Viibryd (vilazodone)

What is Viibryd?

Viibryd is a brand-name prescription medication. It’s used in adults to treat a form of depression called major depressive disorder (MDD). Viibryd isn’t approved for use in children.

Viibryd contains the active drug vilazodone and belongs to a group of drugs called miscellaneous antidepressants. This is because Viibryd works a little differently than other antidepressants.

Viibryd comes as a tablet that you swallow once a day.

Effectiveness

In clinical studies, people with MDD took either Viibryd or a placebo for 8 to 10 weeks. (A placebo is treatment with no active medication.) Depression symptoms eased more in the Viibryd group than in the placebo group.

The symptoms were tracked with a tool called the Montgomery-Asberg Depression Rating Scale (MADRS). The MADRS rates severity of depression with a score between 0 and 60, and higher scores mean more severe depression. The scores of people who took Viibryd were between 2.5 to 5.1 points lower than people who took a placebo. This means that the Viibryd group had fewer symptoms or less severe symptoms.

For more information about how effective Viibryd is in treating MDD, see the “Viibryd uses” section below.

Viibryd generic

Viibryd is an antidepressant that’s available only as a brand-name medication. It’s not currently available in generic form.

Viibryd contains one active drug ingredient: vilazodone.

Viibryd side effects

Viibryd can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Viibryd. These lists don’t include all possible side effects.

For more information on the possible side effects of Viibryd, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

More common side effects

The more common side effects of Viibryd, discussed in “Side effect details” below, can include:

• digestive system problems, such as diarrhea, nausea, vomiting, and abdominal pain
• sexual problems, such as erectile dysfunction and decrease in sex drive
• insomnia (not being able to sleep)
• sleepiness or fatigue (lack of energy)
• weight gain or weight loss
• joint pain
• dry mouth
• dizziness
• headaches

Most of these side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Viibryd aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include the following:

• Bleeding. Symptoms can include:
  • bruising
  • blood in urine or stool
  • nosebleeds
• Mania or hypomania (periods of high energy or racing thoughts). Symptoms can include:
  • racing thoughts
  • feeling restless or out of control
  • increase in energy
• Hyponatremia (low level of sodium in your blood). Symptoms can include:
  • dizziness
  • feeling lightheaded
  • trouble concentrating
  • fainting
• Seizures. Symptoms can include:
  • loss of consciousness
  • falling
  • sudden jerky movements of arms or legs
• Angle-closure glaucoma (a type of eye disease). Symptoms can include:
  • eye pain that’s often severe
  • blurry vision
  • seeing halos around lights

Other serious side effects, explained in more detail below in “Side effect details,” include:

• allergic reactions
• serotonin syndrome (high levels of the chemical serotonin)
• discontinuation syndrome, which is also called withdrawal
• suicidal thoughts and behaviors*

* Viibryd has a boxed warning for suicidal thoughts or behaviors. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see “FDA warning” at the beginning of this article.

Side effect details

You may wonder how often certain side effects occur with this drug, or whether certain side effects pertain to it. Here’s some detail on several of the side effects this drug may or may not cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Viibryd. However, allergic reactions aren’t common with Viibryd treatment. They didn’t occur often enough in clinical trials to compare rates in people who took Viibryd and in people who took a placebo (no treatment).

Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

• swelling under your skin, typically in your eyelids, lips, hands, or feet
• swelling of your tongue, mouth, or throat
• trouble breathing

Call your doctor right away if you have a severe allergic reaction to Viibryd. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Weight gain

Weight gain isn’t likely to occur when taking Viibryd. In studies, only 2% of people who took 40-mg doses of Viibryd gained weight. This was compared to 1% of people who took 20-mg doses of Viibryd and 1% of people who took a placebo. (A placebo is treatment with no active medication.)

Some people had an increase in appetite when taking Viibryd. In studies, 3% of people who took 40-mg doses of Viibryd reported this side effect. This was compared to 1% of people who took 20-mg doses of Viibryd and 1% of people who took a placebo. An increase in appetite may lead to weight gain.

If you notice changes in your weight or appetite that are bothersome to you, let your doctor know. They can work with you to adjust your diet or explore other treatment options.

Sexual side effects

Sexual side effects aren’t likely with Viibryd. However, some people in clinical studies have reported erectile dysfunction, abnormal orgasm, decrease in sex drive, and abnormal ejaculation.

In the studies, people took 20- or 40-mg doses of Viibryd, or a placebo. Comparisons of how many people reported each side effect are shown below:

• Erectile dysfunction: 0% to 3% of people who took Viibryd compared to 1% of people who took a placebo
• Abnormal orgasm: 1% to 2% of people who took Viibryd compared to less than 1% of people who took a placebo
• Decrease in sex drive: 2% to 4% of people who took Viibryd compared to less than 1% of people who a took placebo
• Abnormal ejaculation: 1% to 2% of people who took Viibryd compared to 0% of people who took a placebo

Let your doctor know if you have concerns about sexual side effects while taking this drug. They can discuss ways to help manage the issues.

Weight loss

Weight loss isn’t a direct side effect of Viibryd. But taking the drug can cause digestive system problems, such as nausea, vomiting, and diarrhea, which can cause you to lose weight.

