Vilazodone (Viibryd)

[enduin]

I tried using the search engine, but couldn't really find much on the forum about this drug, probably because it's so new.


My wife has been prescribed Viibryd to try for her depression, and given that we are both really skeptical about AD in general we've been doing some research on it, trying to understand if it's something she's willing to take.
The Doc said its a great drug because it doesn't have the usual sexual/sleep side effects as normal SSRI.

Now I've been reading a few reports on a social anxiety forum, and besides the fact that seems like no one really likes this drug, and while not erasing libido it's also less helpful with mood, there is a consistency of complains about GI side effects (diarrhea, stomach ache, nausea, etc) that caught my attention.

From my understanding the difference between Viibryd and the usual SSRIs is that on top of the SERT blockade Vilazodone also acts as a partial 5-HT1a agonist.
Now, knowing that excess 5-HT in the bloodstream activates the receptors in the stomach (the classic MDMA induced nausea/vomiting, but also with high 5-htp dosages) and causes GI side effects, I was wondering if Viibryd's GI side-effects are caused by Vilazodone activating the 5-HT receptors around the body because of its partial agonist effect.
And if that is true would it make sense to think that long term use of Vilazodone can increase the chances of developing cardiac fibrosis via activation of the heart's 5-HT receptors (even though seems like 5-HT2b are involved in cardiac fibrosis and Vilazodone agonist effect should involve 5-HT1a only)?

If someone can shed some light it would be greatly appreciated!

 

[Epsilon Alpha]

Well firstly it might be wise to continue on with treatment for a few weeks and consult your doctor before making any changes.

Vilazodone is, in my opinion, just another SSRI. I'm not too hopeful for it doing much else other than the standard SSRI. SSRI's in general cause start up GI issues due to the body adapting to the drug.

SSRI's in general have actually been shown to have a moderately protective effect on cardiovascular issues, so I wouldn't sweat it too much. But, with new drugs there's always that random chance that they find something new and horrific.

But, I'm pretty sure Merck made up the "less sexual side effects" claim. 5HT1A activation will increase arousal, but at the same time it inhibits erections (yes it happens in women too).

 

[enduin]

She's not on the Vilazodone yet. And she's not on any AD at the moment. She is still trying to decide if she wants to start taking it or not, and I'm helping her to find more info so that she can make up her mind.
I also got the feeling that it's just another SSRI with slightly different side effects profile, and on top of that the complete uncertainty of what it can do long term. But I'd appreciate any extra feedback or info!

 

[panic_the_digital]

I am very skeptical of the SE claims as it is a close relative of trazodone, which is used off-label for sleep pretty regularly. Not sure on the sexual SE's, but I suspect it is a nothing special me too.

 

[drdoctor]

Some folks seem to have a pro-sexual response to Trazadone, god knows why. Perhaps the mCPP metabolite? Not that any of the pipes have been pleasant to me...

 

[negrogesic]

Yes; toxicities could be made manifest via the pathways you mentioned (and even more via pathways not mentioned or those not currently attributed to the drug). Beyond this is dangerous conjecture. Safer, cheaper and equally efficacious drugs are likely available for your wife.

What I do know, is that this drug is being pushed hard by the reps/dtp ads. Not surprisingly, there is a heavy emphasis on a purported 'sexual' advantage. Reps pushing this drug have been known to be quite aggressive and disreputable (no pun intended - or required).

Drugs obviously need a market and paying 'test-subjects', but make sure you are comfortable paying the premium.

 

[kittyparade]

I've been on Viibryd for over six weeks now; it seems to be no different from any other SSRI I've tried in terms of effects on sex drive or sleep and I had pretty uncomfortable GI effects at the start. It's really expensive, like $150 or something for a 30 day supply -probably why it's so heavily pushed- so it might be worth it to consider other SSRIs or another form of antidepressant. Definitely not everything that my doctor hyped it up to be.

 

[kakti]

My girlfriend has been on it for just over a month now. Previously she was on Buproprion but had about a two year break between. As expected the first two-three weeks there wasn't much difference but now she is very energetic and positive. Sexual drive is....full force, but always has been.

I know this wasn't asked but I can say mdma didn't do anything for her, cocaine works as well as usual.

 

[enduin]

Thanks guys for the feedback!
So far this is consistent with the opinions and reviews I've seen around: mostly negative with very few positive ones.
Besides the fact that I'm not really sold on SSRIs, I'm also quite wary of new aggressively pushed drugs, and so is my wife, so I have a feeling in the end she's not gonna want to take it.

