Brand & Generic Names; Drug Classes
|US brand name: Viibryd|
|Generic name: vilazodone|
|Primary drug class: Antidepressants|
|Additional drug class(es): Miscellaneous Antidepressants, Serotonin-Selective Reuptake Inhibitors. Even though Viibryd is technically not and SSRI, it may as well be considered one.|
Approved & Off-Label Uses (Indications)
Viibryd’s US FDA Approved Treatment(s)
Major Depressive Disorder (MDD). Approved 21 January 2011.
Uses Approved Overseas but not in the US
Off-Label Uses of Viibryd
When & If Viibryd Will Work
Viibryd’s Usual Onset of Action (when it starts working)
At least a month, which surprises me. Given how Viibryd works, including how selective and potent it is, I expected more people to respond sooner. Some people respond sooner, of course, but fewer than I originally thought.
Likelihood of Working
So far it looks as if Viibryd is a decent antidepressant. If your doctor thinks that an SSRI is the way to go based on something more than the basic algorithm of “Give them Celexa first” and you have a strong stomach (i.e. don’t have GI problems as soon as you take any medication, crazy or otherwise), then Viibryd is a pretty good med to start with.
My now-retired doctor said he had “surprisingly” good results from Viibryd. I was in pretty bad shape when I saw him, so I may be misremembering the adjective, but he was very happy with Viibryd, and he knows when someone needs serotonin tweaking and when they don’t.
I’ve been reading other reports in the field. People are reasonably happy with Viibryd. So, for now, Viibryd has moved up from “coin toss” to “more likely to work than not.”
Taking and Discontinuing
How to Take Viibryd
The recommended dose for VIIBRYD is 40 mg once daily.
VIIBRYD should be titrated, starting with an initial dose of 10 mg once daily for 7 days, followed by 20 mg once daily for an additional 7 days, and then an increase to 40 mg once daily . VIIBRYD should be taken with food.
At this point we don’t have much to suggest, other than taking it with breakfast instead of dinner when you first try it. Based upon Viibryd’s mechanism of action (how Viibryd works), side effects, and consumer experiences, taking Viibryd in the morning seems to work better for more people.
Since Viibryd tends to take a long time to work it’s hard to tell if staying at 20mg (or even 10mg) for longer than a week would be helpful or not. Obviously if it works at 10 or 20mg, then just stay at that dosage. If the side effects become too harsh at 40mg, and you feel like 20mg of Viibryd was starting to do something, then talk to your doctor ASAP about going back down to 20mg and giving it a chance to work at that dosage.
How to Stop Taking Viibryd (discontinuation / withdrawal)
Forest, being Forest, are vague and state the obvious. The only thing helpful they offer is a highly detailed description of SSRI-discontinuation syndrome symptoms:
5.6 Discontinuation of Treatment with VIIBRYD
There have been reports of adverse events occurring upon discontinuation of serotonergic antidepressants, particularly when discontinuation is abrupt, including the following:
dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g., paresthesia, such as electric shock sensations), anxiety, confusion, headache, lethargy, emotional lability, insomnia, hypomania, tinnitus, and seizures.
While these events are generally self-limiting, there have been reports of serious discontinuation symptoms. Monitor patients for these symptoms when discontinuing VIIBRYD. Reduce the dose gradually whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, consider resuming the previously prescribed dose. Subsequently, the dose may be decreased, but at a more gradual rate. --the Viibryd PI sheet
As with any potent SSRI: very slowly and carefully. Withdrawing Viibryd the same way you titrated (increased the dosage) should work for most people: from 40mg to 20mg for 7 days, then 10mg for 7 days, then you’re done. You might be able to get a starter kit from your doctor. Some people may need to do 40mg to 30mg to 20mg to 10mg.