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Viibryd vs Wellbutrin
Introduction
For those grappling with major depressive disorder (MDD) or other types of depression, certain medications that modify the concentrations of brain compounds associated with mood, known as neurotransmitters, can help in managing symptoms and stabilizing emotional lows. Viibryd and Wellbutrin are two such medications frequently prescribed for depression. They each influence different neurotransmitters in the brain but both have shown to stabilize moods in patients dealing with depression. Viibryd is a selective serotonin reuptake inhibitor (SSRI) and a 5-HT1A receptor partial agonist which means it primarily affects levels of serotonin while also having an effect on some specific subtype of serotonin receptors. Conversely, Wellbutrin is classified as a norepinephrine-dopamine reuptake inhibitor (NDRI), affecting levels of norepinephrine and dopamine predominantly.
Viibryd vs Wellbutrin Side By Side
| Attribute | Viibryd | Wellbutrin |
|---|---|---|
| Brand Name | Viibryd | Wellbutrin |
| Contraindications | Should not be taken with or recently taken MAO inhibitors | Should not be taken with or recently taken MAO inhibitors |
| Cost | Approximately $330 for 30 tablets of 40 mg | Approximately $500 for 60 tablets of 100 mg |
| Generic Name | Vilazodone | Bupropion |
| Most Serious Side Effect | Increased thoughts about suicide or self-harm, particularly for individuals under 25 | Seizures (convulsions) |
| Severe Drug Interactions | Hazardous interactions with MAO inhibitors | Hazardous interactions with MAO inhibitors |
| Typical Dose | Starts at 10 mg/day, increasing to 20-40 mg/day | 100–200 mg/day, up to 300 mg/day or maximum of 450 mg/day |
What is Viibryd?
Vilazodone (the generic name for Viibryd) is one of the more recent additions to the SSRI class of antidepressants. This drug, first approved by the FDA in 2011, combines serotonin reuptake inhibition with partial serotonergic receptor agonism. Similar to other SSRIs, it works by increasing levels of free serotonin in the brain but also interacts directly with specific serotonin receptors to enhance its effects. It's primarily prescribed for treating major depressive disorder.
Wellbutrin, on the other hand, belongs to a different class of antidepressants known as norepinephrine-dopamine reuptake inhibitors (NDRIs). Unlike SSRIs like Viibryd that mainly target serotonin, Wellbutrin acts on two other neurotransmitters: dopamine and norepinephrine. This gives Wellbutrin a unique influence over mood and energy levels without producing many of the side effects common among SSRIs.
In comparing these two drugs, you'll find that while they both effectively treat depression symptoms - their mechanism differs significantly which might result in variations in individual responses and side-effects encountered.
What conditions is Viibryd approved to treat?
Viibryd is approved for the treatment of certain mental health disorders, including:
- Major depressive disorder (MDD), also known as unipolar depression
- Treatment-resistant depression, when used in combination with other medications
- Anxiety disorders, although this use is considered off-label and should be discussed thoroughly with a healthcare provider.
How does Viibryd help with these illnesses?
Viibryd, like Prozac, also works to manage depression by increasing the amount of serotonin available in the synapses of the brain. It does this through a dual mechanism: as a selective serotonin reuptake inhibitor (SSRI) and as a partial agonist at one type of serotonin receptor - 5-HT1A. The SSRI action blocks the reabsorption of serotonin into neurons which allows for higher levels to be maintained for extended periods. This is important because Serotonin plays an instrumental role in mood regulation, cognition, memory, sleep patterns and more. Meanwhile its partial agonistic action at 5-HT1A receptors may provide additional antidepressant effect or reduce side effects associated with SSRIs. Therefore Viibryd can help limit depressive symptoms and assist patients in managing their condition.
Wellbutrin on other hand functions differently; it acts upon norepinephrine and dopamine neurotransmitters instead of focusing primarily on serotonin pathways like Viibryd does. Wellbutrin inhibits their reuptake leading to increased concentration in synaptic clefts which helps elevate mood but sometimes might not be sufficient for those who have low levels of serotonin.
What is Wellbutrin?
Wellbutrin is a brand name for bupropion, an antidepressant medication that functions as a norepinephrine-dopamine reuptake inhibitor (NDRI). This means it works by increasing the levels of these neurotransmitters in your brain by inhibiting their reabsorption. Interestingly, Wellbutrin also serves as a mild nicotinic receptor antagonist which blocks the action of another neurotransmitter named acetylcholine at its receptors. This unique mechanism sets Wellbutrin apart and was one reason behind its FDA approval back in 1986.
