Vilazodone
Pronunciation: vye-LAZ-oh-done.
- Generic name
- vilazodone
- Drug class
- Serotonin reuptake inhibitor and 5-HT1A receptor partial agonist antidepressant
- Form
- Tablet (commonly 10 mg, 15 mg, 20 mg, 40 mg, depending on market and titration stage)
- Route
- Oral
- Legal status
- Prescription-only in the United States and Canada, the two markets confirmed authorised in this review
Availability and supply rules vary by country
Trade names by country: United States · Canada
Australia: · Full directory
Boxed warning: Increased risk of suicidal thinking and behaviour in children, adolescents, and young adults
Vilazodone (Viibryd) carries a boxed warning (the US FDA's strongest safety warning), the same class-wide warning carried by other antidepressants: antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients in short-term studies. All patients being treated with an antidepressant for any indication should be monitored closely for clinical worsening and emergence of suicidal thoughts, especially early in treatment and after a dose change. Families and caregivers should be told about this need for close observation and should be given clear instructions to contact the prescriber immediately if these signs appear. Viibryd is not approved for use in pediatric patients. (1)
What vilazodone is and how it works
Vilazodone is a prescription antidepressant that combines two mechanisms: it is a serotonin reuptake inhibitor (like an SSRI) and also a partial agonist at the 5-HT1A serotonin receptor. It is approved for major depressive disorder in adults. It must be taken with food -- without food, the body absorbs roughly half as much of the dose, which can reduce how well it works. (1)
Vilazodone carries a genuine safety warning shared with other antidepressants: in short-term studies, antidepressants were linked to an increased risk of suicidal thinking and behaviour in children, adolescents, and young adults. It is not approved for use in children. Anyone starting vilazodone, at any age, should be watched closely for worsening mood or new suicidal thoughts, especially in the first few weeks or after a dose change, and should know to contact their prescriber immediately if these appear.
Mechanism of action: how vilazodone works
Vilazodone combines serotonin reuptake inhibition with partial agonism at the 5-HT1A serotonin receptor, a dual mechanism distinct from a standard SSRI. This is thought to contribute to its antidepressant effect while potentially mitigating some SSRI-typical side effects, though the precise clinical significance of the 5-HT1A partial-agonist component relative to a standard SSRI is not fully established in the label reviewed. (1)
What vilazodone is used for
Major depressive disorder (depression) in adults
Used to treat major depressive disorder (MDD) in adults. It is not approved for use in children or adolescents, and its efficacy has not been demonstrated in pediatric trials. (1)
Before taking vilazodone
Do not take / not appropriate for
- Do not take vilazodone if you are taking, or have taken within the last 14 days, a monoamine oxidase inhibitor (MAOI), including the antibiotic linezolid or IV methylene blue -- combining these can cause a serious, potentially fatal reaction (serotonin syndrome). At least 14 days must pass in either direction between stopping one and starting the other. (United States, Canada) (1)
- Do not take vilazodone if you have a known serious allergic reaction to vilazodone or its ingredients. (United States, Canada) (1)
Tell your clinician about
- Any history of suicidal thoughts, self-harm, or a family history of bipolar disorder or mania.
- Any history of untreated narrow (angle-closure) glaucoma.
- Any history of low blood sodium (hyponatraemia), especially if you are elderly.
- Any history of bleeding problems, or if you take anticoagulants, aspirin, or NSAIDs.
- All other medicines, especially MAOIs, other serotonergic medicines, and any strong CYP3A4 inhibitor or inducer (e.g., itraconazole, clarithromycin, carbamazepine, rifampin).
- Whether you are pregnant, plan to become pregnant, or are breastfeeding.
How to take vilazodone
- Always take vilazodone with food -- absorption is reduced by about 50% without food, which can make it less effective.
- Usually taken once daily.
- It can take several weeks of treatment before the full effect on mood is felt -- do not expect an immediate result.
- Any change in dose, or a decision to stop vilazodone, should always be made together with your prescriber, not on your own, given the risk of discontinuation symptoms.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3)
Missed dose
If you miss a dose, contact your prescriber or pharmacist for guidance rather than taking a double dose. Take your next dose with food as usual.
Overdose
Seek urgent medical attention if you think too much vilazodone has been taken, or if you notice symptoms such as severe drowsiness, confusion, an irregular or fast heartbeat, or signs of serotonin syndrome (see Serious Warnings). Take the medicine packaging with you if possible. (1)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms.
Diarrhea (one of the most common side effects reported).
What to notice: Diarrhea (one of the most common side effects reported).
What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)
Nausea (led about 1.4% of clinical-trial patients to stop treatment).