These digestive problems should improve or go away with time. However, if they continue beyond the first 2 weeks, tell your doctor. It’s possible that a different treatment may be better for you.

Diarrhea

It’s likely that you’ll have diarrhea when you start taking Viibryd. In studies, 26% to 29% of people who took Viibryd reported diarrhea, compared to 10% of people who took a placebo.

It’s possible your symptoms will get better or completely go away after the first couple of weeks of taking Viibryd. But if your symptoms are interfering with daily life or are bothering you, talk with your doctor. They can suggest other treatment options.

Insomnia and other sleep problems

Changes in your sleeping patterns may occur when taking Viibryd.

In studies, insomnia occurred in 6% to 7% of people who took Viibryd, compared with 2% of people who took a placebo. Also, 4% to 5% of people who took Viibryd were more sleepy than usual, compared with 2% of people who took a placebo.

It’s also possible to have nightmares or night sweats when taking Viibryd.

In studies, up to 3% of people who took Viibryd had abnormal dreams, compared with 2% of people who took a placebo. Night sweats were reported in less than 1% of people who took Viibryd. It’s not known how often people who took a placebo had night sweats.

In addition, cases of sleep paralysis have been reported in people taking Viibryd, but it’s not known how often the condition occurs. With sleep paralysis, you’re unable to move or talk for seconds or minutes when falling asleep or waking up. The condition is temporary and shouldn’t last.

Keep in mind, poor sleep can make depression symptoms worse. If you have any sleep problems while taking Viibryd, talk with your doctor. They can suggest ways to help improve your sleep.

Fatigue

Fatigue isn’t likely with Viibryd. Fatigue was reported in 3% to 4% of people in clinical studies, whether they took Viibryd or a placebo.

If you notice a change in your energy level or are sleepy during the day, talk with your doctor. They can suggest treatment options to help you.

Nausea

You may have nausea when taking Viibryd, especially when you first start using the drug or take a new dose. In studies, 22% to 24% of people who took Viibryd had nausea, compared to 7% of people who took a placebo.

It’s possible that your symptoms will get better or completely go away after the first couple of weeks of taking Viibryd. However, if your symptoms are interfering with daily life or are bothering you, talk with your doctor. They can suggest other treatment options.

Headache

Headaches were reported in 14% to 15% of people in clinical studies whether they took Viibryd or a placebo. This means it’s unlikely that Viibryd was the direct cause of the headaches.

If you have frequent or painful headaches, it’s important to tell your doctor. They can help you find ways to treat your headaches.

Dizziness

Dizziness may occur when taking Viibryd. In clinical studies, 6% to 8% of people who took Viibryd had dizziness. This was compared to 5% of people who took a placebo.

If you have dizziness that bothers you or doesn’t go away within a few weeks of starting Viibryd treatment, talk with your doctor. They may suggest other medication options.

Joint pain

Joint pain isn’t likely to occur when taking Viibryd. In clinical studies, only 1% to 2% of people had joint pain, whether they took Viibryd or a placebo.

Joint pain can be caused by many different conditions and medications. If you notice new aches and pains when taking Viibryd, talk with your doctor. They can suggest ways to help you feel more comfortable.

Serotonin syndrome

Serotonin syndrome occurs when you have too much of the chemical serotonin in your body. Although serotonin syndrome isn’t likely to occur when taking Viibryd, it’s a serious side effect that can be life threatening.

In clinical studies, 0.1% of people treated with Viibryd had symptoms of serotonin syndrome. It’s not known how many people who took a placebo had symptoms of serotonin syndrome.

Serotonin syndrome is more likely to occur when you take several drugs that can increase levels of serotonin. Symptoms can include:

• hallucinations (seeing things that aren’t really there)
• confusion
• racing heartbeat
• sweating
• fever
• nausea and vomiting
• stiff muscles
• changes in blood pressure
• tremors
• seizures

If you have any these symptoms, it’s important to tell your doctor. They can help rule out other conditions that cause these symptoms and offer different treatment options if needed.

Discontinuation syndrome

If you stop taking Viibryd suddenly, you may develop discontinuation syndrome, which is also called withdrawal. This can occur when your body gets used to Viibryd and you suddenly quit taking the drug without gradually decreasing your dose. It’s not known how many people develop discontinuation syndrome after they stop taking Viibryd.

Symptoms of discontinuation syndrome can include:

• flu-like symptoms
• anxiety
• insomnia
• vivid dreams
• headaches
• irritability
• changes in mood
• restlessness
• tremors
• sweating
• nausea and vomiting
• electric shock sensations (brain zaps)
• tinnitus (ringing in the ears)
• seizures

If you’re thinking about stopping your Viibryd treatment for any reason, first talk with your doctor. They can recommend a plan to slowly decrease your dose to prevent you from having the symptoms mentioned above.

Suicidal thoughts and behaviors

If you’re age 24 years or younger, taking an antidepressant such as Viibryd may increase your risk for suicidal thoughts and behaviors.*

In clinical trials, people with depression and other psychiatric disorders took various antidepressants, including Viibryd, or a placebo. People ages 24 years and younger had the highest risk of suicidal thoughts and behaviors. Of 1,000 people, compared to those who took a placebo, 14 more people younger than age 18 years and 5 more people between ages 18 and 24 years who took an antidepressant thought of or attempted suicide.

