Is Vilazodone/Viibryd Any Better Than Other Antidepressants?

[@hannahbnanalovesyou]

Vilazadone was been the only antidepressant that’s worked for me. I’ve been on at least 10 different ones throughout the years with no success. Vilazadone doesn’t necessarily make me “happy” but it makes it easier to deal with the ups and downs of life. I can still experience my full range of emotions but my lows aren’t so low. I’m so thankful for this medication, it truly saved my life after over 10 years of Major Depressive Disorder.

[@ShrinksInSneakers]

Thats great, every individual will be different and some will find one medication to be substantially better for them. Unfortunately, the science doesn't support a lot of the pharmaceutical companies claims about the medication and it did not outperform citalopram 40 mg/day in a head to head trial. I'm not saying people should stop using it, or not consider it after other medications have been tried. IMO the most important thing is you feel good and are doing well. Hope this helps

[@DL-ut8vr]

nothing has worked with me besides benzos. I have taken a genesight test also wich proved it...I was also hoping to try this... thank you for the info on your experience.

[@RoxanaAlarconpalomino]

Hello friend, a question. Did taking vilazodone affect your erections and ejaculation? They say antidepressants cause that. But my husband was recommended to take vilazodone, how was it for you?

[@talla8555]

Completely agree. I've tried alot I'm 41 now bit in my teens tried everything. This has been the only medicine that's helped with depression and PMDD.

[@lynettepat2646]

I just started taking it and it is hands down the best antidepressant I have ever been on. I don’t feel anxious and I have a lot of energy.

[@Jay-King]

I was part of a Vilazodone study years ago and it was a life changer for me. Had never felt better in my life! It's about time they made a generic.

[@MplsDiamond]

Generic was approved and released this year in 2022

[@ShrinksInSneakers]

It's here generic Vilazodone for $40 a month not too bad

[@ShrinksInSneakers]

@@MplsDiamond June of 2022

[@MANIFESTFASTWITHJASMINE]

I took Vibryd around 8 years ago after a traumatic experience that left me clinically depressed and it really saved my life. I was able to feel happy and a normal range of emotions without being a zombie. I also did not experience any sexual side effects. It does have 1 side effect I experienced which is that it causes high or lows. I definitely did experience that. So I might be crying for 3 days straight, once and a while, but it was better than being agonizingly depressed all the time. I was able to wean off this drug within 2 years and no longer have depression anymore, but taking this drug was an important stepping stone for me.

[@shannonbolton553]

Most of the conversation on Viibryd is related to depression. How well does it work for GAD, social anxiety and panic?

[@BlondeVolDoll]

Been on Vibryd (however ya spell it) for about 2 months. I have noticed a little difference. Really enjoy all this information! Thankyou! 😊

[@ericjandrade]

This was great. I just got Vilazodone prescribed a three weeks ago and after meeting with my psychiatrist today in follow up, he mentoned the 5-HT1A receptor agonist bit as he notced my anxiety levels were significantly lower. I appreciate this in depth descrption of the medication becauase I am very interested in understandnig the medication I'm taking and why--in this case--I'm getting a much more significant result in terms of anxiety reduction. New subscriber and def looking forward to having a look at your videos. Thank you!

[@jasongendron8309]

did the vilazodone work out?

[@nathankaiser2511]

Thank you Dr, very helpful with lots of clarity Amen

[@Complexanxiety]

This medicine threw my anxiety into overdrive and I started having several anxiety attacks per week.

[@stevo5000]

I enjoy your videos. I'm a bit surprised you haven't yet covered LDN as a treatment for depression or mood disorders. It's known to increase endorphin levels, as a fact and has lots of pub med references to how it has had positive effects on depression related disorders. Have you ever prescribed it for that purpose or do you have any experience with it? A video about that would be great.