Unlike other antidepressants such as Viibryd—an SSRI (Selective Serotonin Reuptake Inhibitor)—Wellbutrin does not hinder the reuptake of serotonin. Consequently, it has a different side-effect profile compared to SSRIs like Viibryd; specifically, it doesn't typically induce sedation or contribute to weight gain and sexual dysfunction—common side effects associated with SSRIs.
The distinctive way in which Wellbutrin affects dopamine and norepinephrine can be particularly effective for treating depression, notably among patients who have not responded well to typical SSRI medications like Viibryd.
What conditions is Wellbutrin approved to treat?
Wellbutrin is a drug that has received FDA approval for the treatment of several conditions, such as:
- Major Depressive Disorder (MDD)
- Seasonal Affective Disorder (SAD), which is also frequently referred to as "winter depression"
In addition to these applications, Wellbutrin can be used off-label to help in smoking cessation and attention deficit hyperactivity disorder (ADHD). It's important to remember that while both Viibryd and Wellbutrin are used for similar purposes, they work differently. Therefore, their effectiveness may vary from patient to patient. Always consult with your healthcare provider before making any changes.
How does Wellbutrin help with these illnesses?
Dopamine is an essential neurotransmitter responsible for reward-driven learning and motivation. Low levels of dopamine have been associated with depression, among other mental health disorders. Wellbutrin operates by escalating the levels of dopamine available in the brain, thereby mitigating some depressive symptoms. Its influence on norepinephrine may also contribute to Wellbutrin's efficacy as an antidepressant. Since it does not significantly impact serotonin levels, it is often prescribed when a patient exhibits poor response to "typical" SSRI/SNRI antidepressants (such as Viibryd), or it might be used in combination with these medications.
How effective are both Viibryd and Wellbutrin?
Both vilazodone (Viibryd) and bupropion (Wellbutrin) are established treatments for depression, with their FDA approvals separated by over two decades. Viibryd was approved in 2011 while Wellbutrin got its approval back in 1985. These drugs work on different neurotransmitters and have unique pharmacological profiles which may make one a more suitable choice than the other based on individual patient characteristics.
The efficacy of both viibryd and wellbutrin in treating depression has been studied through various clinical trials. For instance, a double-blind study conducted in 2015 showed comparable effectiveness between these two medications when it came to reducing depressive symptoms and improving quality of life[1]. However, as with any medication, side effects were reported - sexual dysfunction being notably less common among patients treated with bupropion compared to those receiving SSRI-class antidepressants such as vilazodone.
A review published in 2013 highlighted that vilazodone is effective in alleviating symptoms of depression from the first week of treatment without causing significant weight gain or sexual side effects commonly associated with many other antidepressants[2]. It also emphasized that this drug has a novel mechanism combining selective serotonin reuptake inhibition (SSRI activity) with partial agonism at serotonergic 5-HT1A receptors which might offer some advantages over traditional SSRIs.
On the other hand, according to a meta-analysis carried out in 2009[3], bupropion appeared more effective than placebo for treating depression but had similar efficacy to other common antidepressants like SSRIs or SNRIs. Bupropion is often considered after failure or intolerance to first-line therapies due its unique mechanism involving norepinephrine-dopamine reuptake inhibition thus providing an alternative option for individuals who did not respond adequately or experienced adverse reactions such as sexual problems related to standard SSRI therapy.
[1] https://pubmed.ncbi.nlm.nih.gov/26044835/ [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3666194/ [3] https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006504.pub2/full
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At what dose is Viibryd typically prescribed?
Oral dosages of Viibryd usually start at 10 mg/day for the initial seven days and are then increased to 20 mg/day. Studies have indicated that a dose range from 20-40 mg/day is effective in treating major depressive disorder in most adults. Adolescents may be started on a lower dosage, but there's limited clinical data available for this age group regarding Viibryd. In any population, the dosage can be adjusted after several weeks if there is no response. However, it’s crucial that the maximum daily dosage should not exceed 40 mg under any circumstance.
At what dose is Wellbutrin typically prescribed?
Wellbutrin treatment typically begins with a dosage of 100–200 mg/day. Depending on individual patient responses, the dosing can subsequently be increased to 300 mg/day that is split into two separate doses, with each dose spaced approximately 8 hours apart. If after several weeks there is no observable response to the treatment at this level, a maximum dosage of 450 mg/day may be considered. This higher dose would involve dividing the total daily intake into three distinct doses of 150mg each, and these should ideally be taken every six hours over the course of one day.