There was no increased risk of suicide while taking a placebo for people ages 25 to 64 years. Also, adults ages 65 and older who took an antidepressant had six fewer cases of suicidal thoughts or suicide attempts. This was compared to people in the same age group who took a placebo.

While you take Viibryd, your doctor will monitor you for signs of suicidal thoughts and behaviors. Have loved ones keep an eye out for such signs as well. Symptoms of suicidal thoughts or behaviors can include:

• feeling agitated (anxious) or angry
• unusual changes in your behavior or mood
• thoughts of harming yourself or others
• worsening depression

Tell your doctor right away if you notice any of these symptoms while taking Viibryd.

* Viibryd has a boxed warning for suicidal thoughts or behaviors. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see “FDA warning” at the beginning of this article.

Hair loss (not a side effect)

Taking Viibryd shouldn’t cause you to lose your hair. Hair loss wasn’t reported in clinical studies of people who took the drug for major depressive disorder. However, other antidepressants have been shown to cause hair loss that can be reversed. These antidepressants include:

• sertraline (Zoloft)
• bupropion (Wellbutrin XL)
• fluoxetine (Prozac)
• citalopram (Celexa)
• escitalopram (Lexapro)

If you have hair loss that isn’t normal for you when taking Viibryd, report this to your doctor. They can work with you to try to find the cause and treatments that may help.

Viibryd dosage

The Viibryd dosage your doctor prescribes will depend on several factors. These include:

• the severity of the condition you’re using Viibryd to treat
• other medications you’re taking

Typically, your doctor will prescribe a low starting dose (likely 10 mg). Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Drug forms and strengths

Viibryd comes as tablet that you swallow once a day. It’s available in three strengths: 10 mg, 20 mg, and 40 mg.

Viibryd tablets are also available as two different starter packs for the first 30 days that you begin taking the drug. These packs differ as follows:

• Starter pack option 1 contains seven 10-mg tablets, seven 20-mg tablets, and sixteen 40-mg tablets.
• Starter pack option 2 contains seven 10-mg tablets and twenty-three 20-mg tablets.

Dosage for major depressive disorder

The goal dose of Viibryd is 20 mg or 40 mg each day. But your doctor will usually have you start taking a lower dose at first. They may have you take 10 mg a day for 1 week before increasing your dose to 20 mg a day.

Your doctor may have you stay at 20 mg or increase your dose to 40 mg after taking 20 mg a day for at least 1 week. This may depend on how your condition responds to a dosage of 20 mg a day.

Maximum dosage

The maximum dosage of Viibryd is typically 40 mg per day. However, there can be exceptions when doctors may prescribe a maximum daily dose of 60 mg or 80 mg.

What if I miss a dose?

If you miss a dose, take it as soon as you remember, unless it’s almost time for your next dose. It’s important that you don’t double your dose or take two doses at once. If it’s almost time for your next dose, wait until the scheduled time to take it to get back on track.

If you miss more than one dose and you normally take 20 mg or 40 mg a day, tell your doctor. They can advise you if you should start taking a lower dose again.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Viibryd is meant to be used as a long-term treatment. If you and your doctor determine that Viibryd is safe and effective for you, you’ll likely take it long term.

Major depressive disorder (MDD) tends to last long term, even if there are periods when MDD eases or goes away. For this reason, medications used for depression are often taken long term.

Alternatives to Viibryd

Other drugs are available that can treat your condition. Some may be better suited for you than others. If you’re interested in finding an alternative to Viibryd, talk with your doctor. They can tell you about other medications that may work well for you.

Alternatives for major depressive disorder

Examples of other drugs that may be used to treat major depressive disorder include:

• amitriptyline
• bupropion (Wellbutrin XL)
• citalopram (Celexa)
• desipramine (Norpramin)
• desvenlafaxine (Pristiq)
• escitalopram (Lexapro)
• paroxetine (Paxil)
• sertraline (Zoloft)
• venlafaxine (Effexor)
• vortioxetine (Trintellix)

Common questions about Viibryd

Here are answers to some frequently asked questions about Viibryd.

Is Viibryd an SSRI?

Yes, Viibryd is a type of drug called a selective serotonin reuptake inhibitor (SSRI). These drugs increase the level of serotonin in your body. (Serotonin is a chemical messenger in the brain that’s thought to regulate mood.) However, it’s not completely understood how Viibryd works.

Viibryd is unique because it also binds to serotonin receptors, acting similarly to serotonin. (Receptors are proteins on the outside of cells that act like docking stations.) Both of these actions are thought to balance serotonin levels in the brain.

Because Viibryd works a little differently than other SSRIs, it’s considered to be a miscellaneous antidepressant.

Is Viibryd a controlled substance?

No, Viibryd isn’t a controlled substance. Controlled substances are generally drugs that have more regulations and rules around them than regular prescription or over-the-counter drugs. This is because controlled substances are more likely to be misused or cause issues with dependence or addiction.

Is weight gain a side effect of Viibryd?