[@ShrinksInSneakers]

If we are talking about low dose naltrexone I think the data in depression is limited. I’ve seen a lot of data on chronic pain and inflammatory disorders. If you watched my video on depression and inflammation I can see how the concept would make sense. My concern is psychiatry is filled with a history of medications whos mechanism makes sense but it doesn’t play out clinically. In short I haven’t used it but I’m not opposed to the idea and I can see why it might make sense in patient with high inflammatory markers and depression. Hope this helps

[@Steve-qt2xm]

@@ShrinksInSneakers Yes actually I think you're right about not enough clinical data in relation to how it works with depression. Thanks for replying

[@ShrinksInSneakers]

@@Steve-qt2xm I would say I've seen more data for buprenorphine in low doses for depression but I will be seeing an eye out for more data

[@profet1385]

@@ShrinksInSneakers personally I've been taking LDN for several years and it's been a life saver i can't live without it. I get extreme fatigue and sense of impending doom without it. I'd say it manages my symptoms 70%. I am still often depressed, but I've tried coming off LDN a couple times and it was 10x worse, I was sleeping constantly and not feeling rested, brain fog, et cetera. With that being said, I would not recommend it as a nootropic or antidepressant per se, I have a chronic illness that LDN helps and that's it. Also the dreams on it are really, really cool, I filled several dream journals thanks to it and I'm filling another one.

[@pako2790]

Nice work as always! What about amitriptiline and perphenazine combo? Would you make a video on that? Been tested to more than 6 antidepressants over 3 years and my salvation from severe anxiety and depression came from that combo, 25mg/2mg twice daily. Old fashioned maybe, works like a charm though, got my life back!

[@ShrinksInSneakers]

I think this tell u something I've been saying a lot recently, Old medications are more effective and New Medications are safer but what you give up in safety you gain in efficacy with older meds. Hope this helps I appreciate the support, please spread the word about what we are doing here

[@sassy_steph]

@@ShrinksInSneakers this video helped me since ill be taking thesemeds soon. Was allergic to wellbutrin sadly. IMO id rather have safer meds to use the meds as a tool plus meditation and therapy instead of how paxil made me a zombie. I dont want to run from my feelings, i just want some help through the ups and downs.

[@jessiramz3]

Great video. My doctor and I are trying to find the right medication for me. Can you make a video on Prozac and Wellbutrin combination?Your videos are very informative.

[@mauriciojr.4428]

The right combination is Zoloft + Wellbutrin

[@ShrinksInSneakers]

I will see if we can get that done. Thanks for watching and please subscribe and spread the word about what we are doing here

[@jameshammond680]

What about the sleep paralysis issue? That's why I couldn't tolerate vilazodone. The sleep paralysis was absolutely terrifying. If I'm not mistaken there's a warning for that now with this medication.

[@davidsickel9531]

Dr. Rossi I have been on paroxtine for 20 years and I am considering working with my psychartist to cross taper to Vilazadone for an SSRI that is non anti Cholinergic and that has that partial 5HTA1 action that has less sexual side affects than my current paroxtine. My psychartist is also a fan of Trintellix.

[@sanalsingh]

Hi Sir, please answer, There are 2 medicines, vilazodone and vortioxetine. Do any of these 2 medicines help with OCD?

[@Steve-eh6qv]

I am going to ask my doctor about how to switch from fluoxetine to Viibryd. Im concerned because fluoxetine has a long half life, and it’s metabolite lasts even longer. I’ve been on all ssri/snri with little success along with various augmentation therapies. Therapy helps but I’m tired of feeling tired. Fluoxetine helps with some OCD symptoms but not by much - I’m just on it because I’ve exhausted all other options these past 20 years (I’m 41). I do take Modafinil which helps with energy but I’d like to still switch from fluoxetine to viibryd.

[@robertcoubrough5492]

Doctor: Llevo 8 años tomando fluvoxamina 100mg diarios y alprazolam 1mg diario. La fluvoxamina me a funcionado bien durante todo este tiempo. Pero tiene efectos secundarios indeseables en mi. Como por ejemplo, aumento de peso, somnolencia y lo peor de todo! Pérdida de la libido. Hace unos dias mi Psiquiatra me receto vilazodona. Y necesito si usted es tan amable Doctor, saber su opinión al respecto 🙏

[@mariomello3495]

Olá, usted início lá vilazodona? Soy de Brasil y estoy tomando 40 mg (03 dias hoy) para ansiedad.. estás sentindo mejoras?

