- Last edited on March 6, 2021
Vilazodone (Viibryd)
Primer
Vilazodone (Trade name: Viibryd) is an antidepressant in the serotonin 1A partial agonist and reuptake inhibitor (SPARI) used in the treatment of major depressive disorder.
Pharmacokinetics
See also article: Introduction to Pharmacology
Pharmacokinetics of Vilazodone
Absorption | Take with food! Taking on an empty stomach can result in 50% lower plasma concentrations (and thus and treatment failure) |
---|---|
Distribution | |
Metabolism | |
Elimination | |
Half-life |
See also article: Cytochrome (CYP) P450 Metabolism
Vilazodone: Cytochrome P450 Metabolism
Substrate of (Metabolized by) | 3A4 |
---|---|
Induces | |
Inhibits |
Pharmacodynamics
Mechanism of Action
- Similar to vortioxetine, vilazodone acts like an SSRI but also has direct serotonin receptor interactions that is thought to theoretically add to its clinical benefit. It has the following actions:
- Serotonin (5-HT) transporter (SERT) inhibition
- Serotonin (5-HT) receptor partial agonism
- 5-HT1A, which should theoretically leads to enhanced downregulation of presynaptic 5-HT1A receptors and more a robust disinhibition of serotonin release (but this is not clinically proven!), and may make it an anxiolytic as well as antidepressant in action.
- Serotonin (5-HT) receptor agonism
- 5-HT4 agonism, which causes diarrhea and is a common side effect of vilazodone.
- This is why 5-HT4 agonists (e.g. - cisapride, prucalopride) are used in the treatment of constipation
Toxicity
- Vilazodone is relatively non-toxic in overdose
Indications
Dosing
Dosing for Vilazodone
Starting | |
---|---|
Titration | |
Maximum | |
Taper |
Formulations
- Vilazodone comes in
Monitoring
Contraindications
Absolute
Relative
Drug-Drug Interactions
Side Effects
Adverse Events
Clinical Pearls
- The most recent data suggests there is good tolerability related to weight and sexual side effects as well as anxiety benefits.
- Vilazodone has pro-kinetic effects, which can cause diarrhea
Special Populations
Geriatric
See main article: Geriatric Pharmacology
Pediatric
See main article: Pediatric Pharmacology
Obstetric and Fetal
See main article: Obstetric and Fetal Pharmacology
Medically Ill
See main article: Psychotropic Dosing in the Medically Ill