It’s not likely. Weight gain wasn’t common in studies of people who took Viibryd.

But it’s possible you may have changes in appetite when taking Viibryd because the drug is an antidepressant. Most antidepressants have the potential to cause changes in appetite and weight gain or weight loss. Certain antidepressants such as mirtazapine (Remeron) may be more likely to cause weight gain than others.

If you’re concerned about weight gain while taking Viibryd, talk with your doctor. They can review your diet and exercise routine.

Does Viibryd cause any sexual side effects?

According to clinical studies, it’s possible. Sexual side effects of Viibryd included erectile dysfunction, abnormal orgasm, decrease in sex drive, and abnormal ejaculation.

In the studies, up to 4% of people who took Viibryd had sexual side effects, compared to up to 1% of people who took a placebo. (A placebo is treatment with no active medication.) For more information on the research, see “Sexual side effects” in the “Viibryd side effects” section above.

Sexual side effects are fairly common with antidepressants and other medications taken for conditions such as depression and anxiety. Certain antidepressants such as bupropion (Wellbutrin XL) and mirtazapine (Remeron) are less likely to cause these side effects than others.

If you’re having sexual side effects that are bothersome, talk with your doctor. They can suggest treatment options or a medication other than Viibryd.

Is Viibryd safe for older adults who have depression?

Yes, Viibryd is approved to treat major depressive disorder (MDD) in adults, including older adults.

However, older adults may be more likely than younger people to have a side effect called hyponatremia. This is a low level of sodium in your blood. If you’re age 65 years or older, watch for dizziness, weakness, and headaches, which can be signs of this serious side effect.

Viibryd dosing recommendations for older adults are currently the same as those for people younger than age 65 years. Studies haven’t included many people older than age 65 years. And little is known about how older adults respond to Viibryd compared to younger people. Starting doses for older adults should be on the lower side, with slow dose increases by your doctor if necessary.

If you’re an older adult and have questions about Viibryd, ask your doctor.

Why do I need to take Viibryd with food?

If you take Viibryd on an empty stomach, the drug may not work as well to treat your depression. Your body absorbs the medication better when you take the drug with food. One possible added benefit of taking Viibryd with food is that side effects such as nausea and vomiting may be less severe.

Viibryd uses

The Food and Drug Administration (FDA) approves prescription drugs such as Viibryd to treat certain conditions. Viibryd may also be used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Viibryd for major depressive disorder

Viibryd is an antidepressant approved by the FDA to treat adults with major depressive disorder (MDD). The drug isn’t approved for use in children.

According to the National Survey on Drug Use and Health from 2019, about 7.8% of U.S. adults have an MDD episode each year. MDD is diagnosed when someone has intense, persistent feelings of sadness over a period of time.

If you have MDD, you may notice that it impacts more than one area of your life, including your social habits, sleep, and appetite. It’s important for MDD to be treated to improve quality of life. A combination of counseling or therapy and medication is recommended for the treatment of MDD.

Effectiveness for major depressive disorder

In clinical studies, people with MDD took either Viibryd or a placebo for 8 to 10 weeks. (A placebo is treatment with no active medication.) Depression symptoms eased more in the Viibryd group than in the placebo group.

The symptoms were tracked with a tool called the Montgomery-Asberg Depression Rating Scale (MADRS). The MADRS rates severity of depression with a score between 0 and 60, and higher scores mean more severe depression. The scores of people who took Viibryd were between 2.5 to 5.1 points lower than people who took a placebo. This means that the Viibryd group had fewer symptoms or less severe symptoms.

Viibryd for other conditions

In addition to the uses listed above, Viibryd may be used off-label for other uses. Off-label drug use is when a drug that’s approved for one use is used for a different one that’s not approved. And you may wonder if Viibryd is used for certain other conditions.

Viibryd for anxiety (off-label use)

Viibryd has been studied in people with certain types of anxiety, including generalized anxiety disorder (GAD).

GAD is a condition in which people have extreme worry about normal things. People with GAD have symptoms more days than not, for at least 6 months. The symptoms often affect many aspects of a person’s life. In the United States, about 3% of people ages 18 to 64 years have GAD.

A study of GAD showed that anxiety symptoms eased more in people who took 40 mg of Viibryd than in people who took a placebo. This was according to the Hamilton Anxiety Rating Scale (HARS), a scale used in research to rate anxiety symptoms. Anxiety symptoms didn’t ease significantly in people who took 20 mg of Viibryd compared to people who took a placebo.

Other research has shown that 20 mg or 40 mg of Viibryd may help ease symptoms of moderate or severe anxiety within 8 weeks. Anxiety symptoms eased more in people who took Viibryd than in those who took a placebo. This was according to HARS (mentioned above).

If you’d like to know about taking Viibryd for this condition, or the drug’s dosage for anxiety, talk with your doctor. They can recommend a treatment option that’s right for you.

Viibryd for OCD (not an appropriate use)

Viibryd isn’t FDA-approved for the treatment of obsessive-compulsive disorder (OCD), a type of mental health condition. Research is needed to understand if Viibryd is helpful in easing OCD symptoms.

If you have OCD, your doctor will work with you to find better treatment options.

