Vilazodone
VIIBRYD
Pronunciation: vil-AZ-oe-doen
“Vile lazer done (to) Virile hybrid”
What it isSSRI with 5-HT1A partial agonism; depression.
Why this oneLess sexual dysfunction than a pure SSRI, with the 5-HT1A action built into one molecule rather than requiring buspirone alongside.
What limits itMust be taken with food or absorption halves. Diarrhea and nausea; CYP3A4-dependent.
Pearls
- No faster onset than SSRIs despite the 5-HT1A component.
- More initial nausea than SSRIs; start 10 mg daily.
- Strong CYP3A4 inhibitors: maximum 20 mg/day.
- Off-label GAD and social anxiety; weak evidence.
Vilazodone prescription history
Animated chart of estimated U.S. prescriptions per year, Antidepressants (1957–2026). Vilazodone enters in 2011 (estimated).
FDA-approved for
- depression (2011)
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityGI adverse effects and serotonergic toxicity; interactions occur through CYP3A.
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Major Depressive Disorder | adult | 10 mg QD x7d | 20-40 mg QD | 40 mg QD |
Titration Increase at intervals of ≥7 days
Renal Undefined
Hepatic Undefined
Instructions
- Take once daily with food
- Discontinue gradually
- Screen for bipolar disorder before starting
- Allow ≥14 days between an MAOI and vilazodone (either direction)
Available strengths
- tab 10, 20, 40 mg
Contraindications
- MAOIs (concurrently or within 14 days) due to risk of serotonin syndrome
Cautions
- Serotonin syndrome
- Increased bleeding risk
- Activation of mania/hypomania
- Seizures
- Angle-closure glaucoma
- Sexual dysfunction
- Hyponatremia
- Discontinuation syndrome
Adverse reactions
- Diarrhea
- Nausea
- Vomiting
- Insomnia
Pregnancy Third-trimester use may increase risk of neonatal PPHN and withdrawal; register in pregnancy registry
Lactation Undefined
Cost
Generic entry2019
Serotonin and MAOI
Provisional washout figures
Elevating mechanismSRI
Non-elevating action5-HT1A partial agonist
Exposure dependenceTherapeutic exposure; severe toxicity requires meaningful MAO-A inhibition
Washout BEFORE an MAOI14 days
Evidence confidenceHigh
InterpretationClinically significant SRI plus 5-HT1A partial agonism. A second SRI generally represents therapeutic duplication/additive adverse effects, not the classic life-threatening interaction.
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Memory aids: interaction avatars
Open Vilazodone in the interactive console ↗
Self-check
- What receptor action does vilazodone add to SSRI activity?
5-HT1A partial agonism. - What happens to vilazodone absorption without food?
It halves.