Viibryd® (vilazodone)
Brand
name:
Viibryd®
Generic
name: vilazodone (vil
AZ oh done)
Medication
class: Selective serotonin reuptake inhibitor/5HT1A partial agonist
All FDA black box
warnings are at the end of this fact sheet. Please review
before taking this medication.
What
is Viibyrd® and what does it treat?
Vilazodone
is an antidepressant medication that works in the brain. It is
approved for the treatment of major depressive disorder (MDD).
Symptoms
of depression include:
-
Depressed
mood - feeling sad, empty, or tearful
-
Feeling
worthless, guilty, hopeless, and helpless
-
Loss
of interest or pleasure in your usual activities
-
Sleep
and eat more or less than usual (for most people it is less)
-
Low
energy, trouble concentrating, or thoughts of death (suicidal
thinking)
-
Psychomotor
agitation (‘nervous energy’)
-
Psychomotor
retardation (feeling like you are moving and thinking in slow
motion)
-
Suicidal
thoughts or behaviors
What
is the most important information I should know about Viibyrd®?
Do
not stop taking vilazodone, even when you feel better. Only your
healthcare provider can determine the length of treatment that is
right for you.
Missing
doses of vilazodone may increase your risk for relapse in your
symptoms.
Stopping
vilazodone abruptly may result in one or more of the following
withdrawal symptoms: irritability, nausea, feeling dizzy, vomiting,
nightmares, headache, and/or paresthesias (prickling, tingling
sensation on the skin).
Depression
is also a part of bipolar illness. People with bipolar disorder who
take antidepressants may be at risk for "switching" from
depression into mania. Symptoms of mania include "high" or
irritable mood, very high self esteem, decreased need for sleep,
pressure to keep talking, racing thoughts, being easily distracted,
frequently involved in activities with a large risk for bad
consequences (for example, excessive buying sprees).
Are
there specific concerns about Viibyrd® and
pregnancy?
If
you are planning on becoming pregnant, notify your healthcare
provider to best manage your medications. People living with MDD who
wish to become pregnant face important decisions. Untreated MDD has
risks to the fetus, as well as the mother. It is important to
discuss the risks and benefits of treatment with your doctor and
caregivers.
Caution
is advised with breastfeeding since vilazodone
does
pass into breast milk.
What
should I discuss with my healthcare provider before taking Viibyrd®?
-
Symptoms
of your condition that bother you the most
-
If
you have thoughts of suicide or harming yourself
-
Medications
you have taken in the past for your condition, whether they were
effective or caused any adverse effects
-
If
you experience side effects from your medications, discuss them with
your provider. Some side effects may pass with time, but others may
require changes in the medication.
-
Any
other psychiatric or medical problems you have, including a history
of bipolar disorder
-
All
other medications you are currently taking (including over the
counter products, herbal and nutritional supplements) and any
medication allergies you have
-
Other
non-medication treatment you are receiving, such as talk therapy or
substance abuse treatment. Your provider can explain how these
different treatments work with the medication.
-
If
you are pregnant, plan to become pregnant, or are breast-feeding
-
If
you drink alcohol or use drugs
How
should I take Viibyrd®?
Vilazodone
is usually taken 1 time per day with food or milk.
Typically
patients begin at a low dose of medicine and the dose is increased
slowly over several weeks.
The
dose usually ranges from 10 mg to 40 mg. Only
your healthcare provider can determine the correct dose for you.
Consider
using a calendar, pillbox, alarm clock, or cell phone alert to help
you remember to take your medication. You may also ask a family
member or friend to remind you or check in with you to be sure you
are taking your medication.
What
happens if I miss a dose of Viibyrd®?
If
you miss a dose of vilazodone,
take it as soon
as you remember, unless it is closer to the time of your next dose.
Discuss this with your healthcare provider. Do not double your next
dose or take more than what is prescribed.
What
should I avoid while taking Viibyrd®?
Avoid
drinking alcohol or using illegal drugs while you are taking
antidepressant medications.
They may decrease the benefits (e.g., worsen your condition) and
increase adverse effects (e.g., sedation) of the medication.
What
happens if I overdose with Viibyrd®?