What to notice: Nausea (led about 1.4% of clinical-trial patients to stop treatment).
What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)
Vomiting.
What to notice: Vomiting.
What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)
Insomnia.
What to notice: Insomnia.
What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)
Serious warnings
Worsening depression or emergence of suicidal thoughts (especially in children, adolescents, and young adults) — boxed_warning
Symptoms: New or worsening depression, anxiety, agitation, panic attacks, irritability, hostility, aggression, impulsivity, restlessness, unusual changes in behaviour, or thoughts of suicide or self-harm -- particularly in the first few weeks of treatment or after a dose change.
Action: Contact your prescriber immediately, or seek emergency help if there is any immediate danger. Families and caregivers should watch closely for these signs, especially early in treatment, and report them to the prescriber right away. Vilazodone is not approved for use in children. (1)
Signs of serotonin syndrome — emergency
Symptoms: Agitation, hallucinations, fast heartbeat, high body temperature, muscle rigidity or twitching, loss of coordination, sweating, nausea, vomiting, or diarrhea -- especially if combined with another serotonergic medicine or an MAOI.
Action: Seek emergency medical help immediately. This is a rare but potentially life-threatening reaction; your prescriber will manage any concurrent serotonergic medicines with this risk in mind. (1)
Unusual bleeding or bruising — high caution
Symptoms: Nosebleeds, easy bruising, blood in vomit or stool, or unusually heavy menstrual bleeding -- risk is higher when combined with NSAIDs, aspirin, or anticoagulants.
Action: Contact your prescriber for assessment, particularly if you also take a blood-thinning or anti-inflammatory medicine. (1)
Signs of mania or hypomania — high caution
Symptoms: Unusually elevated mood, racing thoughts, decreased need for sleep, or impulsive behaviour.
Action: Contact your prescriber for assessment before continuing treatment as before -- screening for bipolar disorder is recommended before starting vilazodone. (1)
Eye pain or vision changes (possible angle-closure glaucoma) — high caution
Symptoms: Eye pain, changes in vision, or swelling/redness in or around the eye.
Action: Seek prompt medical attention. Vilazodone should be avoided in patients with untreated narrow (angle-closure) glaucoma. (1)
Signs of low blood sodium (hyponatraemia) — high caution
Symptoms: Headache, confusion, weakness, unsteadiness, or in severe cases seizures -- more common in elderly patients.
Action: Contact your prescriber promptly for assessment, especially if you are elderly. (1)
Interactions
- Monoamine oxidase inhibitors (MAOIs), including the antibiotic linezolid and IV methylene blue: must not be combined with vilazodone, due to risk of a serious, potentially fatal reaction (serotonin syndrome). A 14-day washout period is required in both directions. (1)
- Other serotonergic medicines (triptans, tricyclic antidepressants, lithium, tramadol, St John's Wort): increase the risk of serotonin syndrome. (1)
- Strong CYP3A4 inhibitors (e.g., itraconazole, clarithromycin, voriconazole): raise vilazodone blood levels -- dose should not exceed 20 mg/day, per your prescriber. (1)
- Strong CYP3A4 inducers used for more than 14 days (e.g., carbamazepine, phenytoin, rifampin): lower vilazodone blood levels -- your prescriber may consider a dose increase up to 80 mg/day. (1)
- Anticoagulants, aspirin, and NSAIDs: combined use with vilazodone is associated with a higher risk of bleeding. (1)
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
Vilazodone is used in pregnancy only when the clinical need justifies the risk, decided together with your prescriber. Third-trimester exposure has been associated with an increased risk of persistent pulmonary hypertension of the newborn (PPHN) and neonatal withdrawal-type symptoms, and a less-than-2-fold increased postpartum haemorrhage risk has also been described. (1) (2) (3)
Breastfeeding
Vilazodone is excreted in animal milk; human lactation risk is not established. Discuss breastfeeding with your prescriber to weigh benefits and risks. (1) (2) (3)
Children
Not approved for use in children or adolescents. Safety and efficacy have not been established, and efficacy was not demonstrated in pediatric trials; the boxed-warning suicidality risk is elevated in this age group. (1) (2) (3)
Elderly
No age-based dose adjustment is required, but conservative dosing and monitoring for hyponatraemia are recommended by the prescriber. (1) (2) (3)
Hepatic_impairment
No dose adjustment required for mild-to-severe hepatic impairment per the label reviewed; your prescriber will confirm this applies to you. (1) (2) (3)
Renal_impairment
No dose adjustment required per the label reviewed; your prescriber will confirm this applies to you. (1) (2) (3)
Source_ids
Monitoring
Before starting
- Assessment for personal or family history of bipolar disorder, mania, or suicidal thoughts
- Screening for untreated narrow-angle glaucoma
- Review of all other medicines for MAOI, serotonergic, or CYP3A4 interactions
- Baseline blood sodium level if at higher risk (e.g., elderly)
During treatment
- Close monitoring for worsening mood or emergence of suicidal thoughts, especially in the first few weeks of treatment or after a dose change.
