Vilazodone is an antidepressant medication used to treat major depressive disorder. Although it is one of the least likely antidepressants to cause weight changes, some people who use it may experience slight weight gain. People using vilazodone can incorporate changes into their lifestyle or treatment plan to help manage any weight changes.
- Vilazodone is an antidepressant medication classified as a serotonin partial agonist and reuptake inhibitor (SPARI).
- Vilazodone is unlikely to cause weight changes, although some people may experience some weight gain or loss.
- During vilazodone treatment, people can utilize lifestyle changes or adjunctive medications to help manage any weight gain.
Does vilazodone cause weight gain?
Like many antidepressants and psychotropic medications, vilazodone (Viibryd) may lead to changes in weight for some people, including weight gain. However, vilazodone is found to be one of the least likely antidepressants to cause weight gain and is commonly associated with no significant change in weight during treatment. [1][2]
This can differ between individuals and may depend on several factors. As such, there may be people who gain weight, lose weight, or notice no change in weight during vilazodone treatment. [1]
Why some people gain or lose weight on vilazodone
Various mechanisms associated with antidepressant use can be linked to changes in weight. For example, long-term use can cause an accumulation of serotonin in the synaptic cleft, which can lead to a down-regulation or desensitization of 5-HT2 receptors. This might lead to an increase in appetite and weight for some people. [4][5]
Additionally, there is some evidence that long-term selective serotonin reuptake inhibitor (SSRI) use causes an increase in cravings for carbohydrates, which can lead to weight gain with increased consumption. [5]
These mechanisms may also be present with SPARI medications such as vilazodone, although weight changes are less likely with vilazodone than with SSRIs and other antidepressants. This is likely due to its unique mechanism of action as a serotonin partial agonist reuptake inhibitor (SPARI). [2]
Individual factors
Weight changes can also occur with antidepressant treatment because of the individual’s changes in symptom presentation. Appetite changes are a common symptom of depression.Â
Medications, such as vilazodone, aim to treat depression symptoms, including appetite changes. As such, someone who eats less during a depressive episode might notice that their appetite increases once their condition is treated, and someone who tends to eat more during a depressive episode might find that their appetite decreases. [5]
Because of this, weight changes while on an antidepressant might not simply be due to the medication's effects on the body or metabolism, but also because of the changes in depressive symptoms. Additionally, genetic, environmental, and lifestyle factors can influence a person’s likelihood of losing or gaining weight during treatment. [5]
Is vilazodone more weight-neutral than other antidepressants?
Studies indicate that vilazodone is less likely than other antidepressants to cause weight gain. Research suggests that vilazodone causes little or no change in weight. [1][3]
One study shows an increase of 0.2 kg after 8 weeks and 1.7 kg after one year of vilazodone treatment. However, this is much lower than SSRI treatment, which shows an average weight increase of 6.8 to 10.8 kg in the same time period. [1]
Research indicates that some of the antidepressants most likely to cause weight gain include: [4][6][7]
- Paroxetine: One of the most predominant SSRIs and serotonin and norepinephrine reuptake inhibitors (SNRIs) known for weight gain, with people experiencing an average weight gain of 2.73 kg in 16 weeks.
- Mirtazapine: Possibly the highest weight gain potential among newer antidepressants, with an average increase of 1.74 kg in the first 4-12 weeks of treatment and variable weight gain beyond 16 weeks.Â
- Amitriptyline: A tricyclic antidepressant (TCA), amitriptyline has been reported to cause an average weight gain of 1.52 kg in 4-12 weeks and 2.24 kg after 4-7 months.Â
- Nortriptyline: A TCA with an average weight gain of 2 kg in 4-12 weeks.Â
Aside from vilazodone, the antidepressants least likely to cause weight gain include: [4][6][8]
- Levomilnacipran: An SNRI with no significant change in weight long term.
- Vortioxetine: An SSRI causing no significant change in weight for many. A small number of individuals saw a very slight increase of 0.41 kg over one year.Â
- Bupropion: Unlikely to cause weight gain and may even lead to some weight loss.
- Fluoxetine: Fluoxetine may cause some weight loss initially, with weight stabilization as treatment continues.
Managing weight changes on vilazodone
People utilizing vilazodone treatment can prevent or manage weight changes by: [4][5]
- Making lifestyle changes, such as incorporating more exercise into their routine, managing portion sizes, eating healthy and balanced meals, and reducing or avoiding alcohol intake.
- Therapy such as cognitive behavioral therapy (CBT) can help recognize harmful behaviors and attitudes around food and weight, integrate healthy habits and goals, and prevent triggers associated with increased food consumption.
- Medical interventions such as anti-obesity medications may be necessary for people who experience health issues such as diabetes or obesity, or are unable to engage in weight loss techniques for any reason.
Should you stop vilazodone because of weight gain?
If weight gain is significant and is impacting self-esteem and well-being, it might be appropriate to make some treatment changes. However, it is important to gauge the benefits and risks of all medications. If a treatment is effective, it might be more suitable to try to manage unpleasant effects with other strategies than to stop the medication.
People who experience significant weight gain might wish to change their medication, and this should only be done with professional advice. Never stop or alter your medication without guidance from a physician, as adverse effects, withdrawal symptoms, and unmanaged symptoms can occur. It may be necessary to gradually reduce vilazodone before commencing an alternative medication.
When to seek medical help
People taking vilazodone should receive a regular medication review with their prescribing physician to ensure the safety and effectiveness of the medication, discuss and manage adverse effects, and monitor symptom changes. Outside of these reviews, individuals may wish to seek medical help if they experience:
- A recurrence or exacerbation of the symptoms of the condition being treated, such as worsening mood or suicidal thoughts.
- Unmanageable side effects that get worse or do not go away.
- Extreme changes in weight or appetite.
- Unexpected side effects.
- Signs of vilazodone abuse, such as taking higher doses than prescribed, or using the medication more frequently than directed.
Failing to seek treatment in these situations may increase the risk of serious complications, including worsening mental health symptoms, medication toxicity, serotonin syndrome, or unsafe drug interactions. Prompt medical evaluation can help prevent further harm and ensure appropriate adjustments to care.
