Vilazodone (Oral Route): Comprehensive Medication Guide

Vilazodone is a prescription medication primarily indicated for the treatment of major depressive disorder (MDD) in adults. This guide provides detailed information on its usage, dosing recommendations, pharmacological properties, potential side effects, important warnings, and practical considerations for patients and caregivers.

Overview of Vilazodone

Vilazodone is an oral antidepressant that belongs to the class of serotonin modulators. It acts by increasing levels of serotonin in the brain, a neurotransmitter that influences mood regulation. Vilazodone’s unique mechanism combines selective serotonin reuptake inhibition (SSRI) with partial agonism at the 5-HT1A receptor.

• Primary Indication: Treatment of major depressive disorder (MDD) in adults.
• Brand Name: Viibryd®
• Drug Class: Atypical antidepressant; serotonin modulator and stimulator.

How It Works

Vilazodone increases the amount of serotonin available in the brain. As a serotonin modulator, it blocks the reuptake of serotonin and partially stimulates serotonin receptors, which is hypothesized to enhance antidepressant effects and potentially minimize certain side effects associated with traditional SSRIs. However, clinical research has not consistently demonstrated superiority in efficacy or onset over standard SSRIs.

Key Uses and Indications

• Treatment of Major Depressive Disorder: Vilazodone is FDA-approved for managing symptoms of MDD in adults.
• Other Potential Uses: Research has explored vilazodone for subtypes like depression with anxious distress, but evidence for efficacy in these groups remains mixed.

Important Points Before Taking Vilazodone

Before starting vilazodone, it is vital for patients to discuss their medical history and any other medications or supplements they are taking. Inform your healthcare provider if any of the following apply:

• Allergy to vilazodone or any of its ingredients
• Current use of monoamine oxidase inhibitors (MAOI) or plans to start one
• History of bipolar disorder, seizures, or bleeding disorders
• Pregnancy, plans to become pregnant, or breastfeeding
• Liver or kidney impairment
• Recent or planned use of serotonergic drugs, including triptans, tricyclic antidepressants, and supplements like St. John’s Wort

Dosage and Administration

Vilazodone must be taken exactly as prescribed and always with food, as fasting significantly reduces drug absorption. The following are general dosage guidelines for adults:

• Starting Dose: 10 mg once daily with food for 7 days
• Titration:
  • After 7 days, increase to 20 mg once daily with food
  • After another 7 days, may increase to a maximum of 40 mg once daily with food
• Maximum Dose: 40 mg per day
• Adjustments:
  • With strong CYP3A4 inhibitors (e.g., certain antifungals, antibiotics): Do not exceed 20 mg per day
  • With strong CYP3A4 inducers taken for over 14 days: Dose may be increased up to 80 mg per day

What To Know While Using Vilazodone

• Continue taking vilazodone even if you start feeling better. Suddenly stopping can cause withdrawal symptoms or a relapse of depression.
• It may take several weeks to notice the full benefit of vilazodone. Report any worsening mood or new symptoms promptly.
• Do not alter your dose without consulting your provider.
• Regular follow-up appointments may be necessary to evaluate response and side effects.
• Avoid alcohol and consult a doctor before taking other medications or supplements.

Precautions and Warnings

• Suicidal Thoughts and Behaviors: Some individuals, especially adolescents and young adults, may experience worsening depression or suicidal thoughts during antidepressant therapy. Close monitoring is essential during initial therapy and dose changes.
• Serotonin Syndrome: Symptoms may include agitation, hallucinations, rapid heartbeat, fever, nausea, vomiting, and muscle stiffness. Seek medical attention for any severe or unusual symptoms, particularly when combining vilazodone with other serotonergic substances.
• Bleeding Risk: Use caution with blood thinners or NSAIDs, as vilazodone can increase the risk of bleeding.
• Seizure Risk: Use carefully in people with seizure disorders.
• Discontinuation Syndrome: Stopping suddenly may cause dizziness, sensory disturbances, or agitation. Always taper under medical supervision.
• Bipolar Disorder: May precipitate manic episodes in vulnerable individuals; screen for bipolar disorder before initiating.
• Pediatric Use: Safety and effectiveness have not been established in children or adolescents.

Potential Side Effects

Vilazodone’s side effects profile is similar to other SSRIs and serotonin modulators, though some gastrointestinal adverse events may be more pronounced, especially during titration. Many side effects decrease with continued treatment.

Sexual Side Effects

Sexual side effects, such as decreased libido, have been reported, but rates may be lower than with some older antidepressants. However, studies have not consistently shown significant advantages in this regard.

Drug Interactions

• MAO inhibitors: Do not use vilazodone within 14 days of stopping an MAOI or start an MAOI within 14 days of stopping vilazodone.
• Other serotonergic drugs: Combining with SSRIs, SNRIs, triptans, tramadol, or St. John’s Wort increases serotonin syndrome risk.
• CYP3A4 inhibitors/inducers: Dose adjustments for vilazodone are necessary with drugs that modify CYP3A4 activity.
• Anticoagulants and NSAIDs: Use with caution due to increased bleeding risk.

Storage and Handling

• Store vilazodone at room temperature, away from excess heat and moisture.
• Keep medication out of reach of children and pets.
• Do not use past the expiration date. Safely discard unused medication.

Frequently Asked Questions (FAQs)

What is vilazodone used for?

Vilazodone is used to treat major depressive disorder in adults. It is not approved for use in children or for other conditions unless directed by a healthcare provider.

How long does it take for vilazodone to work?

Some improvement is often noticed within 1–2 weeks, but full therapeutic effects may take 4–6 weeks or longer. Adherence to prescribed dosing and regular follow-up are important.

Can I drink alcohol while taking vilazodone?

It is recommended to avoid alcohol during treatment as it may worsen certain side effects, such as dizziness or drowsiness.

Is it safe during pregnancy or breastfeeding?

The safety of vilazodone during pregnancy or lactation is not fully established. If you are pregnant, planning to become pregnant, or breastfeeding, discuss risks and benefits with your doctor.

Can vilazodone cause withdrawal symptoms?

Discontinuing vilazodone abruptly may cause symptoms such as dizziness, mood changes, irritability, or headache. Tapering under medical supervision helps minimize these effects.

Additional Considerations

• Elderly: Caution in older adults due to increased sensitivity and risk of low sodium.
• Pregnancy: Only use if benefits outweigh potential risks.
• Breastfeeding: Assess risks and benefits; data is very limited.
• Liver/Kidney Impairment: May require adjusted dosing or enhanced monitoring.

Medication Guide Summary

• Vilazodone is an oral antidepressant for adults, prescribed for major depressive disorder.
• Always take with food for optimal absorption and effectiveness.
• Report side effects or new symptoms to your healthcare provider promptly.
• Follow all dosing and monitoring instructions strictly.

References

• Cleveland Clinic: Vilazodone (Viibryd®) Uses & Side Effects
• National Alliance on Mental Illness (NAMI): Vilazodone (Viibryd)
• Psychopharmacology Institute: Vilazodone — Pharmacology, Indications, Dosing
• MedlinePlus: Vilazodone Drug Information

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Medha Deb is an editor with a master's degree in Applied Linguistics from the University of Hyderabad. She believes that her qualification has helped her develop a deep understanding of language and its application in various contexts.

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