[@robertcoubrough5492]

No. Todavía no comenze, estoy con dudas. Le deseo suerte en la evolución de su tratamiento ​@@mariomello3495

[@shiningarmor4921]

Very interesting breakdown of a medication I almost started before my insurance decided they weren’t interested in paying for it. I’m curious of your opinions on adrenergic uptake inhibitors like atomoxetine and viloxazine, as I’ve been doing well on atomoxetine after several failed SSRIs

[@mogotrevo]

viloxazine was horrible.. I can only describe it as catatonia. I doubt I would do any better on atomoxetine but who knows.

[@ShrinksInSneakers]

As options for non-stimulant ADHD treatment they are good in theory they should work for depression as well but there randomized controlled data is limited and it's hard to recommend it other than as an off label option when other medications have failed Hope this helps if you haven't subscribed to the channel please do and spread the word about what we are doing here

[@gts447]

Thanks from r the video, another great one. Yea I wonder if mirtazapine is somewhat similar to vilazadone in the serotonin modulation and maybe the 5ht stuff but that part is probably different. Anyway, good to have some info about a new med. enjoyed the psychedelic series though somewhat disappointed by the conclusions there. Thanks 🙏

[@ShrinksInSneakers]

lol, I figured people would be disappointed. You guys ask me to present evidence based scientific data and a lot of times the since falls behind the subjective user data that we have. I think it's coming but we want real data or this psychedelic thing turns into cannabis where I'm still waiting for the randomized controlled trials to prove the claims. Thanks for watching

[@sandrar9608]

I was on Viibryd 5 years ago but thought it was tearing up my stomach but realized it was something else. Now on the generic but feel it’s not the same at all.

[@ShrinksInSneakers]

thanks for watching and sharing your insights

[@Filthycoffin]

This medication was horrendous for me even though my genetics test told me I would do well with it it gave me severe acathisia tardive dyskinesia dystonia and insomnia where I did not sleep at all for the entire 4 to 6 months that I was in it. It also made me itch really bad

[@Ilovewyatt01]

Are Viibryd and Rexulti similar medications? If not, what are the differences?

[@danielstonemusic94]

Prozacs the goat. Especially combined w zyprexa

[@cesarguitarra1975]

Ocd is an off-label use on this medication, according to what I've read. Do you have any experience prescribing it to an OCD patient? Thanks!

[@BusterHyman2]

What about if I was only prescribed 10mg with no plan on titration up to the target dose?

[@Turtlesrcool95]

Please make a video on Geodon (ziprasidone)

[@asenhris]

Effexor / Wellbutrin combo? I’d love a video on this :)

[@ShrinksInSneakers]

We can do something like that

[@mmsanrio]

Trintellix & Wellbutrin has worked the best for me. 🙏🏼

[@bpggg]

Since SERT inhibition increases the binding at all Serotonin receptors what are the receptors that give the antidepressant effect of SSRIs given the fact that so many receptors, when they experience antagonism, actually produce therapeutic effects downstream. Is the 5HT1A the principal one or are there others? You mention it as an auto receptor in its effect but what about it effects as a post-synaptic receptor? Thank you.

[@ShrinksInSneakers]

There are several, serotonin interacts with 17 different receptors the most well studied are 5-HT1A and 5-HT1B. Others are also believed to have antidepressant effects depending on the activity antagonism Vs agonism. 5-HT1A postsynaptically is also known to be involved with depression treatment. Many of these effects were studied in knock out mice as a model. This is more in-depth topic that probably requires a video to fully appreciate. Hope this helps get you started.