Viibryd for post-traumatic stress disorder (not an appropriate use)

A clinical study showed that Viibryd didn’t benefit people with both post-traumatic stress disorder (PTSD) and depression. More research is needed to see if Viibryd can help people who have PTSD with or without depression.

If you have PTSD, other treatments are likely a better choice for you. Talk with your doctor to discuss treatment options.

Viibryd and withdrawal

If you stop taking Viibryd “cold turkey” (suddenly), you may have withdrawal symptoms.

This is also called discontinuation syndrome. Your body can get used to having the medication, so if you stop using the drug too quickly, you may feel ill.

Withdrawal symptoms can last days to weeks. If you’re switching to another medication or stopping your use of Viibryd, it’s important that your dose is decreased slowly.

Symptoms of withdrawal can include:

• flu-like symptoms
• anxiety
• insomnia
• vivid dreams
• nausea and vomiting
• headaches
• irritability
• changes in mood
• sweating
• tremors
• tinnitus (ringing in the ears)
• electric shock sensations (brain zaps)
• seizures

If you’re thinking about stopping your use of Viibryd or want to change to another medication, tell your doctor. They can help adjust the dose of Viibryd safely so you won’t feel ill.

Viibryd cost

As with all medications, the cost of Viibryd can vary. The cost with insurance may differ. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Financial assistance

If you need financial support to pay for Viibryd, help is available.

Allergan, Inc., the manufacturer of Viibryd, offers the Viibryd Savings Program. For more information and to find out if you’re eligible for support, call 800-678-1605 or visit the program website.

To learn more about saving money on prescriptions, check out this article.

Generic version cost

Viibryd is not available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

Viibryd vs. Trintellix

You may wonder how Viibryd compares to other medications that are prescribed for similar uses. Here we look at how Viibryd and Trintellix are alike and different.

Uses

Viibryd and Trintellix are both approved by the Food and Drug Administration for the treatment of major depressive disorder (MDD) in adults.

Drug forms and administration

Viibryd contains the drug vilazodone. Trintellix contains the drug vortioxetine.

Both Viibryd and Trintellix come as tablets that you swallow once a day.

Viibryd strengths

Viibryd is available in three strengths: 10 mg, 20 mg, and 40 mg.

Viibryd tablets are also available as two different starter packs for the first 30 days that you begin taking the drug. Starter pack option 1 contains seven 10-mg tablets, seven 20-mg tablets, and sixteen 40-mg tablets. Starter pack option 2 contains seven 10-mg tablets and twenty-three 20-mg tablets.

Trintellix strengths

Trintellix is available in three strengths: 5 mg, 10 mg, and 20 mg.

Side effects and risks

Viibryd and Trintellix are both antidepressants and can cause very similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Viibryd, with Trintellix, or with both drugs (when taken individually).

• Can occur with Viibryd:
  • insomnia (not being able to sleep)
  • sleepiness or fatigue (lack of energy)
  • joint pain
  • headaches
• Can occur with Trintellix:
  • constipation
  • itching
• Can occur with both Viibryd and Trintellix:
  • digestive system problems, such as diarrhea, nausea, vomiting, and abdominal pain
  • sexual problems, such as erectile dysfunction and decrease in sex drive
  • dry mouth
  • dizziness
  • weight gain or weight loss

Serious side effects

This list contains examples of serious side effects that can occur with both Viibryd and Trintellix (when taken individually):

• allergic reactions
• suicidal thoughts or behaviors*
• serotonin syndrome (high levels of the chemical serotonin)
• bleeding
• mania or hypomania (periods of high energy or racing thoughts)
• discontinuation syndrome
• seizures
• angle-closure glaucoma (a type of eye disease)
• hyponatremia (low level of sodium in your blood)

* Viibryd and Trintellix have a boxed warning for suicidal thoughts or behaviors. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see “FDA warning” at the beginning of this article.

Effectiveness

The only condition both Viibryd and Trintellix are used to treat is MDD in adults.

Separate studies of the two drugs were compared in a larger review of studies. The review suggests that Viibryd and Trintellix have slight differences in side effects but no major differences in effectiveness or safety. Both Viibryd and Trintellix were found to be effective for treating MDD.

Costs

Viibryd and Trintellix are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

Trintellix generally costs more than Viibryd. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Viibryd and alcohol

You should avoid drinking alcohol when taking Viibryd. Although there isn’t a direct interaction between Viibryd and alcohol, side effects of Viibryd can be more severe when you drink alcohol. These side effects include dizziness and drowsiness, which could make it dangerous to operate heavy machinery or drive.

If you drink alcohol, talk with your doctor about the possible risks and whether Viibryd is right for you.

Viibryd vs. Lexapro

Like Trintellix (above), the drug Lexapro has uses similar to those of Viibryd. Here’s a comparison of how Viibryd and Lexapro are alike and different.

Uses

Both Viibryd and Lexapro have been approved by the Food and Drug Administration (FDA) to treat major depressive disorder (MDD) in adults. Lexapro is also approved for the treatment of MDD in children ages 12 to 17 years.

