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Viibryd vs Lexapro
Introduction
For patients suffering from major depressive disorder (MDD) or other forms of depression, certain medications that modify the concentrations of neurotransmitters, the brain chemicals influencing mood, can be instrumental in managing depressive symptoms and achieving emotional stability. Viibryd and Lexapro are two such medications often prescribed for depression. They both influence neurotransmitters in the brain, aiding in mood stabilization for depression patients. Viibryd is a novel antidepressant that functions as a selective serotonin reuptake inhibitor (SSRI) and a 5-HT1A receptor partial agonist; it primarily impacts levels of serotonin. Lexapro, on the other hand, is a more traditional SSRI, which also affects serotonin levels but does not have the additional partial agonist activity.
Viibryd vs Lexapro Side By Side
Attribute | Viibryd | Lexapro |
---|---|---|
Brand Name | Viibryd | Lexapro |
Contraindications | Cannot be taken with, or shortly after, monoamine oxidase (MAO) inhibitors. | Cannot be taken with, or shortly after, monoamine oxidase (MAO) inhibitors. |
Cost | For brand name: around $330 for 30 tablets of 40 mg. For generic (vilazodone): $0.84 to $2.52 per day for dosages of 40 mg/day. | For brand name: around $356 for 30 tablets of 20 mg. For generic (escitalopram): starts from as low as $0.30/day to about $0.90/day. |
Generic Name | Vilazodone | Escitalopram |
Most Serious Side Effect | Serotonin syndrome, thoughts of suicide or self-harm, severe nervous system reactions. | Increased suicidal thoughts or behaviors, serotonin syndrome. |
Severe Drug Interactions | MAO inhibitors due to risk of serotonin syndrome. | MAO inhibitors due to risk of serotonin syndrome. |
Typical Dose | Starts at 10 mg/day for the first week, then 20 mg/day, up to a maximum of 40mg/day. | Begins at 10 mg/day, can be increased to 20 mg/day after at least one week. |
What is Viibryd?
Vilazodone (the generic name for Viibryd) is a newer medication classed as a serotonergic antidepressant. It was first approved by the FDA in 2011. Viibryd works by increasing the levels of free serotonin in the brain, but it also has a unique function—it partially stimulates the serotonin receptors, effectively amplifying the effects of the increased serotonin levels. It is prescribed for the treatment of major depressive disorder (MDD). Viibryd has a selective but dual-action influence on the serotonin system, which is thought to result in fewer sexual side effects than other antidepressants that only increase serotonin levels.
Escitalopram (the generic name for Lexapro), on the other hand, is a selective serotonin reuptake inhibitor (SSRI) that was first approved by the FDA in 2002. Lexapro works similarly to Viibryd in that it increases the levels of free serotonin in the brain by preventing its reuptake. It's also prescribed for major depressive disorder and generalized anxiety disorder. Lexapro solely targets the serotonin system and doesn't have the same partial stimulatory effect on the serotonin receptors as Viibryd. This difference may result in varying side effect profiles and efficacy between the two drugs.
What conditions is Viibryd approved to treat?
Viibryd is approved for the treatment of different manifestations of depression:
- Major depressive disorder (MDD)
- Generalized anxiety disorder (GAD)
- Panic Disorder
On the other hand, Lexapro is used in treating:
- Major depressive disorder (MDD)
- Generalized anxiety disorder (GAD)
How does Viibryd help with these illnesses?
Viibryd works to manage depression by increasing the amount of serotonin available in the synapses of the brain. It achieves this by inhibiting its reuptake by the neurons, ensuring levels can be maintained higher for extended periods. Serotonin is a neurotransmitter, a chemical messenger in the brain and throughout the body, that plays a vital role in mood, cognition, memory, sleep patterns, hunger, and body temperature, among other things. It is believed that individuals with depression have relatively lower levels of serotonin. Therefore, by boosting serotonin, Viibryd can mitigate the negative effects of depression and help patients manage their condition and stabilize their mood. Viibryd further differentiates itself from other SSRIs by also acting as a partial agonist at the 5-HT1A receptor, which can help in enhancing the anti-depressive effect.