[@bpggg]

@@ShrinksInSneakers I've been reading journal articles. Hopefully not too trouble you too much in the future: What serotonin receptors as being effected as pure agonists would be implicated in depression treatment? And the same question insofar as anxiety if you could. I'm just asking so I can get a strong foothold in my journal search on Pubmed. I'm just mainly into this as far as intellectual curiosity. I'm bipolar 2 by diagnosis but I work in a large forensic psychiatric hospital (that will go unnamed) and my interests have expanded beyond my diagnosis. I'm a big fan of Dr. Stahl. I really enjoy your videos and thank you for your response. I hope you will be able to answer my follow up questions sometime.

[@bpggg]

@@ShrinksInSneakers Since you kindly answered my question on this video thread I wanted to pose another. I, at one point, through a process of defacto cross-titration was discovered to have a very good response to Latuda and Abilify in combination (I know antipsychotic polypharmacy is generally not desirable). My dr had discontinued my Abilify without titration as it was not quite helping with my depression although it seemed to keep my mood stable albeit a "low" stable (I have Bipolar 2). I was on 30mg daily. He started the Latuda at 60mg daily and my mood improved markedly within days, nice and euthymic. Then I began to decompensate a few days later apparently as the Abilify washed out. It was decided to reintroduce the Abilify at the original dose while keeping the Latuda and about a week later I was stable and euthymic again. My notion is that the Abilify was primarily the agent binding to the D2 receptors due to it's strong affinity and that Latuda was working more on the receptors that Abilify not as strongly, but still effects, such as 5HT7. What are your thoughts on the matter? Just an idea on my part. Anyway a few years ago I developed essential tremor and the only medication that helped was Primidone. Alas due to hepatic metabolism issues the Latuda became non-existent in my system (we did labs) and the Abilify level at 30mg plunged. At 60mg Abilify I do well enough but it has never been the same. I apologize for the flurry of questions but I figured it might be a good chance to ask another. Thanks again.

[@myqe2]

Violently ill from villbryd for one month.

[@jasonr8364]

Which medication is the most effective of all time

[@ShrinksInSneakers]

right now the two things that are most effective for depression are Ketamine and ECT we might beading the new TMS protocal created at Stanford SAINT as well. The effect size for SSRIs is 0.33 and 0.36 for SNRIs. These newer medication haven't faired much better (these are low to moderate effect sizes that are used as a measure to show how effective a medication is, the larger the number the better). to put it in perspective ketamine is around 0.8 which is a large effect size

[@RoxanaAlarconpalomino]

Doctor, can vilazodone improve premature ejaculation?

[@mmsanrio]

I was given Viibryd about 9 yrs ago. It was ok for a couple of mos, I think? But then the brain explosions, loud bee buzzing painfully loud in & out, & caused horrific sleep paralysis for the 1st time in my life. I even woke to see the grim reaper during daylight nap & it was about 6’ tall & standing next to my bed! Similar to a horror movie, I made a plan to fight the demons. I had to call out for Jesus! The demon was pulling, I was fighting it (feeling all torn up) & it finally jumped off me & the bed, swatted my feet & ran out of the room. I moved my bedroom to another room in the house. PTSD! It took me weeks of brain explosions to get off of it. I had to take Prozac to get off Viibryd. It’s easy to hate your Dr. for offering such a med. All the sleep paralysis stories are out there! I just can’t understand why it did this to me. 😢

[@mmsanrio]

And I don’t believe in the grim reaper (maybe I should?) but there it was, red eyes too. I tried to catch naps to recover in daylight as to avoid the dark. During 1 doze off, it felt like I was hit in the head & then the bright orange brain 💥 explosion with it. I’ve felt zaps before, these are explosions. Just be careful what you wish for when deciding to try a new a/d. Always wean w/ Prozac?

[@rosedragon108]

my understanding was that Viibryd did NOT give the concomitant weight gain

[@stevenj429]

What do you think about a combination of Ketamine and Viibryd for severe OCD? I'm curious about this, because I started Viibryd a month ago (so far no side effects and feel fine), and my doctor wants me to do Ketamine with it as well. I start Ketamine in a month. I am extremely sensitive to the SSRIs in terms of side effects, so I have been unable to go up to a high dose of Prozac, Zoloft, etc. I have also tried Clomipramine, and the side effects were horrific on that as well.

