazid (Marplan®), rasagiline (Azalect®) and selegiline (Emsam®).
Although rare, there is an increased risk of serotonin syndrome when vilazodone is used with other medications that increase serotonin, such as other antidepressants, migraine medications called “triptans” (e.g., Imitrex®), some pain medications (e.g., tramadol (Ultram®), and the antibiotic linezolid (Zyvox®).
The following medications may increase the levels and effects of vilazodone requiring decreased dose of vilazodone:
- Antibiotics, such as clarithromycin (Biaxin®), erythromycin (Ery-Tab®), and telithromycin (Ketek®)
- Antifungals, such as fluconazole (Diflucan®), ketoconazole (Nizoral®), and itraconazole (Sporanox®)
- Blood pressure medications, such as verapamil (Calan®, Covera-HS®, Isoptin SR®) and diltiazem (Cardizem®, Tiazac®)
- HIV medications such as protease inhibitors: indinavir (Crixivan®), ritonavir (Norvir®), saquinavir (Fortovase®, Invirase®), and lopinavir/ritonavir (Kaletra®)
- Nefazodone
The following medications may decrease the levels and effects of vilazodone requiring increased dose of vilazodone: carbamazepine (Tegretol®), oxcarbazepine (Trileptal®), rifampin (Rifadin®), phenytoin (Dilantin®), and phenobarbital
–NAMI
Dosing Forms: The typical starting dose for Viibryd (vilazodone) is 10 mg by mouth daily with food for 7 days. After 7 days, the dose is raised to 20 mg daily. The dose can go as high as 40 mg daily after one more week if needed. –Good Rx
Pros
- Compared to other antidepressants, Viibryd (vilazodone) has a lower risk of weight gain and sexual side effects
- Only has to be taken once a day
- Can be used in older adults (65 years of age or older)
- May work more quickly than other antidepressants
- May be helpful for people who have mixed anxiety and depression
Cons
- It may take several weeks before you feel the full effects of Viibryd (vilazodone)
- Cannot be used if you are taking (or just recently stopped taking) a monoamine oxidase inhibitor (MAOI)
- Not approved for use in children
- Can interact with a lot of different medications
- Must be taken with food
- Can cause gastrointestinal side effects, like nausea and diarrhea
- There is no generic, so it may be more expensive
–Good Rx
Additional Information
Officcal Medication Website: Vilazodone (Viibryd)