What is Lexapro?
Lexapro is a brand name for escitalopram, which is a selective serotonin reuptake inhibitor (SSRI). This means it increases the levels of serotonin in the brain by reducing its reabsorption. Lexapro was first approved by the FDA in 2002. As an SSRI antidepressant, it specifically inhibits the reuptake of serotonin, unlike other classes of antidepressants. Its action on serotonin means that its side-effect profile can be different to that of other antidepressants, in particular in that it can cause sexual dysfunction, nausea, and increased sweating (common side effects of SSRIs such as Viibryd). The effects on serotonin can be beneficial for the treatment of depression and anxiety, particularly in patients who do not respond well to other classes of antidepressant drugs such as Viibryd. Lexapro is often chosen for its generally well-tolerated nature and efficacy in treating both depression and generalized anxiety disorder.
What conditions is Lexapro approved to treat?
Lexapro, also known by the generic name Escitalopram, has been approved for use in the treatment of:
- Major depressive disorder (MDD)
- Generalized anxiety disorder (GAD)
It is often chosen because it tends to produce fewer side effects than other medications and can be used over a longer period of time.
How does Lexapro help with these illnesses?
Serotonin is a neurotransmitter that has a significant impact on mood, anxiety, and overall happiness. Insufficient levels of serotonin have been linked to depression. Lexapro, an SSRI (Selective Serotonin Reuptake Inhibitor), functions by increasing the availability of serotonin in the brain, which can help to relieve a variety of depressive symptoms. It may also affect other neurotransmitters, contributing to its effectiveness as an antidepressant. Lexapro is often prescribed when a patient does not respond well to other SSRI antidepressants (such as Viibryd) or can be used in combination with them. It's important to note that although Lexapro and Viibryd both work on the serotonin system, they do so in slightly different ways and may have different side effects.
How effective are both Viibryd and Lexapro?
Both vilazodone (Viibryd) and escitalopram (Lexapro) are reputable options for treating major depressive disorder, and they were approved by the FDA within a decade of each other. Since they have different mechanisms of action, they may be prescribed under different circumstances. The effectiveness of vilazodone and escitalopram in treating depression was compared in a 2015 double-blind, randomized study; the two drugs exhibited comparable efficacy in managing the symptoms of depression and shared similar safety profiles. In this study, there was no significant difference in the reduction of depression severity between patients receiving vilazodone and those receiving escitalopram.
A 2011 review of escitalopram studies demonstrated that it is effective in alleviating symptoms of depression starting from the first week of treatment, that its side effect profile is favorable over many other antidepressants, and that it is well-tolerated in a wide range of patients, including the elderly. Escitalopram has become one of the most widely prescribed antidepressant drugs worldwide, with a recommended dose of 10-20 mg/day to achieve optimal efficacy.
A 2012 meta-analysis indicated that vilazodone seems to be more effective than placebo in treating depression, and that it appears to be similar in efficacy to other common antidepressants. Nonetheless, vilazodone is often considered after first-line treatment options because it's a relatively new drug and data confirming its efficacy as a stand-alone treatment is less robust than that for escitalopram. However, due to its unique pharmacology as a serotonin receptor modulator and reuptake inhibitor, vilazodone may be an optimal treatment for patients who did not respond well to SSRIs or have a particular need to avoid common side effects of SSRIs, such as sexual dysfunction.
At what dose is Viibryd typically prescribed?
Oral dosages of Viibryd typically start at 10 mg/day for the first week, then increase to 20 mg/day. If required, after another week it may be increased again to a maximum daily dose of 40mg. Conversely, oral doses of Lexapro usually begin at 10 mg/day and can be increased up to a maximum dosage of 20 mg/day if needed. There's no pediatric dose established for either medication as they're not approved for use in children or adolescents under the age of 18 years old. In both cases, dosage adjustments should only occur under supervision from your healthcare provider based on individual response and tolerability.
At what dose is Lexapro typically prescribed?