In addition, Lexapro is approved to treat generalized anxiety disorder (GAD) in adults, while Viibryd is sometimes used off-label for GAD. Off-label drug use is when a drug that’s approved for one use is used for a different one that’s not approved. To learn more, see “Viibryd for other conditions” in the “Viibryd uses” section above.

Drug forms and administration

Viibryd contains the drug vilazodone. Lexapro contains the drug escitalopram.

Both Viibryd and Lexapro come as tablets that you swallow once a day. Lexapro also comes as an oral solution (liquid) that you swallow once a day.

Viibryd strengths

Viibryd is available in three strengths: 10 mg, 20 mg, and 40 mg.

Viibryd tablets are also available as two different starter packs for the first 30 days you begin taking the drug. Starter pack option 1 contains seven 10-mg tablets, seven 20-mg tablets, and sixteen 40-mg tablets. Starter pack option 2 contains seven 10-mg tablets and twenty-three 20-mg tablets.

Lexapro strengths

Lexapro oral tablets are available in three strengths: 5 mg, 10 mg, 20 mg. The Lexapro oral solution is available in one strength: 1 mg/mL.

Side effects and risks

Viibryd and Lexapro are both antidepressants and cause very similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Viibryd, with Lexapro, or with both drugs (when taken individually).

• Can occur with Viibryd:
  • headaches
• Can occur with Lexapro when taken for MDD:
  • sweating
• Can occur with both Viibryd and Lexapro when taken for MDD:
  • digestive system problems, such as diarrhea, nausea, vomiting, abdominal pain, and constipation
  • sexual problems, such as erectile dysfunction and decrease in sex drive
  • insomnia (not being able to sleep)
  • sleepiness or fatigue (lack of energy)
  • dry mouth
  • dizziness
  • weight gain or weight loss
  • joint pain

Serious side effects

This list contains examples of serious side effects that can occur with both Viibryd and Lexapro (when taken individually).

• suicidal thoughts or behaviors*
• serotonin syndrome (high levels of the chemical serotonin)
• bleeding
• mania or hypomania (periods of high energy or racing thoughts)
• discontinuation syndrome
• hyponatremia (low level of sodium in your blood)
• seizures
• angle-closure glaucoma (a type of eye disease)
• allergic reactions

* Viibryd and Lexapro have a boxed warning for suicidal thoughts or behaviors. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see “FDA warning” at the beginning of this article.

Effectiveness

Viibryd and Lexapro have different FDA-approved uses, but they’re both used to treat MDD in adults. These drugs haven’t been directly compared in clinical studies, but studies have found both Viibryd and Lexapro to be effective for treating MDD.

Costs

Viibryd and Lexapro are both brand-name drugs. Lexapro is also available as a generic drug called escitalopram. Brand-name medications usually cost more than generics.

Viibryd costs less than brand-name Lexapro tablets and more than the generic version of Lexapro. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

How Viibryd works

Viibryd is used to treat a form of depression called major depressive disorder (MDD). This is a type of mood disorder.

MDD affects a person’s feelings, making it hard for them to carry out everyday activities such as working, eating, and sleeping. MDD is believed to be caused when levels of chemicals called neurotransmitters (such as serotonin) are out of balance in the body and brain.

Genetics, certain medications, and environmental factors are among the many possible causes of the chemical imbalances. If you have MDD, taking Viibryd can help create a better balance of chemicals.

It’s not completely understood how Viibryd works. Viibryd is a type of drug called a selective serotonin reuptake inhibitor (SSRI), which helps increase the level of serotonin in your body. Viibryd is unique because it can also bind to serotonin receptors, acting similarly to serotonin. (Receptors are proteins on the outside of cells that act like docking stations.) Both of these actions are thought to balance serotonin levels in the brain.

Because Viibryd works a little differently than other SSRIs, it’s considered to be a miscellaneous antidepressant.

Viibryd interactions

Viibryd can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase the number of side effects or make them more severe.

Viibryd and other medications

Below is a list of medications that can interact with Viibryd. This list doesn’t contain all drugs that may interact with Viibryd.

Before taking Viibryd, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Viibryd and Adderall

Viibryd may increase levels of a chemical called serotonin in your body. The drug Adderall may also cause this effect. (Adderall is a type of medication called an amphetamine, which is usually used to treat attention disorders.)

If you take Viibryd and Adderall, you might be more likely to have too much serotonin. This is called serotonin syndrome, and its symptoms can include a racing heartbeat, sweating, and changes in blood pressure.

Serotonin syndrome can be serious. So it’s important to talk with your doctor if you take Viibryd and Adderall, and have these side effects. For more about serotonin syndrome, see “Side effect details” in the “Viibryd side effects” section above.

Viibryd and CYP3A4 inducers

Medications called CYP3A4 inducers can lower the level of Viibryd in your body. If you take one of these medications for at least 2 weeks while using Viibryd, you may need a higher dose of Viibryd. Your doctor would gradually increase the dose over 1 to 2 weeks to 60 mg or 80 mg.

Examples of CYP3A4 inducers include:

• carbamazepine (Tegretol), a drug taken for seizures and several other conditions
• phenytoin (Dilantin), another drug used for seizures
• rifampin (Rifadin), an antibiotic, which is a drug used to treat infections caused by bacteria

If you stop taking any of these medications during your Viibryd treatment, your doctor will need to lower your dose of Viibryd. They’ll do this gradually over 1 to 2 weeks.

