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Vilazodone

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Molecule Summary

Uses
Major Depressive Disorder (MDD) in adults
Therapy
Anti-Depressant
Side Effects
Dry Mouth, Nausea, Vomiting, Diarrhoea, Tiredness, Weakness, Strange Dreams, Headache, Difficulty Urinating, Blurred Vision, Burning Sensations or Tingling in the Hands or Feet, Excessive Perspiration, Changes in Sex Desire, Delayed Ejaculation, Changes in Appetite or Weight, Disorientation, Unsteadiness
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Molecule Description

Vilazodone is a prescription medicine used to treat Major Depressive Disorder (MDD) or clinical depression in adults. Vilazodone belongs to a class of medicines called selective serotonin reuptake inhibitors (SSRI). The mode of action of Vilazodone is by maintaining the levels of a neurotransmitter called serotonin. Vilazodone limits the reuptake of serotonin by the nerve cells, increasing serotonin activity. Serotonin regulates mood and promotes positive thinking as well aiding in sleep and digestion.

Uses

  • As per CDSCO, Vilazodone is used to treat clinical depression/major depressive disorder in adults.

Contraindications

When should one not use Vilazodone

  • If you have an allergic reaction to Vilazodone
  • If you have uncontrolled angle-closure glaucoma (an eye condition causing high fluid pressure inside the eye)
  • If you have severe liver disease/liver failure
  • If you are on treatment (or have taken in the last 14 days) with monoamine oxidase inhibitors (MAOIs) like linezolid or intravenous methylene blue; this can result in serotonin syndrome

Side effects

Common side effects of this drug are:

  • Dry mouth
  • Nausea
  • Vomiting
  • Diarrhoea
  • Tiredness
  • Strange dreams
  • Headache
  • Difficulty urinating
  • Blurred vision
  • Burning sensations or tingling in the hands or feet
  • Excessive perspiration
  • Changes in sexual desire
  • Delayed ejaculation
  • Changes in appetite or weight
  • Disorientation
  • Change in gait or unsteadiness while walking

Precautions and Warnings

Pregnancy

Pregnancy

Vilazodone is not safe to use during pregnancy. A few studies have shown a definite risk to the foetus, especially if the medicine is used in the last trimester of pregnancy. Exposure in late pregnancy may cause pulmonary hypertension (increased blood pressure in the lungs) or withdrawal effects in the newborn. Your doctor will weigh the benefit-risk ratio before prescribing Vilazodone.

Breast Feeding

Breast Feeding

Vilazodone is generally not advised while breastfeeding. Limited data suggest that a small amount of this medicine may pass into breast milk and harm the baby. Data from animal studies show a definite risk to the foetus with decreased birth weight and delayed maturation.

Driving

Driving

Vilazodone may moderately impair alertness and concentration and may cause drowsiness, dizziness, slow reflexes, and blurred or double vision, especially at the beginning of treatment. Avoid driving while taking Vilazodone.

Alcohol

Alcohol

Do not consume alcohol when you are on treatment with Vilazodone. Alcohol can interfere with Vilazodone and cause exaggerated side effects like excessive drowsiness, blurred vision, restlessness, irregular heartbeat, low blood pressure, and heart blockage.

Other General Warnings

Other General Warnings

Talk to your doctor if
  • You have liver-related issues.
  • You have kidney-related issues.
  • You develop an irregular heartbeat after starting treatment with Vilazodone.
  • You recently had a heart attack or stroke.
  • You develop chest pain after starting treatment with Vilazodone.
  • You develop low blood sodium levels.
  • You have lung failure or have been diagnosed with respiratory or lung disease.
  • You have planned surgery or a dental procedure.
  • You need to take medication that might interact with Vilazodone.
  • You are an older adult over 65. The effects of this medicine are exaggerated in this age group.
  • You develop abnormal limb movements after starting Vilazodone.
  • You experience changes in sexual desires after taking Vilazodone.
  • You are on treatment with a blood thinner or have an episode of blood vomiting.
  • You use other anti-anxiety medicines or sedatives, as they can interfere with Vilazodone and cause adverse reactions.

Mode of Action

How Does It Work?

Vilazodone belongs to a class of medicines called selective serotonin reuptake inhibitors (SSRI). It exerts its action by maintaining the levels of a neurotransmitter called serotonin. Vilazodone limits the reuptake of serotonin by the nerve cells, increasing serotonin activity. Serotonin is a neurotransmitter (chemical messenger) that regulates mood and promotes positive thinking. Other functions such as sleeping, eating, and digestion also benefit from this medicine.

Interactions

Interactions with other medicines

  • Concomitant use of monoamine oxidase inhibitors (MAOIs) like selegiline and linezolid increases the risk of Serotonin Syndrome, which can be life-threatening.
  • Blood thinners/antiplatelet agents (aspirin) and anticoagulants (warfarin) increase the risk of bleeding.
  • Strong CYP3A4 enzyme inhibitors like antifungal medicines (itraconazole and voriconazole) and antibiotics (clarithromycin) increase the blood levels of Vilazodone leading to an increased risk of side effects.
  • Strong CYP3A4 enzyme inducers like anti-epileptic medication (carbamazepine and phenytoin) and anti-tuberculosis medication (rifampin) decrease the blood levels of Vilazodone leading to low efficacy of the medicine.
  • Medication used to treat heart failure (digoxin) increases digoxin blood levels leading to fatal arrhythmias (changes in heart rhythm).
  • Medicines that cause drowsiness like allergy medication (cetirizine), cold and cough medicine (codeine), opiates (tramadol), or narcotic pain relievers (fentanyl) with Vilazodone can increase the side effects of Vilazodone and cause extreme drowsiness.

Interactions with food items

  • Avoid grapefruit and its juice and other citrus fruits while on treatment with Vilazodone, as it can increase the potency of Vilazodone and worsen its side effects.

Dosage

Overdose

Vilazodone overdose may cause weakness, headache, difficulty urinating, blurred vision, burning sensations or tingling in the hands or feet, excessive perspiration, disorientation, unsteadiness or shakiness, sudden muscle movements, agitation, convulsion, confusion, hypotension, increased heart rate, diminished reflexes, and loss of consciousness. In case of a suspected overdose, immediately rush the affected person to the nearest hospital for emergency management.

Missed a Dose

If you have missed a Vilazodone dose, try to take the missed dose immediately. But if it is already time to take the next dose, skip the missed dose and take the next one. Do not take both doses together or within a few hours as it can cause an overdose.

Frequently Asked Questions (FAQs)

People with liver disease should exercise caution if using Vilazodone. The doctor will decide on dosage adjustments. Regular monitoring of liver function tests (LFT) is generally recommended.

Vilazodone is not recommended for children and adolescents under 18. The effectiveness and safety of this medicine are not proven for this age group. If your child is showing symptoms of depression, consult a doctor immediately for appropriate treatment.

Consult your doctor before taking Vilazodone if you have diabetes, as it might fluctuate blood glucose levels. Regular monitoring of blood sugar levels is advised. Talk to your doctor if you experience fluctuations in blood sugar levels after starting treatment.

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