Lexapro therapy typically begins at a dose of 10 mg/day. If necessary, the dosage can be increased to 20 mg/day after at least one week. The higher dose is usually divided into two doses taken approximately 12 hours apart. If there is no noticeable improvement in symptoms after several weeks on this regimen, your healthcare provider may recommend an increase to the maximum daily dosage of 20 mg, which should be split into two doses of 10mg each and taken roughly twelve hours apart. Always remember that any changes in medication or dosage should only be made under direct guidance from your healthcare provider.
What are the most common side effects for Viibryd?
Common side effects of Viibryd and Lexapro include:
- Diarrhea
- Nausea
- Dry mouth
- Sleepiness/drowsiness (somnolence)
- Insomnia, difficulty sleeping or unusual dreams
- Dizziness, nervousness, and anxiety
- Excessive sweating
- Decreased sex drive (libido), abnormal ejaculation or impotence -Tremors (unintentional trembling or shaking) -General weakness and fatigue (asthenia)
In addition to the common side effects listed above, both medications can also cause more serious but less common side effects such as serotonin syndrome, a potentially life-threatening condition if left untreated. Symptoms of serotonin syndrome may include agitation, hallucinations, rapid heartbeat, fever, overactive reflexes.
Always consult with your healthcare provider for advice about potential risks versus benefits when considering these drugs.
Are there any potential serious side effects for Viibryd?
While Viibryd and Lexapro are both designed to treat depression and anxiety, they do have different side effects. For Viibryd, you should watch for:
- Thoughts of suicide or self-harm: Like many antidepressants, it can increase the risk of suicidal thoughts in some people.
- Signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
- Changes in vision: look out for blurred vision, tunnel vision or eye pain
- Heart problems such as fast heartbeats or feeling like you might pass out
- Low sodium levels - symptoms may include headache, confusion slurred speech severe weakness vomiting loss coordination feeling unsteady -Severe nervous system reactions including stiff muscles high fever sweating confusion fast uneven heartbeats tremors feeling like you might pass out.
In rare cases users may experience symptoms of serotonin syndrome which can be life-threatening if not treated promptly. Symptoms include agitation hallucinations fever sweating shivering fast heart rate muscle stiffness twitching loss coordination nausea vomiting diarrhea.
What are the most common side effects for Lexapro?
Lexapro, a commonly prescribed antidepressant, has several potential side effects that patients should be aware of:
- Dry mouth and sore throat
- Changes in vision
- Nausea, constipation or diarrhea, stomach pain
- Decreased appetite which may lead to weight loss
- Difficulty with sleep including insomnia or vivid dreams
- Increased sweating and possible nervousness or anxiety
- A potential increase in heart rate
- Confusion or agitation
- Possible skin rash.
In rare cases it may cause increased urination. Some people also experience headaches, dizziness as well as muscle or joint pain while on Lexapro. Always consult your healthcare provider if you notice any new symptoms after starting this medication.
Are there any potential serious side effects for Lexapro?
While Lexapro is generally safe and effective, it can occasionally lead to serious side effects. It's critical to be aware of the following potential symptoms:
- Allergic reactions, which may include skin rash, hives, or itching; fever or swollen glands; difficulty breathing; swelling in your face or throat.
- Increased suicidal thoughts or behaviors
- Seizures or convulsions
- Sudden changes in mood or behavior such as agitation, restlessness, panic attacks, irritability
- Vision problems like blurred vision and seeing halos around lights
- Heart issues including fast heartbeat and chest pain
- Symptoms of Serotonin syndrome: agitation, hallucinations (seeing things that are not there), coordination problems overactive reflexes.
If you notice any of these signs while taking Lexapro consult with your healthcare provider immediately.
Contraindications for Viibryd and Lexapro?
Both Viibryd and Lexapro, along with other antidepressant medications, can potentially worsen symptoms of depression in certain individuals. If you find your depression symptoms intensifying or notice an increase in suicidal thoughts or behaviors, it is crucial that you seek immediate medical attention.
Neither Viibryd nor Lexapro can be taken if you are currently using, or have recently used, monoamine oxidase (MAO) inhibitors. Always inform your healthcare provider about any medications you are taking; MAOIs will require a period of about two weeks to clear out of your system before you can safely start taking Viibryd or Lexapro. This is to avoid a potentially life-threatening drug interaction known as serotonin syndrome.
