Viibryd (vilazodone) for anxiety: What you need to know

Viibryd (vilazodone) for anxiety: What you need to know

Reviewed by:
Austin Lin, MD
Staff Psychiatrist
at Talkiatry
March 21, 2024
In this article

If you’re struggling with depression and anxiety, you’re not alone. Anxiety affects as many as 6.8 million Americans each year. Luckily there are a number of treatment options that can help you feel better.  

One such treatment is Viibryd, the brand name for the drug vilazodone, a newer antidepressant medication that works differently from others. If you’re just starting Viibryd or are interested in learning more, read on to discover how this medication works, who it’s best for, and who should avoid it.


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How does vilazodone work?  

Vilazodone is a relatively new drug that was approved for the US in 2011 and it’s part of a unique class of medications known as serotonin partial agonists and reuptake inhibitors (SPARIs). SPARIs work in two ways to boost serotonin levels in the brain, which can alleviate symptoms of major depression and anxiety.  

First, Viibryd acts like a selective serotonin reuptake inhibitor (SSRI). In your brain there are natural chemicals like serotonin, which help regulate your mood. Viibryd prevents the serotonin from being absorbed by your neurons (nerve and brain cells) so you have more of it. This increased serotonin activity can help regulate your mood and can alleviate depressive symptoms.

Second, the medication acts as an agonist. This means vilazodone stimulates the serotonin receptors and tells them to produce more serotonin, which doubly helps your well being and emotions. (Viibryd is considered a partial agonist, meaning it has a milder effect compared to full agonists.)  

In other words, Viibryd helps your brain sustain more of the neurotransmitters that make you feel good—by limiting their reabsorption and stimulating their production. By doing this, it can help you feel better from anxiety and depression

What conditions does Viibryd treat?

Viibryd has been FDA-approved to treat major depressive disorder (MDD), and multiple clinical studies have shown it to be effective. Some psychiatrists may prescribe it as a first-line, or primary treatment for, while others may only prescribe it to you if other antidepressants like SSRIs don’t help with your symptoms. While it has less potential side effects than other SSRIs, the long-term effects are not yet established. It is also only available in the brand-name at this time, which can make it expensive.

While Viibryd hasn’t been approved for the treatment of generalized anxiety disorder (GAD), it is often prescribed for it off-label. When a medication is prescribed “off-label,” it means doctors and researchers have found it beneficial for that purpose. In this case, clinical trials and a 2015 double-blind study found that Viibryd was significantly more effective in treating symptoms of GAD than the placebo.

How to take vilazodone for anxiety and depression

When you’re taking Viibryd, it's important to follow the prescribed dosage and instructions provided by your healthcare provider. Viibryd is taken orally, with food, once a day and it comes in 10mg, 20mg, and 40mg tablets. Try to take it consistently at the same time each day so you maintain steady levels of the medication in your system.  

Your doctor may start you with a smaller initial dose of Viibryd (usually 10 mg once daily) for a week, then incrementally increase based on how you’re doing, based on the intensity of your symptoms, your medical history, and how your body responds to it. The recommended maximum dosage is around 40 mg. Finding the optimal dosage can take time, but don’t worry. You’ll collaborate with your doctor to find the right dosage that works best for you.

Related article: Signs your antidepressants dose is too low or too high

What happens if you miss a dose?

If you forget to take a dose of Viibryd, take it as soon as you remember. However, if it's almost time for your next scheduled dose, it's best to skip it and continue with your regular schedule. Don’t double up on doses to make up for a missed one, since this can increase the risk of side effects. When in doubt, you can reach out to your doctor on what to do.

It’s worth noting that vilazodone has a half life of 25 hours. That’s how long it takes for half the amount of a drug to leave your system. The shorter a medication’s half-life is, the sooner you will begin to feel withdrawal symptoms after you miss a dose or stop taking it. Since vilazodone has a fairly average half-life, missing one dose isn’t likely going to have a negative effect. Just try to remember to take the next dose.    

How long do I have to take it?

