Vilazodone
Viibryd
Serotonin Partial Agonist Reuptake InhibitorGeneric availableTDM data
The mechanism of action of vilazodone in the treatment of major depressive disorder is not fully understood, but is thought to be related to its enhancement of serotonergic activity in the CNS through selective inhibition of serotonin reuptake. Vilazodone is also a partial agonist at serotonergic 5-HT 1A receptors; however, the net result of this action on serotonergic transmission and its role in vilazodone’s antidepressant effect are unknown.
Compare Vilazodone →FDA-Approved Indications
- Major depressive disorder (adults)
Common Off-Label Uses
- Generalized anxiety disorder
- OCD
What Sets This Drug Apart
- Dual SSRI + 5-HT1A partial agonist (SPARI mechanism) — 5-HT1A agonism may reduce sexual dysfunction compared to pure SSRIs
- MUST be taken with food: absorption doubles with meals vs fasted state; food requirement is non-negotiable for therapeutic levels
- FDA-approved for MDD only; no other psychiatric indications
- Potential sexual dysfunction advantage vs SSRIs: 5-HT1A partial agonism may counteract SERT-driven sexual effects, though data are mixed
- Titration required: start 10 mg daily x7 days, then 20 mg daily x7 days, then 40 mg daily (target); rushed titration increases GI side effects
Boxed Warning
SUICIDAL THOUGHTS AND BEHAVIORS