Viibryd for Anxiety: Does Vilazodone Help, and What to Expect
Author:
Blossom Editorial
Viibryd (vilazodone) is an antidepressant approved by the FDA to treat major depressive disorder in adults. It isn't FDA-approved for anxiety, but it may help with generalized anxiety disorder (GAD), and some prescribers use it off-label for anxiety symptoms. Here's what the research shows, how Viibryd is taken, and what to consider when deciding whether it might fit your treatment plan.
Key Takeaways
Anxiety is common, and Viibryd is one possible option: About 2.7% of American adults have GAD in a given year, and Viibryd can have generally positive results for GAD over eight weeks.
It's used off-label for anxiety: Viibryd is FDA-approved only for depression, so prescribers usually consider it after first-line anxiety medications or when depression and anxiety occur together.
How you take it matters: Viibryd should be taken with food and started at a low dose that's increased gradually, so follow your prescriber's titration plan and report side effects like diarrhea or nausea.
What Is Viibryd?
Viibryd is the brand name for vilazodone, an antidepressant that combines two actions. Like other selective serotonin reuptake inhibitors (SSRIs), it blocks the reabsorption of serotonin, a brain chemical involved in mood and anxiety. It also acts as a partial agonist at serotonin 5-HT1A receptors, which means it partially activates a receptor that's involved in regulating anxiety.
That second action is similar to how buspirone, an anxiety medication, works. Because of this combination, vilazodone is sometimes described as a serotonin partial agonist reuptake inhibitor (SPARI). A generic version, vilazodone, is also available.
Is Viibryd FDA-Approved for Anxiety?
No. Viibryd is FDA-approved for major depressive disorder in adults. Prescribers can still use it for anxiety, which is known as off-label use. Off-label prescribing is common in psychiatry and is often guided by clinical research and a provider's judgment.
For GAD, medications such as escitalopram, paroxetine, duloxetine, venlafaxine, and buspirone have FDA approval and are typically considered first. Viibryd may be considered when those options haven't worked or weren't well tolerated, or when someone is being treated for both depression and anxiety.
How Common Is Generalized Anxiety Disorder?
GAD involves excessive, hard-to-control worry about everyday things that lasts for months. It's one of the most common anxiety disorders. National survey data show that about 2.7% of American adults have GAD in a given year, and 5.7% will experience it at some point in their lives. It's also more common in women (3.4%) than in men (1.9%).
Does Viibryd Work for Anxiety?
Research on Viibryd for anxiety is promising but limited compared with older medications. Most of the evidence comes from three short-term trials in adults with GAD, along with research in people who have both depression and anxiety.
Generalized Anxiety Disorder (GAD)
Three studies have tested vilazodone for GAD over eight weeks. A study involving 680 adults showed that the 40 mg dose improved anxiety scores.
Two other studies, in which people took 20 to 40 mg depending on their response, also found benefits. One of these trials found vilazodone more effective than placebo for GAD, and another trial of 400 adults found that vilazodone outperformed placebo on all measures of anxiety and functional impairment. However, 71% of people taking vilazodone completed the trial, compared with 81% on placebo, which may suggest side effects led some people to stop.
Anxiety With Depression
Many people with depression also experience significant anxiety. Reviews of vilazodone's depression trials suggest it may offer added benefit for depressed patients with high anxiety, although this finding is considered suggestive rather than definitive.
How It Compares With Other Medications
There aren't head-to-head studies comparing Viibryd with first-line medications for GAD. In depression, one large trial found that vilazodone 20 mg and 40 mg and citalopram can be beneficial in depression and a meta-analysis of five trials found it effective and generally well tolerated for depression.
Viibryd Dosage for Anxiety
Viibryd's dosing follows the same schedule whether it's used for depression or off-label for anxiety. Your prescriber will tailor the plan to you.