It’s safe to take antidepressants for long term use and many mental health professionals recommend taking them for 6-12 months. Once you’re feeling better and more stable, you can talk to your doctor about stopping. They will help you safely come off vilazodone by tapering your dosage, or reducing it gradually over time. Abruptly stopping Viibryd (and many other antidepressants) can lead to withdrawal symptoms and make your depression or anxiety symptoms come back. Remember your doctor will help minimize this risk and if you have any concerns about your medication regimen be sure to let them know.

How long does it take for Viibryd to work?

You may notice changes in your sleep, mood, and appetite as early as 1-2 weeks after starting Viibryd. While these can be important signs that the medication is working, you likely won’t feel the full benefit of Viibryd for 6-8 weeks.

Signs that Viibryd is working include a reduction in depressive or anxiety symptoms, improved mood, increased energy levels, better concentration, and enhanced overall sense of well-being. When you start taking a new medication try keeping a daily log of your symptoms and how they change over time, and share it with your doctor. This can help them understand if Viibryd is working and make any necessary adjustments to your treatment plan, whether that means trying a different dosage or a different medication.

Since it takes a few weeks for your brain to get used to the medication and for you to start feeling better. Even if you don't notice an immediate difference, it's important to keep taking your medication as prescribed.  

Potential side effects

Viibryd may have fewer side effects compared to other antidepressants, but it still carries some risks, ranging from common and relatively mild to less common and more severe. Here's a breakdown of the all the potential side effects associated with it:  

Common side effects:

  • Nausea
  • Diarrhea
  • Insomnia or changes in sleep patterns
  • Dry mouth
  • Headache
  • Dizziness
  • Fatigue  

Less common side effects:

  • Constipation
  • Indigestion or stomach discomfort
  • Weight changes (either loss or gain)
  • Sweating
  • Tremors or shaking
  • Blurred vision
  • Muscle stiffness or weakness
  • Decreased sex drive or sexual dysfunction

Rare but serious side effects:

  • Serotonin syndrome, which happens when you have too much serotonin (your doctor will let you know what to look out for and will try to minimize this risk)
  • Allergic reactions, such as rash, itching, swelling, severe dizziness, trouble breathing
  • Mania or hypomania
  • Seizures
  • Liver problems
  • Increased the risk of suicidal thoughts in certain groups, particularly in adolescents, and young adults*

Many effects of Viibryd may go away over time as your body adjusts to the medication. For example, two common side effects, nausea and gastrointestinal discomfort, usually get better within the first few weeks of taking it.  

However, if you experience a worsening of side effects or they persist, make sure to discuss them with your healthcare provider. They may recommend adjusting the dosage or trying a different medication to minimize side effects while still effectively managing your symptoms.

​​*If you struggle with these thoughts, make sure to speak to your doctor about them before starting Viibyrd, and closely monitor your symptoms, especially during the initial weeks of treatment and when changing the dosage.

Interactions and precautions: Who shouldn’t take Viibryd?

There are situations when people may not react well to Viibryd because of certain medications they’re on or medical conditions they have.

Here are some about potential drug interactions to be aware when taking vilazodone:

  • MAOIs (monoamine oxidase inhibitors), such as  
  • Serotonergic drugs, such as certain antidepressants, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, and St. John's wort, which carries an increased risk of serotonin syndrome
  • CYP3A4 inhibitors and inducers, like ketoconazole and rifampin, which can alter the metabolism of other medications
  • NSAIDs (non-steroidal anti-inflammatory drugs), like ibuprofen and aspirin, which may increase the risk of bleeding

As with all medications, anyone who has had an allergic reaction to Viibryd or any of its ingredients should not take it.

Your doctor will ask about any medications and supplements you're taking before you start using Viibryd. This helps them make sure there won't be any harmful interactions or unwanted effects. They'll also ask you about any pre-existing medical conditions you might have, to make sure Viibryd doesn’t have any adverse effects. For example, if you have a condition like a seizure disorder, make that known to your psychiatrist so they can make an informed decision and provide you further medical advice.  