If
an overdose occurs, call your doctor or 911. You may need urgent
medical care. You may also contact the poison control center at
1-800-222-1222.
A
specific treatment to reverse the effects of vilazodone does not
exist.
What
are the possible side effects of Viibyrd®?
Common
Side Effects
Diarrhea,
nausea, vomiting, dry mouth, dizziness,
insomnia
Rare
Side Effects
Night
sweats, decreased appetite, migraine headaches, sleepiness, tremor,
blurry vision, dry eyes, abnormal dreams, agitation, restlessness,
increased urination, sexual dysfunction
Serious
Side Effects
Palpitations,
irregular heartbeat
Are
there any risks of taking Viibyrd® for long periods of time?
To
date, there are no known problems associated with long term use of
vilazodone. It is a safe and effective medication when used as
directed.
What
other medications may interact with Viibyrd®?
Vilazodone
should not be taken with or within 2 weeks of taking monoamine
oxidase inhibitors (MAOIs). These include phenelzine (Nardil®),
tranylcypromine (Parnate®),
isocarboxazid (Marplan®),
rasagiline (Azalect®)
and selegeline (Emsam®).
Although
rare, there is an increased risk of serotonin syndrome when
vilazodone is used with other medications that increase serotonin,
such as other antidepressants, migraine medications called “triptans”
(e.g., Imitrex®),
some pain medications (e.g., tramadol (Ultram®),
and the antibiotic linezolid (Zyvox®).
Vilazodone
may increase the effects of other medications that can cause bleeding
(e.g., ibuprofen (Advil®, Motrin®), warfarin (Coumadin®) and
aspirin).
The
following medications may increase the levels and effects of vilazodone:
-
Antibiotics,
such as clarithromycin (Biaxin®),
erythromycin (Ery-Tab®),
and telithromycin (Ketek®)
-
Antifungals,
such as fluconazole (Diflucan®),
ketoconazole
(Nizoral®),
and itraconazole
(Sporanox®)
-
Blood
pressure medications, such as verapamil (Calan®,
Covera-HS®,
Isoptin SR®)
and diltiazem (Cardizem®,
Tiazac®)
-
HIV
medications such as protease inhibitors: indinavir (Crixivan®),
ritonavir (Norvir®),
saquinavir (Fortovase®,
Invirase®),
and lopinavir/ritonavir (Kaletra®)
-
Nefazodone
The
following medications may decrease the levels and effects of vilazodone: carbamezapine (Tegretol®),
oxcarbazepine (Trileptal®),
rifampin (Rifadin®),
phenytoin (Dilantin®),
and phenobarbital
How
long does it take for Viibyrd® to work?
Sleep,
energy, or appetite may show some improvement within the first 1-2
weeks. Improvement in these physical symptoms can be an important
early signal that the medication is working. Depressed mood and lack
of interest in activities may need up to 6-8 weeks to fully improve.
Provided
by the College of Psychiatric and Neurologic Pharmacists
(January
2013)
Summary
of Black Box Warnings
Suicidal
Thoughts or Actions in Children and Adults
-
Depression
and certain other psychiatric disorders are themselves associated
with increases in the risk of suicide.
-
Patients
with major depressive disorder (MDD), both adult and pediatric, may
experience worsening of their depression and/or the emergence of
suicidal ideation and behavior (suicidality) or unusual changes in
behavior, whether or not they are taking antidepressant medications.
This risk may persist until significant remission occurs.
-
In
short-term studies, antidepressants increased the risk of
suicidality in children, adolescents, and young adults when compared
to placebo. Short-term studies did not show an increase in the risk of suicidality with antidepressants
compared to placebo in adults beyond age 24. Adults age 65 and
older taking antidepressants have a decreased risk of suicidality.
-
Patients,
their families, and caregivers should be alert to the emergence of
anxiety, restlessness, irritability, aggressiveness and insomnia.
If these symptoms emerge, they should be reported to the patient’s
prescriber or healthcare professional.
-
All
patients being treated with antidepressants for any indication
should watch for and notify their healthcare provider for worsening
symptoms, suicidality and unusual changes in behavior, especially
during the first few months of treatment.
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