 

[negrogesic]

I should caution against any overemphasis on my comments regarding how the drug has been marketed.

For example, Lyrica was so aggressively marketed, that physicians and consumers were strongly 'reminded' about an controversial indication for which it could be prescribed (fibro). Nonetheless, pregabalin is a rather unique drug that has some real advantages over gabapentin, etc.

In other words, on occasion some of these heavily pimped drugs can pull a decent trick or two.

 

[Cloroxtastebad]

Thanks guys for the feedback!
So far this is consistent with the opinions and reviews I've seen around: mostly negative with very few positive ones.
Besides the fact that I'm not really sold on SSRIs, I'm also quite wary of new aggressively pushed drugs, and so is my wife, so I have a feeling in the end she's not gonna want to take it.

I personally have tried numerous ssri's with varied results, bu one thing they all had in common was a numbing effect on me. Emotionally speaking that is. Vilazodone, of which I'm currently on 40mg of, has not given me the numbness that turned me away from other ssri's. The sexual side effects have been little to nothing.

One thing to keep in mind, is that with a new drug of the ssri class, which hasn't seen a new approved one in the USA for years, its not out of the ordinary for many negative comments and discussion about it. People tend to share their bad experiences way more often than positive ones. It will be hard to determine the true effectiveness of this drug until it has been out for a much longer period.

 

[Crimethink]

In my experience Vilazodone was just like any other SSRI - maybe a bit less edgy.
If you're worried about GI, sexual side effects or anxiety (same receptor 2a) you can add on cyproheptadine or Remeron to an antidepressant you think would be better suited to you. Remeron has the benefit of sometimes working in as little as 24hrs, prevents SSRI side effects - though it can cause sedation initially & increased appetite.

 

[arctica]

From what I understand, Viibryd has some similarities to both SSRIs and Abilify, which is often used to augment other antidepressants. Both Viibryd and Abilify (I was taking them on separate occasions maybe a year apart) made me acutely suicidal the first 2-3 days I was on the drug, but the agitation has seemed to diminish over the last few weeks. Also, Viibryd gave me a skin rash, FWIW. Abilify is a newer antipsychotic, partial agonist at D(2) and 5-HT(1A) receptors, antagonist at 5-HT(2A).

Vilazodone is, in my opinion, just another SSRI. I'm not too hopeful for it doing much else other than the standard SSRI. SSRI's in general cause start up GI issues due to the body adapting to the drug.

I think the big(?) difference is that regular SSRIs don't have any 5HT1A agonist properties. I read on another forum that someone's shrink was suggesting people who don't have insurance coverage for Viibryd could try a "poor man's version" by augmenting a regular SSRI with buspirone/Buspar which is available in generic to see if they got any effect. Obviously not to be taken as medical advice, but an interesting thought experiment.

 

[puffj]

Forest Pharmaceuticals. Celexa. Huge drug. Went generic, so they evergreened it and took the s-antiomer of it and put it in a new pill. Celexa or citalopram if you prefer is a racemic mix of r and s citalopram. The patent on celexa ran out, forest needed a new blockbuster anti-depressant. So they took their racemic blend and just separated the s citalopram and patented it. Now it's called escitalopram, or Lexapro. Maybe you've heard of it. This is called evergreening. Taking a drug and patenting a purer form of it. Lexapro's patent ran out last year. Guess who had no new blockbuster to make up for it? They had hoped a drug called savella would get approved for depression (milnacipran) because in france it's approved for depression... but the fda looked at the research and said it was a shit drug and gave it approval for fibromyalgia... and I've heard it works terribly. So now forest needs another drug. Along comes Viibryd. Not even as good as lexapro, but the reps tell the doctors it's better safer less side effects trials have shown b lah blah blah. Nope. It's a shit drug. Lexapro works better and Celexa works the exact same as lexapro. The FDA needs to start denying drugs that aren't actually more effective than their predecessor's because the market is now being flooded with drugs that actually work worse and people are being hurt by them and paying insane money for them. And it's made the pharma industry focus on how they can get their next big bullshit drug out the door asap without investing any time or money into new drug research to see if, gasp, god forbid they can find something better. Viibryd is shit. it's worse than lexapro. Don't be fooled. Take it from a guy who almost worked for forest until I met their managers and saw how sleazy and disgusting the were.