Viibryd and Xanax

If you take Viibryd with the drug alprazolam (Xanax), you should see how you feel before operating heavy machinery or driving. (Xanax is usually used to treat anxiety.)

Although Viibryd and Xanax don’t have a direct interaction, they both affect the brain and nervous system. This can cause dizziness, drowsiness, or fatigue (lack of energy). These conditions can be a safety issue when you’re driving or doing physical activities that may result in injury.

If you take Xanax or other medications used to treat anxiety, talk with your doctor before you use Viibryd.

Viibryd and CYP3A4 inhibitors

Taking more than 20 mg of Viibryd with certain medications known as CYP3A4 inhibitors can increase side effects of Viibryd. (To learn more, see the “Viibryd side effects” section above.) CYP3A4 inhibitors can increase levels of Viibryd in your body.

Examples of CYP3A4 inhibitors include:

• voriconazole (Vfend) and itraconazole (Sporanox), drugs used for infections caused by a fungus
• clarithromycin (Biaxin), a drug used for infections caused by bacteria

If you stop taking the CYP3A4 inhibitor, your doctor may adjust your dose of Viibryd.

Viibryd and MAOIs

If you take a medication known as a monoamine oxidase inhibitor (MAOI), tell your doctor before taking Viibryd. MAOIs increase your risk for a potentially serious condition called serotonin syndrome. For more about serotonin syndrome, see “Side effect details” in the “Viibryd side effects” section above.

If you have symptoms of serotonin syndrome, it’s important to let your doctor know right away.

Examples of MAOIs include:

• linezolid (Zyvox), a drug used to treat infections caused by bacteria
• methylene blue (ProvayBlue), a drug used to treat a certain blood disorder called methemoglobinemia

You shouldn’t take an MAOI and Viibryd within 14 days of one another. If you have any questions about MAOIs or Viibryd, ask your doctor.

Viibryd and certain migraine medications

If you take certain migraine medications when using Viibryd, your risk for serotonin syndrome may be higher. Serotonin syndrome is a potentially serious condition that requires treatment. See “Side effect details” in the “Viibryd side effects” section above for more information.

If you have symptoms of serotonin syndrome, it’s important to let your doctor know right away.

Some of the migraine medications that can interact with Viibryd are:

• sumatriptan (Imitrex)
• frovatriptan (Frova)
• almotriptan (Axert)
• eletriptan (Relpax)
• rizatriptan (Maxalt)

Before you start taking Viibryd, tell your doctor if you’re using any migraine medications. Your doctor may monitor you more closely for side effects or suggest another migraine treatment.

Viibryd and certain depression or anxiety medications

If you take certain medications for depression or anxiety when taking Viibryd, your risk of serotonin syndrome may be higher. Serotonin syndrome is a potentially serious condition that requires treatment. See “Side effect details” in the “Viibryd side effects” section above for more information. If you have symptoms of serotonin syndrome, it is important to let your doctor know right away.

Some of the depression or anxiety medications that can interact with Viibryd include:

• amitriptyline
• citalopram (Celexa)
• escitalopram (Lexapro)
• fluoxetine (Prozac)
• paroxetine (Paxil)
• venlafaxine (Effexor)

Before you start taking Viibryd, tell your doctor if you’re using any of these medications for depression or anxiety. They may monitor you more closely for side effects or suggest a different medication for you.

Viibryd and drugs that can increase the risk of bleeding

Taking Viibryd can increase your risk of bleeding. The risk of bleeding rises when you use Viibryd with other medications that can also increase bleeding risk.

These medications include antiplatelets and anticoagulants, which are used to prevent blood clots. Because these drugs thin blood and can make bleeding more likely, your doctor may monitor you more closely if you take them with Viibryd. Watch for signs of bleeding, such as bruising, nosebleeds, or blood in urine or stool.

Examples of medications used to help prevent blood clots include:

• clopidogrel (Plavix)
• dabigatran (Pradaxa)
• rivaroxaban (Xarelto)
• warfarin (Coumadin)

Other drugs not used for clotting disorders can also increase the risk of bleeding. These include other antidepressants and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil), naproxen (Aleve), and aspirin (Bayer).

If you’re taking a drug that may increase your risk of bleeding, talk with your doctor before taking Viibryd. They may choose to monitor you more closely or suggest another medication option.

Viibryd and digoxin

If you need to take the heart medication digoxin (Lanoxin) while using Viibryd, you may need a lower dose of digoxin than usual. This is because Viibryd can raise levels of digoxin. Your doctor will monitor you more often to make sure your digoxin level is right.

Viibryd and herbs and supplements

You should check with your doctor or pharmacist before using any herbal products or supplements while taking Viibryd. Some supplements may increase or decrease the levels of Viibryd in your body.

Also, it’s possible that tryptophan or St. John’s wort could increase your risk of serotonin syndrome, although specific studies aren’t available to prove an interaction. Serotonin syndrome is a potentially serious condition that requires treatment. See “Side effect details” in the “Viibryd side effects” section above for more information.