- Monitoring for signs of serotonin syndrome if other serotonergic medicines are used concurrently.
- Monitoring for unusual bleeding, especially if combined with NSAIDs, aspirin, or anticoagulants.
Storage
Store at room temperature, away from moisture and direct light, out of reach of children.
Study the drug class: SNRIs and other antidepressants
Professional information
Clinician-facing context only, sourced from the current US FDA prescribing information and Health Canada Drug Product Database entry reviewed for this dossier; verify against the current full label before prescribing.
United States, Canada
Indication: Major depressive disorder (adults)
Dose summary: Days 1-7: 10 mg/day with food. Days 8-14: 20 mg/day with food. Day 15+: may increase to 40 mg/day with food (>=7 days between increases). Maintenance range 20-40 mg/day; maximum 40 mg/day. Must be taken with food (absorption reduced ~50% without food).
Renal context: No dose adjustment required for mild-to-severe renal impairment per the label reviewed. (1) (2)
Hepatic guidance
No dose adjustment required for mild-to-severe hepatic impairment per the label reviewed.
Overdose note
Manage with supportive care and close monitoring for cardiac and CNS effects and serotonin syndrome; no specific antidote. (1)
Frequently asked questions
Is vilazodone available in the US, UK, Europe, Canada, Australia, and New Zealand?
Confirmed availability in this review is limited to the United States (Viibryd) and Canada (Viibryd, Health Canada DIN 02443724, Marketed status confirmed 2024-01-17). A direct UK search found no licensed vilazodone product. Availability in the European Union, Australia, and New Zealand could not be confirmed via a primary regulator source despite genuine search attempts -- do not assume it mirrors the US/Canada situation. (1) (2) (3)
Why does vilazodone have a boxed warning about suicidal thoughts?
Because in short-term clinical trials, antidepressants as a class -- including vilazodone -- were linked to a higher rate of suicidal thinking and behaviour in children, adolescents, and young adults, compared with placebo. Vilazodone is not approved for use in children. Anyone starting vilazodone at any age should be watched closely for worsening mood or new suicidal thoughts, especially early in treatment, and should contact their prescriber immediately if these appear. (1)
Why must vilazodone be taken with food?
Because absorption is reduced by about 50% if it is taken without food, which can make it less effective. Always take vilazodone with a meal. (1)
Can I take vilazodone if I'm also taking another antidepressant or an MAOI?
Vilazodone must never be combined with a monoamine oxidase inhibitor (MAOI), and a 14-day washout period is required in both directions because of the serious, potentially fatal risk of serotonin syndrome. Combining vilazodone with other serotonergic medicines also needs your prescriber's assessment. Never start, stop, or combine antidepressants without medical guidance. (1)
What is the mechanism of action of vilazodone?
Vilazodone combines serotonin reuptake inhibition with partial agonism at the 5-HT1A serotonin receptor, a dual mechanism distinct from a standard SSRI. This is thought to contribute to its antidepressant effect while potentially mitigating some SSRI-typical side effects, though the precise clinical significance of the 5-HT1A partial-agonist component relative to a standard SSRI is not fully established in the label reviewed. (1)
References
- VIIBRYD (vilazodone hydrochloride) tablet -- full prescribing informationU.S. Food and Drug Administration / DailyMed (NIH), full prescribing information · United States · dated 2024-01-01 · accessed 2026-07-30 · source 1
- VIIBRYD (vilazodone hydrochloride 10 mg) -- Drug Product Database entryHealth Canada -- Drug Product Database (DPD) · Canada · dated 2024-01-17 · accessed 2026-07-30 · source 2
- emc search: 'vilazodone' -- No search resultselectronic medicines compendium (emc), United Kingdom -- product search · United Kingdom · dated 2026-07-30 · accessed 2026-07-30 · source 3
Brand names by country
Single-ingredient vilazodone names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- VIIBRYD10 mg, 20 mg, 40 mg · allergan, inc.
Canada
- Viibryd (2)health canada dpd confirmed marketed din 02443724 · 10 mg tablets (DIN 02443724); additional strengths per product monograph · AbbVie Corporation (Saint-Laurent, Quebec)