How much do Viibryd and Lexapro cost?
For the brand name versions of these drugs:
- The price of 30 tablets of Viibryd (40 mg) averages around $330, which works out to approximately $11/day.
- The price of 30 tablets of Lexapro (20 mg) averages around $356, working out to approximately $12/day.
Thus, if you are in the higher dosage range for Viibryd (i.e., 40 mg/day), then brand-name Lexapro is slightly more expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which of these drugs is right for you.
For the generic versions of Viibryd (vilazodone) and Lexapro (escitalopram), costs are significantly lower:
- Vilazodone (40 mg tablets) is available in packs of 30 tablets and above, with approximate costs of $0.84 to $2.52 per day for dosages of 40 mg/day.
- Escitalopram is available in packs of 30 up to 90 tablets (20 mg), with the cost to you starting from as low as $0.30/day (if you buy the largest pack upfront), and not exceeding about $0.90/day.
Popularity of Viibryd and Lexapro
Vilazodone, also known as Viibryd, is a relatively new antidepressant that was approved by the FDA in 2011. It's an SSRI and partial serotonin receptor agonist used to treat major depressive disorder (MDD). In 2020, it was estimated to have been prescribed to about 1.5 million people in the US.
Escitalopram, commonly recognized by its brand name Lexapro among others, has been on the market for much longer than Viibryd since it received FDA approval in 2002. Escitalopram works by preventing the reuptake of one neurotransmitter—serotonin—by nerve cells after it has been released. In contrast with Vilazodone’s more modest prescription numbers, Lexapro was prescribed to approximately 13 million people in the USA in 2020 alone. This makes escitalopram one of America's most utilized antidepressants accounting for nearly a quarter of SSRI prescriptions and just over ten percent of overall antidepressant prescriptions.
Conclusion
Both Viibryd (vilazodone) and Lexapro (escitalopram) are commonly prescribed for the treatment of major depressive disorder and generalized anxiety disorder, with extensive clinical trials and studies indicating that they are more effective than placebo. The drugs could potentially be used together, but this should only be done under the careful supervision of a healthcare provider due to potential interaction risks. Viibryd and Lexapro work differently, with Viibryd acting as both a serotonin reuptake inhibitor and a partial serotonin receptor agonist, while Lexapro is a selective serotonin reuptake inhibitor (SSRI).
Viibryd is typically considered when patients have not responded adequately to first-line treatments like Lexapro, or when the common sexual side-effects of SSRIs are a concern. Both medications are available in generic form, which can provide considerable cost savings, especially for patients paying out-of-pocket. However, it should also be noted that both Viibryd and Lexapro may require an adjustment period, meaning that full effects might not be noticeable immediately.
While both drugs are generally well-tolerated, each has its own side effect profile. Lexapro is known to potentially cause sexual dysfunction and weight changes, whereas Viibryd has been associated with less sexual side effects. With both drugs, it's crucial that patients closely monitor their moods, particularly when initiating treatment, and seek immediate medical help if they notice worsening depression or develop suicidal thoughts or feelings of self-harm.
Refrences
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- Garnock-Jones, K. P., & McCormack, P. L. (2010, September). Escitalopram. CNS Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/11204760-000000000-00000
- Waugh, J., & Goa, K. L. (2003). Escitalopram. CNS Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00023210-200317050-00004
- Blier, P. (2016, March 23). Neurobiology of Depression and Mechanism of Action of Depression Treatments. The Journal of Clinical Psychiatry. Physicians Postgraduate Press, Inc.http://doi.org/10.4088/jcp.13097tx3c
- McCormack, P. L. (2015, October 26). Vilazodone: A Review in Major Depressive Disorder in Adults. Drugs. Springer Science and Business Media LLC.http://doi.org/10.1007/s40265-015-0490-y
- Choi, E., Zmarlicka, M., & Ehret, M. J. (2012, September 15). Vilazodone: A novel antidepressant. American Journal of Health-System Pharmacy. Oxford University Press (OUP).http://doi.org/10.2146/ajhp110374