If you have symptoms of serotonin syndrome, it is important to let your doctor know right away.

If you take tryptophan or St. John’s wort, tell your doctor. They may have you stop taking the supplement during your Viibryd treatment.

How long does it take to work?

You might not notice a big difference in your depression symptoms for a few weeks after starting to take Viibryd. It can take 2 to 4 weeks for you to feel better. Other people may notice your symptoms easing before you do.

If you feel worse or have changes in your thinking or mood* after starting Viibryd treatment, talk with your doctor.

* Viibryd has a boxed warning for suicidal thoughts or behaviors. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see “FDA warning” at the beginning of this article.

Viibryd precautions

This drug comes with several precautions.

FDA warning: Suicidal thoughts and behaviors

This drug has a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

If you’re age 24 years or younger, taking an antidepressant such as Viibryd may increase your risk for suicidal thoughts and behaviors. This is according to short-term clinical studies.

While you take Viibryd, your doctor will monitor you for signs of suicidal thoughts and behaviors. Have loved ones keep an eye out for such signs as well. As for children, more research is needed to understand how safe and effective Viibryd is for them.

Other precautions

Before taking Viibryd, talk with your doctor about your health history. Viibryd may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

• Bipolar disorder. If you have bipolar disorder and take Viibryd, the drug may cause hypomania or mania (periods of high energy or racing thoughts). These conditions may cause racing thoughts, increased energy, and restlessness. You should be screened for bipolar disorder before taking Viibryd.
• Seizures. Viibryd, like other antidepressants, may increase the risk of seizures. If you have a history of seizures, be sure to tell your doctor before taking Viibryd.
• Glaucoma. If you have a condition called angle-closure glaucoma that hasn’t been treated, taking Viibryd could trigger glaucoma symptoms to occur suddenly. Ask your doctor what other treatments for major depressive disorder are better for you.
• Pregnancy. The effects of taking Viibryd during pregnancy are mostly unknown. For more information, please see the “Viibryd and pregnancy” section below.
• Breastfeeding. More information is needed to understand if Viibryd is found in breast milk and how the drug could affect breastfed children. For more information, please see the “Viibryd and breastfeeding” section below.

Note: For more information about the potential negative effects of Viibryd, see the “Viibryd side effects” section above.

Viibryd and pregnancy

It’s not known if Viibryd is safe to take during pregnancy. Viibryd hasn’t been studied in pregnant people.

In animal studies, Viibryd didn’t cause birth defects when pregnant females were given the drug at much higher than normal doses. However, results of animal studies may not apply to humans.

Viibryd is similar to other depression medications called selective serotonin reuptake inhibitors (SSRIs).

Newborns of pregnant people who take SSRIs may have an increased risk of a longer hospital stay and trouble breathing and feeding. And some studies have shown that newborns of pregnant people who took SSRIs had an increased risk of high blood pressure in the arteries of the lungs.

Though Viibryd works a little differently than SSRIs, there is a chance that the drug could cause some of the same effects.

If you’re pregnant or are planning to become pregnant, talk with your doctor before taking Viibryd. You and your doctor should discuss the benefits of Viibryd treatment and also consider the possible side effects.

Viibryd and birth control

It’s not known if Viibryd is safe to take during pregnancy. If you or your sexual partner can become pregnant, talk with your doctor about your birth control needs while you’re using Viibryd.

Viibryd and breastfeeding

It’s not known if Viibryd is found in the breast milk of breastfeeding people. It’s also not known if it’s safe to breastfeed while taking Viibryd.

If you’re breastfeeding or are planning to breastfeed, ask your doctor if Viibryd is right for you.

How to take Viibryd

You should take Viibryd according to your doctor or healthcare professional’s instructions. Your pharmacist can give you more advice about taking Viibryd as well.

When to take

Take Viibryd once a day with food. Try to take Viibryd at the same time each day.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Taking Viibryd with food

It’s important to take Viibryd with food. Studies have shown that Viibryd might not work as well if you take it on an empty stomach. Taking the drug with food may also help ease digestive system side effects such as nausea and vomiting.

Can Viibryd be crushed, split, or chewed?

Yes, you can crush, split, or chew Viibryd. Your doctor and pharmacist can help you decide the best option for you. If you need to split Viibryd, a pill cutter can make it easier to split the drug evenly.

Viibryd overdose

Using more than the recommended dosage of Viibryd can lead to serious side effects.

Overdose symptoms

Symptoms of an overdose can include:

• serotonin syndrome, a condition in which you have high levels of the chemical serotonin (For details, see the “Viibryd side effects” section above.)
• fatigue (lack of energy) or feeling sluggish
• restlessness
• hallucinations (seeing things that aren’t really there)
• feeling disoriented or confused (trouble thinking or concentrating)

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

Viibryd expiration, storage, and disposal

When you get Viibryd from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee the effectiveness of the medication during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk with your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Viibryd tablets should be stored at room temperature (77°F/25°C) in a tightly sealed container away from light. Avoid storing this medication in areas where it could get damp or wet, such as in bathrooms.

Disposal

If you no longer need to take Viibryd and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

The FDA website provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.