Viibryd Tapering Guide
vilazodone
Boxed Warning
Suicidality risk in children, adolescents, and young adults under 25 during initial treatment.
Overview
Vilazodone is a selective serotonin reuptake inhibitor (SSRI) and partial agonist at the 5-HT1A receptor. It is used for the treatment of major depressive disorder.
10mg, 20mg, 40mg
Tablets: 10mg, 20mg, 40mg
Category C (risk cannot be ruled out)
Mechanism of Action
Combined SSRI activity with 5-HT1A receptor partial agonism, providing dual serotonergic modulation. Blocks SERT while partially activating 5-HT1A autoreceptors.
Taper Notes
Unique dual mechanism (SSRI + 5-HT1A partial agonist). Must be taken with food for adequate absorption. Taper slowly — withdrawal can include GI disturbance and dizziness.
Hyperbolic Tapering Guidance
Reduce gradually over months. Consider 10mg steps initially, then smaller reductions at lower doses. No liquid formulation available — tablet splitting may be necessary.
Summary written by TaperCommunity, informed by the Maudsley Deprescribing Guidelines (Horowitz & Taylor) and related literature — see Sources & References below. Not affiliated with or endorsed by the Maudsley.
Common Withdrawal Symptoms
Interactions & Safety
Drug Interactions
- MAOIs — contraindicated (risk of serotonin syndrome)
- Strong CYP3A4 inhibitors (ketoconazole) — reduce vilazodone dose to 20mg
- Serotonergic drugs (triptans, tramadol, St. John's Wort) increase serotonin syndrome risk
Food Interactions
- MUST be taken with food — bioavailability drops ~50% without food
- No specific food contraindications beyond the requirement to take with food
Contraindications
- MAOIs within 14 days
- Known hypersensitivity to vilazodone
Toxicity
Serotonin syndrome risk when combined with serotonergic agents. GI side effects are the most common dose-limiting toxicity.
Pharmacokinetics
ADME Profile
Oral bioavailability 72% with food (significantly reduced without food). Tmax ~4–5 hours. Must be taken with food.
Not well characterized; extensively distributed.
Hepatic via CYP3A4 (major), CYP2C19, and CYP2D6. Active metabolites are not clinically significant.
Primarily fecal (2% unchanged in urine).
96–99%
Apparent clearance ~40 L/hr
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Other Drug Profiles
Sources & References
Viibryd (vilazodone) information on this page is sourced from peer-reviewed research, regulatory bodies, clinical guidelines, and patient-advocacy organizations.
Encyclopedic & chemical databases
Neutral, high-authority entity references.
Peer-reviewed research
Primary literature cited in this taper guide.
- Horowitz MA, Taylor D 2019 — Tapering of SSRI treatment to mitigate withdrawal symptoms (hyperbolic taper) (The Lancet Psychiatry)
- Davies J, Read J 2019 — A systematic review into the incidence, severity and duration of antidepressant withdrawal effects (Addictive Behaviors)
- Framer A 2021 — The patient voice: an exploration of the experience of withdrawal from antidepressants (Therapeutic Advances in Psychopharmacology)
Clinical guidelines
Evidence-based deprescribing and prescribing standards.
Deprescribing-specific resources
Clinician-facing references on tapering protocols.
- Deprescribing.org — Evidence-based deprescribing algorithms from the Bruyère Research Institute
- Royal College of Psychiatrists — Stopping antidepressants — UK clinical guidance on safely discontinuing antidepressants
Patient-advocacy & lived-experience
Long-running communities documenting withdrawal experience.
- Surviving Antidepressants — tapering forum — Long-running community archive of antidepressant taper experiences
- Inner Compass Initiative — Withdrawal Project — Peer-led resources for psychiatric drug withdrawal
- Mad in America — antidepressant withdrawal archive — Journalism and personal narratives on SSRI/SNRI discontinuation
- RxISK — adverse drug reaction reporting — Independent database of patient-reported adverse effects
TaperCommunity does not provide medical advice. Always consult a qualified prescriber before adjusting psychiatric medication.