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vilazodone

Adjunctive therapy

Brand: Viibryd

Published 2026-02-15 · Last reviewed 2026-02-22 · 5 references

Content sourced from FDA labeling (DailyMed) and peer-reviewed literature.

Print sheet Review evidence

At a glance

Class: Adjunctive therapy·Typical dose: Initiate 10 mg once daily with food for 7 days, increase to 20 mg once daily for 7 days, then advance to 40 mg once daily with food if tolerated.·Half-life: Single-dose mean 25 h; Steady-state mean 25 h·LAI available: No

Class: Adjunctive therapy
Typical dose: Initiate 10 mg once daily with food for 7 days, increase to 20 mg once daily for 7 days, then advance to 40 mg once daily with food if tolerated.
Half-life: Single-dose mean 25 h; Steady-state mean 25 h
LAI available: No

Quick answers

What is vilazodone?: Vilazodone (Viibryd) is a serotonin reuptake inhibitor and 5-HT1A partial agonist approved for adult major depressive disorder; it offers an SSRI-like efficacy profile with a modest signal for less sexual dysfunction in some comparative studies.
What is Viibryd?: Viibryd is a brand name for vilazodone.
What is Viibryd (vilazodone) used for?: Label indications include: Major depressive disorder.
What drug class is Viibryd (vilazodone)?: SPARI Antidepressant.
What is the mechanism of action of Viibryd (vilazodone)?: Serotonin reuptake inhibitor and 5-HT1A partial agonist.
What strengths does Viibryd (vilazodone) come in?: Film-coated tablets: 10 mg, 20 mg, 40 mg.

General information

Vilazodone (Viibryd) is a serotonin reuptake inhibitor and 5-HT1A partial agonist approved for adult major depressive disorder; it offers an SSRI-like efficacy profile with a modest signal for less sexual dysfunction in some comparative studies.

Because food increases exposure twofold, every dose must be taken with a meal (≥350 calories)—a critical counseling point to avoid treatment failure in serious mental illness care plans.

The compare view and the vilazodone evidence feed can help contrast activation, GI tolerability, and meal requirements against other SSRIs before switching therapies or adding augmentation.

U.S. approvals

Major depressive disorder (2011)

Formulations & strengths

Film-coated tablets: 10 mg, 20 mg, 40 mg.

Generic availability

Generics launched in 2023–2024; verify formulary status because some payers retain brand prior authorization requirements.

Consider for patients who experienced SSRI-related sexual dysfunction or weight gain, but reinforce food-dependent absorption and GI tolerability strategies during titration.

View labelExact

Mechanism of action

Refer to the Glossary entry on Neurotransmitters for background on receptor systems involved in serious mental illness.

Combines high-affinity serotonin transporter inhibition with partial agonism at 5-HT1A receptors, potentially mitigating anxiety and sexual adverse effects.

Shows negligible affinity for adrenergic, dopaminergic, histaminic, or muscarinic receptors, contributing to a relatively neutral cardiometabolic profile.

SERT inhibition.
5-HT1A partial agonism (~60% intrinsic activity).
Minimal off-target receptor binding.

Metabolism & pharmacokinetics

Bioavailability increases roughly 50–70% with food; median Tmax 4–5 hours fed (≈6 hours fasting).
Extensively metabolized by CYP3A4 (primary) with minor contributions from CYP2C19 and CYP2D6 to inactive metabolites; ~96% protein bound.
Terminal half-life ≈25 hours; about 35% of a dose is recovered in urine and 33% in feces as metabolites (<1% unchanged). No dosage adjustment is required for mild-to-moderate renal or hepatic impairment, but severe hepatic impairment has not been studied.

Dosing & administration

Initiate 10 mg once daily with food for 7 days, increase to 20 mg once daily for 7 days, then advance to 40 mg once daily with food if tolerated.
Limit to 20 mg/day when co-administered with strong CYP3A4 inhibitors (ketoconazole, clarithromycin); monitor carefully with moderate inhibitors. Avoid strong CYP3A4 inducers (carbamazepine, rifampin, St. John’s wort) because exposure is markedly reduced.
If therapy is interrupted for >3 days, restart the titration to minimize GI adverse effects; taper to 20 mg then 10 mg over at least 1 week when discontinuing to limit withdrawal symptoms.

Adverse effects

FDA boxed warnings

Antidepressants increase the risk of suicidal thinking and behavior in children, adolescents, and young adults—monitor closely during initiation and dose changes.

Common side effects (≥10%)

Diarrhea: Most frequent adverse effect; often improves after the first 1–2 weeks—taking with food helps.
Nausea: Mitigated by gradual titration and morning dosing with meals.
Insomnia or vivid dreams: Prefer morning administration and assess for activation.
Headache and dizziness: Usually transient; educate on fall precautions during titration.

Other notable effects

Activation/anxiety, especially during early titration—consider slower titration if patients report jitteriness.
Hyponatremia/SIADH has been reported with serotonergic agents; monitor sodium when risk factors (older age, diuretics) exist.
Mania/hypomania can emerge in susceptible patients—screen for bipolar disorder prior to initiation and coordinate care through the bipolar disorder hub.

Interactions

Strong CYP3A4 inhibitors (ketoconazole, itraconazole, clarithromycin) increase exposure—limit to 20 mg/day; monitor when moderate inhibitors are used.
Strong CYP3A4 inducers (carbamazepine, rifampin, phenytoin, St. John’s wort) significantly lower concentrations; avoid combination or select an alternative antidepressant.
Contraindicated with MAOIs, linezolid, and methylene blue—observe 14-day washouts to reduce serotonin syndrome risk.
Additive serotonergic effects with SSRIs, SNRIs, triptans, lithium, or tramadol; counsel on serotonin syndrome symptoms and monitor closely.
Heightened bleeding risk when combined with NSAIDs, antiplatelets, or anticoagulants—ensure gastroprotection when appropriate.

Other useful information

Counsel patients to take vilazodone with a substantial meal at the same time each day; missed doses taken without food may deliver subtherapeutic exposure.
Monitor for early insomnia, restlessness, and GI upset; supportive care (taking with breakfast, hydration, antidiarrheals) can improve adherence.
Discuss pregnancy planning; data are limited, so weigh maternal benefit versus fetal risk and coordinate with obstetrics for individualized decisions.

References

Related hubs:SMI toolkit·Support resources