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ViiBryd (vilazodone), a new SSRI


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Hi Sydney!

 

Just jumping in here with my usual recommendation for anyone with a psychiatric diagnosis who is taking or has been taking psych drugs, especially polydrugs: Anatomy of an Epidemic by Robert Whitaker, and The Emperor's New Drugs by Irving Kirsch.

 

I also am a member of the polydrug club and for many years took Wellbutrin and Buspar, along with Xanax and amitriptyline, and later Lamictal and Neurontin. And a few other things along the way. Now tapering off Celexa, Lamictal, Neurontin, Xanax and Valium.

Started on Prozac and Xanax in 1992 for PTSD after an assault. One drug led to more, the usual story. Got sicker and sicker, but believed I needed the drugs for my "underlying disease". Long story...lost everything. Life savings, home, physical and mental health, relationships, friendships, ability to work, everything. Amitryptiline, Prozac, bupropion, buspirone, flurazepam, diazepam, alprazolam, Paxil, citalopram, lamotrigine, gabapentin...probably more I've forgotten. 

Started multidrug taper in Feb 2010.  Doing a very slow microtaper, down to low doses now and feeling SO much better, getting my old personality and my brain back! Able to work full time, have a full social life, and cope with stress better than ever. Not perfect, but much better. After 23 lost years. Big Pharma has a lot to answer for. And "medicine for profit" is just not a great idea.

 

Feb 15 2010:  300 mg Neurontin  200 Lamictal   10 Celexa      0.65 Xanax   and 5 mg Ambien 

Feb 10 2014:   62 Lamictal    1.1 Celexa         0.135 Xanax    1.8 Valium

Feb 10 2015:   50 Lamictal      0.875 Celexa    0.11 Xanax      1.5 Valium

Feb 15 2016:   47.5 Lamictal   0.75 Celexa      0.0875 Xanax    1.42 Valium    

2/12/20             12                       0.045               0.007                   1 

May 2021            7                       0.01                  0.0037                1

Feb 2022            6                      0!!!                     0.00167               0.98                2.5 mg Ambien

Oct 2022       4.5 mg Lamictal    (off Celexa, off Xanax)   0.95 Valium    Ambien, 1/4 to 1/2 of a 5 mg tablet 

 

I'm not a doctor. Any advice I give is just my civilian opinion.

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I'm amazed at some of the things I've been a sucker for.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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  • 1 month later...
  • Administrator

Hello, CaptHowdy.

 

Surely you jest.

 

Please start a topic in the Intro section and tell us about yourself.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • 2 months later...

After what I've went through this past weekend, I never want to hear of this medication again! After the insomnia, dry heaves, nausea, blurred vision (which is starting to clear up) I finally had enough. I called the clinic's crisis line. The counselor on the other end called my psych. She called back 3 minutes later stating the doctor ordered me to discontinue use, and call for a followup on Monday. Monday, I was feeling well enough that I was able to mow the lawn, as well as fill out a few job applications online. I called him on monday, and talked to his nurse. She transferred me to the medication office, and I have yet to hear back. Last night, I was up every hour on the hour. I finally got to sleep (fitfully) around 2:00 am. I was up again around 9:00 am when I got a phone call for a job interview with a local catering company as a customer service rep.

 

I'm so hacked at this clown of a psych, I'm changing doctors. All the lit I've seen on Viibryd says you have to discontinue slowly. The psych has me on 10mg of this junk, which has given me fits from the start. He tells me to drop Viibryd cold turkey. I'll be definitely be looking for a new psych. When I first started with this clinic they had me in group therapy. Now I can't even find group therapy in this clinic. But I guarantee, except for my diabetes and hypertension, no more antidepressants or psychotropics.

History:

1995--Prozac--Quit CT by GP

1995--Effexor--Quit per my GP

1996--Amitriphene--Quit CT when changed GP

2005--Citalopram and BusPar. Prescribed when I decompensated in my GP's office. GP referred me to behavior health. Psychiatrist prescibed these drugs. Taken off citalopram in 2011 due to FDA warning. Quit Buspar during transition to viibryd.

Viibryd--2011 to present. Had a severe reaction in March 2012. Advised both GP and Psychiatrist I was trying to get off these drugs.

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  • 1 month later...

Viibryd not effective in treating depression - Tell me something I don't already know

 

This from a PowerPoint presentation given at the Riverside community regional medical center in Riverside, CA

 

ANTIDEPRESSANTS 

•   You'll see Viibryd (VI-brid) marketed as a new "dual-acting" serotonergic antidepressant. 

   Viibryd (vilazodone) inhibits serotonin reuptake like SSRIs...plus it's also a partial serotonin agonist. 

   The company hoped Viibryd would be more effective than SSRIs. 

   But it's not. 

   Viibryd doesn't work better than fluoxetine or citalopram...and it causes more GI side effects. 

   You might also hear that Viibryd has a low risk of sexual side effects...but it's too soon to tell if this is true. 

   Viibryd comes in a starter kit to help minimize GI problems. If you start a patient on Viibryd, give 10 mg/day for 7 days...20 mg/day for 7 days...then 40 mg/day thereafter. 

   Don't exceed 20 mg/day if patients are taking a strong CYP3A4 inhibitor...ketoconazole, clarithromycin, ritonavir, etc. 

   Tell patients to take Viibryd with food for adequate absorption...and caution about possible nausea, diarrhea, insomnia, and dizziness. 

   Viibryd will cost $150 per month. Continue to use an SSRI or SNRI first for depression.