What are the most common side effects for Viibryd?
Potential side effects of Viibryd compared to Wellbutrin include:
- Anxiety and nervousness
- Sleep disturbances, including insomnia and somnolence (sleepiness/drowsiness)
- General feelings of weakness or fatigue (asthenia)
- Unintentional trembling or shaking (tremor)
- Decreased appetite
- Nausea and dyspepsia (burning, discomfort, or pain in the upper abdomen)
- Diarrhea
- Dry mouth
- Changes in sexual desire or ability, which can manifest as decreased libido, abnormal ejaculation, or impotence
- Skin rash and excessive sweating
- Vivid dreams
- Symptoms similar to those experienced during a flu infection
Pharyngitis (inflammation at the back of the throat), sinusitis (inflammation within the sinuses), and yawning are also possible side effects. Remember that each individual may respond differently to medication; consult your healthcare provider for personalized advice.
Are there any potential serious side effects for Viibryd?
When comparing Viibryd to Wellbutrin, it's important to be aware of the potential side effects. For Viibryd these may include:
- Increased thoughts about suicide or self-harm, particularly for individuals under 25
- Signs of allergic reaction: hives, difficulty breathing, swelling in your face or throat
- Changes in vision such as blurred vision or seeing halos around lights; sudden eye pain or redness can also occur and could indicate a serious eye problem
- Heart conditions like fast or pounding heartbeats, fluttering in your chest accompanied by shortness of breath and feeling like you might pass out
- Hyponatremia (low sodium levels) - indications can include headache, confusion, slurred speech, severe weakness and unsteadiness
- A possible severe nervous system reaction leading to rigid muscles along with high fever sweating confusion fast uneven heartbeats tremors feeling as though you might faint
- Symptoms indicative of serotonin syndrome which includes agitation hallucinations fever excessive sweating shivering fast heart rate muscle stiffness twitching loss of coordination nausea vomiting diarrhea
If any of these symptoms occur while taking Viibryd it is crucial that you seek immediate medical attention.
What are the most common side effects for Wellbutrin?
Wellbutrin, as an alternative to Viibryd, may bring about a different set of side effects. Users might experience dry mouth and throat irritation due to the drug's mechanism in the body. Some people have reported experiencing ringing in their ears along with slightly blurred vision. Digestive problems such as nausea, vomiting, stomach pain or discomfort are also common; these can sometimes lead to changes in appetite or even constipation. Wellbutrin has been known to cause sleep disturbances like insomnia for some individuals. Physically, tremors and sweating episodes might occur alongside feelings of anxiety or nervousness due to its stimulant properties. An increase in heart rate is another potential effect users should be aware of when taking this medication. Psychologically speaking, confusion, agitation or hostility could present themselves especially at the early stages of treatment before your system adjusts fully to the medication regimen. Skin reactions resulting in rash cannot be ruled out either with Wellbutrin use. Some patients on Wellbutrin report weight loss which could be attributed directly or indirectly (through reduced appetite) to this drug therapy. Frequency of urination might go up because it enhances metabolic functions within our bodies. Lastly but no less importantly: headaches and dizziness - common complaints among many medications owing largely due individual tolerance levels – while muscle/joint pain can result from heightened sensitivity caused by increased neuronal activity triggered by this antidepressant agent.
Remember that everyone reacts differently towards medications; thus not all users will necessarily experience these side effects while on Wellbutrin treatment plan so always consult your healthcare provider promptly if you notice any new/unusual symptoms after starting any new medicine regimen!
Are there any potential serious side effects for Wellbutrin?
While Wellbutrin is generally safe for use, there are instances where it may cause serious side effects. Symptoms that could indicate a major problem include:
- Severe allergic reactions: this can manifest as itching, hives or skin rashes which might be red or purple and involve blistering and peeling
- Breathing difficulties accompanied by swelling in the face, throat or tongue
- Seizures (convulsions): Wellbutrin has a higher risk of seizures compared to other antidepressants so any convulsive activity should be immediately reported
- Significant changes in mood or behavior: these may come across as confusion or unusual shifts in demeanor.
- Visual disturbances like blurred vision, tunnel vision, eye pain/swelling and seeing halos around lights
- Fast-paced irregular heartbeats which seem abnormal
- Signs suggesting a possible manic episode such as racing thoughts, having too much energy than usual, engaging in reckless behavior, extreme happiness/irritability levels beyond the normal spectrum; talking excessively more than one's usual capacity; severe sleep problems.
