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Vilazodone

    DEA Class;  Rx

    Common Brand Names; Viibryd

    •  Antidepressants, Other; 
    • Antidepressants, SSRI/5HT-1A Partial Agonist

    Oral antidepressant that modulates serotonin; a dual selective serotonin reuptake inhibitor and partial serotonin 5-HT1A agonist
    Used for the treatment of major depressive disorder in adults
    Increased risk of suicidality during the initial stages of treatment in pediatric and young adult patients

    Indicated for the treatment of major depression.

    Hypersensitivity

    • Diarrhea (28%)
    • Nausea (23%)
    • Dizziness (9%)
    • Xerostomia (8%)
    • Insomnia (6%)
    • Vomiting (5%)
    • Fatigue (4%)
    • Abnormal dreams (4%)
    • Libido decreased (4%)
    • Abnormal orgasm (3%)
    • Dyspepsia (3%)
    • Flatulence (3%)
    • Gastroenteritis (3%)
    • Somnolence (3%)
    • Paresthesia (3%)
    • Arthralgia (3%)
    • Restlessness/akathisia (3%)
    • Jittery sensation (2%)
    • Tremor (2%)
    • Delayed ejaculation (2%)
    • Erectile dysfunction (2%)
    • Increased appetite (2%)
    • General disorders and administrative site conditions: Irritability
    • Psychiatric disorders: Hallucinations, suicide attempt, suicidal ideation
    • Gastrointestinal disorders: Acute pancreatitis
    • Nervous system disorders: Sleep paralysis

    May precipitate mixed/manic episode if initiated for bipolar disorder

    May cause serotonin syndrome or neuroleptic malignant syndrome-like reactions, including agitation, hallucinations, coma, autonomic instability (eg, tachycardia, labile blood pressure, hyperthermia), neuromuscular aberrations (eg, hyperreflexia, incoordination), and/or gastrointestinal symptoms (eg, nausea, vomiting, diarrhea)

    Use with caution in patients with history of seizures; has not been systematically evaluated in patients with seizure disorders (caution advised)

    Serotonin reuptake inhibition may increase risk of bleeding (caution with drugs that inhibit platelets or coagulation)

    Decrease dose gradually when discontinuing, to avoid dysphoric mood, irritability, insomnia, agitation, and confusion

    CYP3A4 (major substrate); CYP2C19 (minor substrate, minor inhibitor, minor inducer); CYP2D6 (minor substrate, minor inhibitor); CYP2C8 (moderate inhibitor); increased plasma concentration (by 50%) observed when coadministered with strong CYP3A4 inhibitors (eg, ketoconazole)

    Highly bound to plasma proteins (administration to patient taking another drug that is highly protein bound may increase free concentrations of the other drug)

    There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to antidepressants during pregnancy

    There are no data on presence in human milk, effects on breastfed infant, or on milk production

    Adults

    40 mg/day PO.

    Geriatric

    40 mg/day PO.

    Adolescents

    Safety and efficacy have not been established.

    Children

    Safety and efficacy have not been established.

    Infants

    Safety and efficacy have not been established.

    Neonates

    Safety and efficacy have not been established.

    Vilazodone hydrochloride

    tablet (Vibryd; generic)

    • 10mg
    • 20mg
    • 40mg