Starting and Adjusting the Dose
Prescribing information recommends starting at 10 mg once daily with food for seven days, then increasing to 20 mg once daily. The dose may be increased to 40 mg after at least another seven days. The recommended target range is 20 to 40 mg daily. Starting low and increasing slowly helps reduce stomach-related side effects.
Why Taking It With Food Matters
Unlike many antidepressants, Viibryd's absorption is affected by food. Taking it on an empty stomach can lower the amount of medication your body absorbs, which may make it less effective. Most people take it with a meal at the same time each day.
How Long Does Viibryd Take to Work for Anxiety?
Like other antidepressants, Viibryd usually takes around eight weeks to show its full effect. Some people notice small changes in sleep, worry, or tension earlier, but it's important to give the medication time while staying in touch with your prescriber.
Viibryd Side Effects
Most side effects are mild to moderate and tend to be most noticeable when starting or increasing the dose. The most common side effects include:
Diarrhea
Nausea
Vomiting
Trouble sleeping
Sexual side effects are possible, as they are with many serotonin-based medications.
Important Safety Considerations
Viibryd carries several important safety warnings that your prescriber will review with you. Key considerations include:
Suicidal thoughts in young people: Like all antidepressants, Viibryd has a boxed warning about increased suicidal thoughts and behaviors in children, teens, and young adults.
Serotonin syndrome: Combining Viibryd with other serotonin-affecting drugs, such as triptans, tramadol, or St. John's wort, may raise the risk of this serious reaction.
MAOI interactions: Viibryd shouldn't be taken with or within 14 days of a monoamine oxidase inhibitor.
Bleeding risk: Taking it with aspirin, NSAIDs, or blood thinners may increase the risk of bleeding.
Bipolar disorder: Prescribers screen for bipolar disorder first, since antidepressants can trigger mania in some people.
Drug interactions: Some antifungal medications can raise vilazodone levels, so the dose may need to be limited to 20 mg.
Stopping safely: Viibryd should be tapered gradually rather than stopped suddenly.
Other Medication Options for Anxiety
Viibryd is one of many medications used for anxiety. Depending on your symptoms and history, your prescriber may also consider:
SSRIs: Escitalopram (Lexapro), sertraline, and paroxetine are common first choices, and the timeline for how long it takes for Lexapro to work for anxiety is similar to Viibryd's.
Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs): Duloxetine and venlafaxine are FDA-approved for GAD.
Buspirone: A non-habit-forming anxiety medication that also acts on 5-HT1A receptors.
Other non-addictive options: Hydroxyzine and other non-addictive anxiety medications may be used for some people.
Short-term or situational options: Propranolol may help physical symptoms of performance anxiety, and benzodiazepines are sometimes used briefly because they risk dependence.
Therapy, especially cognitive behavioral therapy, is also highly effective for anxiety and is often combined with medication.
When to Seek Medical Attention
Contact your prescriber promptly if you notice worsening anxiety, agitation, restlessness, or trouble sleeping after starting or changing your dose of Viibryd. Seek emergency care for symptoms of serotonin syndrome, such as confusion, fever, sweating, muscle stiffness or twitching, or a racing heart, or for signs of an allergic reaction.
If you have new or worsening thoughts of suicide or self-harm, call or text 988 to reach the 988 Suicide & Crisis Lifeline.
How Blossom Health Can Help
Finding the right anxiety medication can take some trial and adjustment. Blossom Health connects you with board-certified psychiatric providers for virtual care, and every provider can evaluate your symptoms, discuss whether Viibryd or another option makes sense, and prescribe medication when appropriate.
Blossom works with many insurance plans, and several plans cover anxiety treatment, so check your coverage and book a visit with Blossom Health.
Medical Disclaimer
This article is for informational purposes only and is not a substitute for professional medical advice. Always consult a qualified healthcare provider before starting, changing, or stopping any medication. If you are in crisis or thinking about harming yourself, call or text 988 or call 911.
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