In case you experience any of these symptoms while on Wellbutrin therapy do not hesitate to contact your healthcare provider promptly for advice.
Contraindications for Viibryd and Wellbutrin?
Both Viibryd and Wellbutrin, like most antidepressant medications, may potentially exacerbate symptoms of depression in some individuals. If you observe a worsening of your depressive state or an increase in suicidal thoughts or behavior while on these medications, it is crucial to seek immediate medical assistance.
Neither Viibryd nor Wellbutrin should be taken if you are currently taking monoamine oxidase (MAO) inhibitors or have used them recently. It's essential to inform your healthcare provider about all the medications you're taking; MAOIs require roughly 5 weeks to clear from your system to prevent hazardous interactions with both Viibryd and Wellbutrin.
How much do Viibryd and Wellbutrin cost?
For the brand name versions of these drugs:
- The price of 60 tablets of Wellbutrin SR (100 mg) averages around $500, which works out to $16–32/day, depending on your dose.
- The price for 30 tablets of Viibryd (40 mg) is approximately $330, working out to roughly $11/day.
This means if you are in the higher dosage range for Wellbutrin (i.e., 300 mg/day or higher), then brand-name Viibryd may be less expensive on a per-day treatment basis. However, cost should not be a primary consideration in determining which drug is right for you.
As it pertains to generic versions:
- Bupropion (the active ingredient in Wellbutrin), available from 100mg doses upwards, costs between $0.25 and $0.80 per day at low dosages or between about $.50 and $1.50 per day at more typical dosages.
- As yet there is no generic equivalent available for Viibryd making it generally more expensive than its counterparts with generics like bupropion.
Remember that cost isn't everything – while one medication might be cheaper than another, efficacy and side effects vary among individuals so always consult with your healthcare provider before making any decisions regarding medications.
Popularity of Viibryd and Wellbutrin
Vilazodone, in generic form as well as brand names such as Viibryd, was estimated to have been prescribed to about 1.2 million people in the US in 2020. Vilazodone accounted for around 2% of antidepressant prescriptions in the US. As an SSRI and a partial agonist at serotonin receptors, vilazodone has a unique mechanism of action among antidepressants.
Bupropion, including brand versions like Wellbutrin, was prescribed to approximately 5.8 million individuals in the USA during the same year. In terms of overall antidepressant prescriptions within the US, bupropion represents just over 12%. It persists as one of the most commonly utilized "atypical" antidepressants (not categorized under SSRIs or another large class of antidepressants). The prevalence of bupropion has been generally increasing since its introduction and particularly so from around 2013 onwards.
Conclusion
Both Viibryd (vilazodone) and Wellbutrin (bupropion) have substantial records of usage in patients with depression, backed by many clinical studies showing that they are more effective than placebos. In certain instances, these drugs might be used together; however, this requires careful consideration by a physician due to potential interactions between the two. Their mechanisms of action differ - Viibryd acts mainly on serotonin while having partial agonist activity at one subtype of serotonin receptor called 5-HT1A receptors; whereas Wellbutrin primarily influences norepinephrine and dopamine.
Viibryd is often considered as an alternative treatment option when first-line SSRIs or SNRIs are not well-tolerated or effective enough, while Wellbutrin would typically be seen as an adjunctive therapy to other antidepressants, including Viibryd, especially in cases where there's a need to avoid common sexual side-effects associated with most other antidepressants.
Both medications can take time for their full effects to become apparent which means an adjustment period may be necessary after starting treatment.
The side effect profiles for both drugs are generally manageable but do vary; sexual dysfunction is less commonly reported with Wellbutrin than it is with many other antidepressants including Viibryd. However, regular monitoring of mood changes should occur once either medication regimen begins. If worsening depression or thoughts about self-harm emerge during treatment initiation or any point thereafter immediate medical assistance should be sought.
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Refrences
- Oliveira Sennfelt, D. A., Marques da Silva, M. A. R., & da Silva Tavares, A. P. (2011, October). Bupropion in the Treatment of Major Depressive Disorder in Real-life Practice. Clinical Drug Investigation. Springer Science and Business Media LLC.http://doi.org/10.2165/1159617-s0-000000000-00000
- El Mansari, M., Ghanbari, R., Janssen, S., & Blier, P. (2008, December). Sustained administration of bupropion alters the neuronal activity of serotonin, norepinephrine but not dopamine neurons in the rat brain. Neuropharmacology. Elsevier BV.http://doi.org/10.1016/j.neuropharm.2008.07.028
- 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