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Vilazodone (Viibryd) is a newer antidepressant medication with a unique mechanism of action. Side effects can occur when taking vilazodone, and it can cause withdrawal symptoms when stopped abruptly. Always take vilazodone as prescribed and consult with a doctor about any concerning effects.
- Vilazodone (Viibryd) is an antidepressant medication known as a partial serotonin agonist and reuptake inhibitor.
- Vilazodone is approved to treat major depressive disorder.
- Vilazodone is believed to be less likely than other antidepressants to cause side effects, although adverse effects may occur.
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What is vilazodone?
Vilazodone is one of the newest antidepressant medications to have been produced and approved in the United States. It is a partial serotonin agonist and reuptake inhibitor, although it is sometimes referred to as a selective serotonin reuptake inhibitor (SSRI). However, it differs from other antidepressants in this class because of its dual mechanism of action. [1]
One action, serotonin reuptake inhibition, is similar to the action of SSRIs, like fluoxetine (Prozac) and sertraline (Zoloft). However, vilazodone causes an additional action— stimulating 5-HT1A receptors—which is thought to contribute to its fast and potent therapeutic effects. [2][3]
Research also suggests that vilazodone could cause fewer side effects than other antidepressants, including those related to sexual issues and weight changes. [1]
Brand names for vilazodone
Vilazodone is available as a generic medication and as a brand-name medication called Viibryd. Both forms of vilazodone are produced as tablets in strengths of 10 mg, 20 mg, and 40 mg. [4]
Conditions for which vilazodone is prescribed
Vilazodone is approved by the Food and Drug Administration (FDA) to treat major depressive disorder (MDD). Its impact on serotonin activity can help improve mood and other symptoms of depression, such as those relating to appetite, sleep, and cognition. [1]
Vilazodone might sometimes be prescribed off-label for purposes that are not FDA-approved. Like other antidepressants, vilazodone might be prescribed to treat anxiety disorders, although more research is needed to clarify its effectiveness for these conditions. [5]
How it should be used
Vilazodone is available as a tablet in varying strengths. It should be swallowed whole and taken with food. Taking vilazodone on an empty stomach can impact how well the medication works and can decrease its effectiveness. [4][6]
Vilazodone is usually taken once per day. If someone forgets to take their medication, they should take the dose as soon as they remember, unless it is close to the next scheduled dose time. In this case, skip the missed dose and take the next one as prescribed. Never take double the prescribed dose to make up for a missed dose.
Vilazodone dosage
A typical therapeutic dose of vilazodone is 20 mg to 40 mg once daily. Treatment will usually start with a dose of 10 mg once daily for a week, followed by 20 mg once daily. After a week, the dose can be increased to 40 mg if needed. [6]
During treatment, the prescribing doctor will monitor the individual for adverse effects and make any required changes.
Vilazodone is not approved for use in people under the age of 18. However, if it is deemed a necessary treatment, the doctor may recommend a reduced dose. [6]
Common side effects of vilazodone
It is common to experience side effects when starting a new medication or when increasing the dose. Usually, side effects will only last a couple of weeks.
Common side effects of vilazodone include: [3][4][6]
- Dizziness
- Diarrhea
- Nausea
- Vomiting
- Tingling or pain in the hands or feet
- Shaking
- Restlessness
- Unusual dreams
- Insomnia
- Headache
- Fatigue
- Heartburn
- Dry mouth
- Change in appetite
- Joint pain
- Flatulence
- Decrease in sex drive
Rare and severe side effects
In some cases, vilazodone can cause rare or severe side effects. If any of the following side effects occur, or any other side effects occur that last for more than a couple of weeks, contact the prescribing doctor immediately, as a change in dosage or medication may be required: [6][7]
- Extreme changes in mood or behavior
- Slurred speech or severe weakness
- Seizures
- Unusual or unexplained bleeding
- Blurred vision or swollen, red eyes
- Hallucinations
- Mania
- Rash or hives
- Trouble breathing
- Fainting or falls
Vilazodone can cause people to experience thoughts of self-harm or suicide, particularly in people under the age of 24, and at the start of treatment. Any signs of worsening mood or concerning thoughts or behaviors should be reported to a doctor for management and advice.
Vilazodone may not be an appropriate treatment for certain populations, and it should be used with caution: [6]
- Children under 18 years old
- Adults over 65 years old
- People with kidney problems
- People with a history of bipolar or manic symptoms
- People who are pregnant or breastfeeding
A doctor can determine if vilazodone treatment is safe for these individuals and if dosage adjustments are needed.
Is it addictive?
Vilazodone, like other antidepressants, is not considered an addictive substance. It does not cause a feeling of euphoria or ‘high’, and does not impact dopamine levels or affect the brain’s reward circuit in the same way as common drugs of abuse.
However, vilazodone misuse might occur, as prolonged use can cause the development of physical dependence. This can lead to withdrawal symptoms when the medication is stopped, particularly if it is stopped abruptly, and may contribute to misuse.
Vilazodone withdrawal and cessation
If it is deemed appropriate and necessary to stop vilazodone treatment, the medication should be reduced gradually, rather than being stopped abruptly. Suddenly stopping vilazodone use can cause withdrawal symptoms, also called discontinuation syndrome. Symptoms are typically mild and transient, although serious symptoms can occur. [6]
Symptoms of discontinuation syndrome can include: [2][6]
- Nausea
- Dizziness
- Headache
- Irritability
- Sleep issues
- Changes in mood
- Sweating
- Tingling
- Fatigue
- Seizures
- Unusual sensations in the brain that feel like electric shocks or “brain zaps”
The prescribing doctor will usually recommend gradual dose reductions (called tapering) when treatment is discontinued. If intolerable symptoms occur, tapering can be stopped or slowed to help reduce the severity of withdrawal symptoms.
Never stop taking vilazodone without professional advice and a safe tapering schedule. Abruptly stopping vilazodone increases the risk of severe discontinuation syndrome symptoms.
Harmful drug combinations
Vilazodone can interact with other substances, causing harmful effects or changes in the effectiveness of the medication. For example: [4][6]
- Monoamine oxidase inhibitors (MAOIs): MAOIs should not be used within two weeks of vilazodone, as this can cause serious and potentially fatal symptoms associated with neuroleptic malignant syndrome or serotonin toxicity.
- Serotonin syndrome: Using substances that increase serotonin levels, such as other antidepressants, triptans, and tramadol, alongside vilazodone, can cause an increased risk of serotonin syndrome.
- Increased level of vilazodone: Some medications can cause the level of vilazodone to be increased, such as certain antibiotics, antifungals, blood pressure medications, HIV medications, and nefazodone.
- Decreased level of vilazodone: Some medications can decrease the level of vilazodone, such as carbamazepine, phenytoin, and phenobarbital.
Always discuss with the prescribing doctor any current or recent medications or supplements before starting vilazodone treatment.
Further information
Vilazodone can be a safe and effective treatment for depression and other mental health conditions. It should always be taken exactly as prescribed. Never change the dose or stop taking vilazodone without professional guidance, as adverse effects can occur.
If vilazodone causes serious side effects, the dosage can be changed, or alternative treatments can be implemented at the prescribing doctor’s recommendations. Medications work differently for different people; individuals may need to try more than one medication before finding one that works well for them. [8]
The most effective treatment for depression typically involves a combination of medications and talk therapy. A doctor can advise about available options and make a referral to mental health services. [8]
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