Remember, If you have any questions about whether Viibryd is safe and suitable for you, reach out to your healthcare provider. Your well-being is their top priority and they can give you personalized guidance based on your specific situation.  

Viibryd vs. other antidepressants  

Viibryd can be effective in the treatment of major depressive disorder and generalized anxiety disorder in adults and may have a lower incidence of side effects, including those related to sexual dysfunction, than other antidepressants.  

If you're struggling with depression or anxiety, know that help is available—and treatment works. Medication, therapy, or a combination of both, can improve your quality of life and lessen your symptoms. A good place to start can be to talk to a psychiatrist. Talkiatry is a national psychiatry practice that provides 100% virtual in-network care. Our team of mental health professionals is dedicated to providing personalized treatment tailored to your unique circumstances. To get started, you can take our online assessment to get matched with a psychiatrist and schedule your first visit.

FAQs

How is Viibryd different from other antidepressants?

Viibryd, like Trintellix, differs from other antidepressants because it has a unique way of acting in your body as a combination of SSRI, like Celexa (citalopram) and a partial agonist of serotonin receptors. It also has a lower risk of sexual side effects and is suitable for people with a history of liver problems, which can make it a favorable option for some people.

Is Viibryd a strong antidepressant?  

Viibryd (vilazodone) is considered to be an effective antidepressant, though its strength may vary depending on the dosage you’re prescribed as well as how your body responds to it since medication affects people differently.

Is Viibryd similar to Wellbutrin?

Viibryd and Wellbutrin (bupropion) are two different types of antidepressant. While Viibryd primarily targets serotonin, Wellbutrin affects dopamine and norepinephrine. They are both prescribed for depression and anxiety, though Wellbutrin has other off-label uses, like smoking cessation and seasonal affective disorder.  

Does Vilazodone cause weight gain?

Vilazodone may have a lower risk of weight gain compared to some other antidepressant medications. However, weight gain and loss can still occur as a side effect in some people because everyone responds to medication differently.  

To learn more, check out: Antidepressants and weight loss

What is the best medication for anxiety?

The best medication for you depends on a few factors, including your medical history and your goals. Some of the more common medications prescribed for anxiety are SSRIs like Paxil (paroxetine) and Zoloft (sertraline) and SNRIs (norepinephrine reuptake inhibitors) like Effexor (venlafaxine). These are called first-line treatments, meaning they’re usually the first medications doctors will try. However, these treatments aren’t effective for everyone. Your health care provider can help you figure out which one that is. Other anxiety medications include buspirone and benzodiazepines.

The information in this article is for education and informational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.

Dr. Austin Lin is a double board-certified adult and addiction psychiatrist who has been in practice for over 9 years. At the center of Dr. Lin’s clinical approach is a strong emphasis on establishing trust and using a collaborative approach to help patients develop an individualized and cohesive plan so that they are able to achieve their goals.

Dr. Lin's practice focuses on medication management. Typically, he offers this in conjunction with supportive therapy, motivational interviewing, and/or cognitive behavioral therapy in 30-minute follow-up visits. Occasionally, Dr. Lin may recommend that additional therapy is needed and ask that you bring a therapist into your care team in order to provide the best outcome.

Dr. Lin received his medical degree from St. George’s University School of Medicine. He went on to complete his residency in psychiatry at Harvard South Shore, an affiliate of Harvard Medical School, where he served as Chief Resident and earned his 360° Professionalism award. He then had additional training in Addiction Psychiatry through his fellowship at the University of Texas Southwestern Medical Center. After completing training, Dr. Lin has worked as an Addiction Psychiatrist and Director of Adult Services in the Trauma and Resilience Center (TRC) at the University of Texas Health Science Center at Houston (UTHealth). He specialized in treating patients with a history of depression, anxiety, trauma, and substance use disorders.

Dr. Lin has held an academic appointment at UTHealth, and he has spent his professional career supervising and teaching medical students and psychiatry residents.



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