Vilazodone: Difference between revisions

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{{MedTemplate

~~| generic = Vilazodone~~

| brand = Viibryd

| classes = Serotonin partial agonist reuptake inhibitor (SPARI)

~~| structure =~~

| mechanism = Combines SERT inhibition (typical SSRI mechanism) with 5HT1A receptor partial agonism. The 5HT1A partial agonism is proposed to: (1) provide intrinsic 5HT1A agonist activity beyond what SERT inhibition produces, and (2) accelerate downregulation of 5HT1A autoreceptors, potentially shortening the typical 4-6 week onset for SSRI effect.

| classes = ~~SSRI, Antidepressant~~

| uses = Major depressive disorder in adults (FDA-approved 2011)

| mechanism = SSRI and 5-~~HT1A partial agonist~~

| starting_dose = 10 mg PO once daily × 7 days, then 20 mg × 7 days, then 40 mg as target dose (take with food)

| uses =

| preparations = 10 mg, 20 mg, 40 mg tablets

| starting_dose =

| fda_max = 40 mg/d

| preparations =

| routes = Oral

| fda_max =

| onset = 4-6 weeks for full antidepressant effect (claimed earlier onset for some patients due to 5HT1A partial agonism)

| routes =

| duration = Daily dosing

| onset =

| halflife = ~25 hours

| duration =

| bioavailability = ~72% (with food); much lower fasting (~36%)

| halflife =

| pregnancy = Limited data; weigh benefits/risks

| bioavailability =

| legal = Rx

| pregnancy =

| intro = '''Vilazodone''' (brand name Viibryd) is a serotonin partial agonist reuptake inhibitor (SPARI) FDA-approved in 2011 for major depressive disorder. Combines SERT inhibition with 5HT1A receptor partial agonism, similar in spirit to buspirone-augmented SSRI therapy, but in a single molecule. Stahl positions SPARIs as a mechanistic refinement of SSRIs intended to accelerate the typical 4-6 week onset and improve tolerability via 5HT1A modulation.

| legal =

| intro =

In practice, head-to-head trials have not consistently shown superiority over generic SSRIs. The medicine carries the typical SSRI side effect profile though sexual dysfunction may be somewhat reduced. Must be taken with food (substantial bioavailability difference).

~~| pharmacokinetics =~~

| pharmacodynamics= SERT inhibition (Ki ~0.1 nM); 5HT1A partial agonist (Ki ~0.2 nM). Minimal NET, DAT, or non-5HT1A serotonin receptor activity.

| pharmacodynamics =

| effects = Nausea, diarrhea, headache, somnolence, insomnia, vomiting. Sexual dysfunction (variably reported as similar to or less than SSRIs). SSRI discontinuation syndrome possible. Class warning for suicidal thoughts in pediatric/young adult patients.

~~| indications =~~

| interactions = <pharmaInteractions/>

~~| dosing~~ =

| effects =

~~| contraindications~~ =

| interactions =

~~| pregnancy_details =~~

~~| monitoring =~~

~~| counseling =~~

~~| anecdotes =~~

~~| seealso =~~

~~| references~~ =

}}

[[Category:Antidepressants]]

[[Category:Multimodal Serotonergic Agents]]

[[Category:Selective Serotonin Reuptake Inhibitors (SSRIs)]]

[[Category:Serotonin Partial Agonist Reuptake Inhibitors (SPARIs)]]

MDElliottMD (talk | contribs)