vilazodone VIIBRYD
Class: SPARI/Phenylpiperazine-2-benzofurancarboxamideFDA Indications: MDD
Off-Label Use: Anxiety
Prescribing
Forms: 10, 20, 40mg tabletDose Range: 20-40 mg/day
Starting: Start with 10 mg qd x7 days, followed by 20 mg qd x7 days, then ↑ to 40 mg qd. Should be taken with food!
Precautions
Contraindications: Concomitant use of MAOIsSerious Side Effects: Serotonin syndrome; ↑ risk of SI in children and young adults; may impair platelet aggregation; SIADH
Side Effects: headache, diarrhea, nausea, dizziness, insomnia, abnormal dreams, hyperhidrosis, sexual dysfunction
Pharmacodynamics
1° MOA: Serotonin partial agonist and reuptake inhibitor2° MOA: 5-HT1A receptor partial agonist
Target: SERT, 5HT1A
Pharmacokinetics
t½: 25 (20-30)° TMAX: 4-5°Substrate of: 3A4; 2D6, 2C19
Inhibits: ∅ ; Induces: ∅
Active Metabolites: ∅
DDIs
- - DO NOT CO-PRESCRIBE WITH MAOIs (need a 14-day washout period)
- - 3A4 inhibitors can ↑ levels; likewise, 3A4 inducers can ↓ levels
Misc
- - AUC ↓ ~50% if not taken with food
- - preferentially occupies 5HT1A autoreceptor vs the postsynaptic receptor, which has been theorized to accelerate and augment the clinical effects of SSRI
- - Clinical trials showed significant antidepressant efficacy with an onset of effect in 1 week, unlike other antidepressants
- - exhibits dose-proportional linear pharmacokinetics
- - minimal sexual dysfunction
Special Populations
Category C—There are no adequate and well-controlled studies in pregnant women
There are no clinical data regarding the effect on lactation and nursing
There were no pharmacokinetic differences for vilazodone in patients >65
Mild to severe renal impairment does not affect the clearance.
Mild to severe hepatic impairment does not affect the clearance.
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