[@ShrinksInSneakers]

It's hard to say at this time as there are only a few small studies that looked at ketamine in OCD. I would say there is more evidence right now for TMS in OCD. I think we may learn that ketamine will be a good option in the future but right now we need more data.

[@stevenj429]

@@ShrinksInSneakers Thanks! I will look into TMS. Out of curiosity, which drug(s) do you normally use first for your patients with OCD? And how long should that person give that drug to work?

[@ShrinksInSneakers]

@@stevenj429 Important question, the standard of practice is SSRIs to start but the dose must be higher than those used to treat depression. Examples would be fluoxetine 120 mg/day, or Sertraline 300 mg/day. This should be continued for a full 12 weeks not the typical 4 weeks for depression. The next step if that does not work would possibly be a trial of clomipramine a TCA or the adjunctive use of a dopamine blocking medication such as risperidone or aripiprazole the two approved medications for this treatment.

[@stevenj429]

@@ShrinksInSneakers Thanks so much for your responses! I probably should have stayed on Prozac longer. I went off of it due to sexual side effects and low motivation (Prozac increased motivation at first, then it dropped). Is there anything that can be added to Prozac to decrease these? I've heard of Wellbutrin being added to Sertraline to combat these side effects, is it safe to add Wellbutrin to Prozac?

[@ShrinksInSneakers]

@@stevenj429 Usually Buspirone, I have an entire video on it if you are interested check it out.

[@crystalcruz3768]

I am pretty sure viibryd caused my histamine intolerance. Anyone else have this happen to them?

[@rosedragon108]

when it says "with food" - how MUCH does that mean? and WHAT does that mean? are we looking for a dual effect from a macro-nutrient aka protein? or are we 'protecting' VIIBRYD from stomach digestion? - aka can i just eat a couple tablespoons of peanuts? or do i need a "balanced meal: carbs and protein and fat?

[@ps4killzone584]

Is this drug likely to be helpful with OCD?

[@ShrinksInSneakers]

At this time there are no randomized controlled trials on Viibryd in OCD. I can't provide much information without the data. With OCD the primary neurotransmitter is serotonin and that is why many say clomipramine is the gold standard because it's most serotonergic of the TCAs. I do not consider OCD treatment with SSRIs to be failed until the medications have been maximized 120 mg fluoxetine for example for a complete 12 weeks before deciding it's a failed trial. Hope this helps if you haven't subscribed to the channel please do and spread the word about what we are doing here.

[@nickdaskalakis9289]

Sounds a lot like Valdoxan and probably just as expensive

[@garysimone4977]

How did this even get approved ?????

[@Chris-ed1pw]

vilazodone is generic now btw

[@attheranch873]

OK, to make a very long story short, you’re saying that it’s not proven to be any better than any other antidepressants. I wish you would’ve started with that and I wouldn’t have wasted my time listening to a bunch of stuff I don’t understand..

[@Bemandyd]

Ugh the statistics and numbers in this video were so unnecessary😵‍💫

[@ShrinksInSneakers]

yeah it's a lot but I want viewers to be educated on what they put in their body and all scientific research and true understanding of data requires some statistics, I do hear where you are coming from and thanks for being a part of the community

[@roccorubino6288]

Waaaaayyy too much medical jargon. You lost me early on.

[@ShrinksInSneakers]

This channel targets higher level information, sorry it couldn't be more helpful. If you really want to understand what you're taking/prescribing some medical jargon is required. Best of luck

[@garysimone4977]

What do you make of all the recent studies basicly disputing pretty much your theory. Plus no long term studies ( more then 13 months ) have not been done , thus no info on long term effect Only 7% better then placebo , only 23% effective over 8 weeks. ALL DUE RESPECTTHATS A DIISASTER RESULTS Badicly all these ssri etc are crap Dr