Edited by Altostrata
added title

History:

1995--Prozac--Quit CT by GP

1995--Effexor--Quit per my GP

1996--Amitriphene--Quit CT when changed GP

2005--Citalopram and BusPar. Prescribed when I decompensated in my GP's office. GP referred me to behavior health. Psychiatrist prescibed these drugs. Taken off citalopram in 2011 due to FDA warning. Quit Buspar during transition to viibryd.

Viibryd--2011 to present. Had a severe reaction in March 2012. Advised both GP and Psychiatrist I was trying to get off these drugs.

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Would you list a reference to where this was found and who presented it? I'm not questioning the info, but important to know the source.

Thanks.

Pristiq tapered over 8 months ending Spring 2011 after 18 years of polydrugging that began w/Zoloft for fatigue/general malaise (not mood). CURRENT: 1mg Klonopin qhs (SSRI bruxism), 75mg trazodone qhs, various hormonesLitigation for 11 years for Work-related injury, settled 2004. Involuntary medical retirement in 2001 (age 39). 2012 - brain MRI showing diffuse, chronic cerebrovascular damage/demyelination possibly vasculitis/cerebritis. Dx w/autoimmune polyendocrine failure.<p>2013 - Dx w/CNS Sjogren's Lupus (FANA antibodies first appeared in 1997 but missed by doc).

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Yes, meistersinger, always include links (if available), authors, and sources in these kinds of informational posts.

 

I moved this topic because the Journals section requires a formal citation and abstract. It is for scientific articles only.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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Would you list a reference to where this was found and who presented it? I'm not questioning the info, but important to know the source.

Thanks.

 

This was not from a formal, peer-reviewed paper. it was part of a PowerPoint presentation at this hospital, the link I can't currently find in safari for iPhone's cache.

History:

1995--Prozac--Quit CT by GP

1995--Effexor--Quit per my GP

1996--Amitriphene--Quit CT when changed GP

2005--Citalopram and BusPar. Prescribed when I decompensated in my GP's office. GP referred me to behavior health. Psychiatrist prescibed these drugs. Taken off citalopram in 2011 due to FDA warning. Quit Buspar during transition to viibryd.

Viibryd--2011 to present. Had a severe reaction in March 2012. Advised both GP and Psychiatrist I was trying to get off these drugs.

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  • 5 months later...
  • Administrator

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Interesting info about ViiBryd from Duquesne University School of Pharmacy www.duq.edu/Documents/aboutus/publications/PIC/Question-SSRI/Viibryd/Titration.pdf (pdf):

 

....

Vilazodone (Viibryd), a new oral antidepressant in the same class at nefazodone (Serzone), received

FDA-approval in January 2011 for the treatment of major depressive disorder (MDD) in adults. Vilazodone

inhibits reuptake of serotonin with partial 5-HT1A receptor agonist activity; however, its antidepressant effect is attributed to its SSRI properties. Like nefazodone, vilazodone is metabolized by CYP 3A4 into an active metabolite known as meta-chlorophenylpiperazine (mCPP). This metabolite has a high affinity for a number of serotonin receptors, including 5-HT2C where it functions mostly as an agonist throughout the CNS.

 

Stimulation of 5-HT2C under normal circumstances will initially produce some degree of anxiety,

restlessness, and dysphoria; however, continued use seems to produce a paradoxical effect and have resultant

antianxiety effects. SSRIs including citalopram typically have an antagonist effect at 5-HT2C resulting in

receptor up-regulation; therefore, discontinuation of a SSRI and addition of Viibryd, results in both loss of 5-HT2C antagonism and additive agonist effects. The effect is profound dysphoria and anxiety. These effects

will taper off with continued use, but a careful titration schedule needs to be in place to mediate the effects at the initiation of vilazodone therapy.

 

Currently, no recommendations are available on switching from an SSRI to vilazodone, so nefazodone

recommendations are concluded to provide the most probable recommendations for vilazodone. It is

recommended to taper off the citalopram over 2-4 weeks depending on the current dose and complete a seven

day washout period (based on a half-life of 35 hours). Then carefully initiate the vilazodone starting at 10 mg and titrating to a final recommended dose of 40 mg. The titration schedule of vilazodone when switching

from an SSRI should be much more conservative with step-ups in therapy every 10-14 days, as opposed to

every week when vilazodone is the initial therapy for MDD.

 

References:

 

Ferentz KZ. A guide to switching anti-depressant therapy. Patient Care Neurology and Psychology.

2007;16-21.

Callahan PM, Cunningham KA. Involvement of 5-HT2C receptors in mediating the discriminative

stimulus properties of m-chlorophenylpiperazine (mCPP). Eur J Pharmacol. 1994;257:27-38.

Stahl SM. Mechanism of action of trazodone: a multifunctional drug. CNS Spectr. 2009;14:536-46.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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I saw an ad for Viibryd a couple of days ago and was saddened. My thinking is that new and more effective antidepressants translates to more brain damage on and worse SE getting off . The name makes me want to throw up!

15+ years on various ADs and combos. Spent 3 yrs tapering (off & on ) off 225mg Effexor venlafaxine) XR & Remeron (mirtazapine). Finished tapering Oct 2014.

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ViiBryd is not more effective than any other antidepressant. It's another con job.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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I realized why the name bugs me so much. It reminds me of soma from Huxley's Brave New World.

15+ years on various ADs and combos. Spent 3 yrs tapering (off & on ) off 225mg Effexor venlafaxine) XR & Remeron (mirtazapine). Finished tapering Oct 2014.

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It does, doesn't it?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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  • 7 months later...

So, what's the answer?  It's a sad world we live in when all psych's are different and have different opinions.  Idiots to say don't taper!!!

Jennie

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Doctors do not know enough about these drugs and their adverse effects to be prescribing them.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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