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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 36. This is the beginning of the thread.
Posted by roscopeeco on January 22, 2011, at 2:07:52
,
Posted by SLS on January 22, 2011, at 4:42:02
In reply to New antidepressant just approved. Vilazodone (nm), posted by roscopeeco on January 22, 2011, at 2:07:52
Vilazodone is a SRI / 5-HT1a receptor partial agonist. I am sure it will help with anxiety. I need to see robust antidepressant effects before I would consider discontinuing Nardil. Nardil and SRIs don't play well together - serotonin syndrome. Abilify, which I am currently taking with some success, happens to be a fairly potent 5-HTa partial agonist.
- Scott
Posted by Phillipa on January 22, 2011, at 10:38:12
In reply to Vilazodone - Thanks! » roscopeeco, posted by SLS on January 22, 2011, at 4:42:02
That's not the same as ago right? I was under the impression that this med was lagging behind agomelatonin? In what countries was it approved? Phillipa
Posted by theo on January 22, 2011, at 12:24:45
In reply to Vilazodone - Thanks! » roscopeeco, posted by SLS on January 22, 2011, at 4:42:02
What dose of Abilify are you currently taking? My doc suggesting re-trying Abilify if Luvox CR fails, ever tried or heard any success stories with Luvox CR for anxiety, mild depression? Tried generic fluvoxamine before and it was no good for me, but doc says the name brand CR is much better. I posted asking for input on it.
Thanks!
Posted by Conundrum on January 22, 2011, at 14:08:12
In reply to New antidepressant just approved. Vilazodone (nm), posted by roscopeeco on January 22, 2011, at 2:07:52
> ,
Pharmacologically, it looks unimpressive. Why would you want 5 HT1A partial agonism if you have serotonin acting as a full agonist. Isn't that the way serotonerigic drugs are though to work, by activating and downregulating that receptor? The only advantage I can see, from a pharmacological standpoint, is that the partial agonist might work more like an antagonist, and keep serotonin output higher than on a normal SSRI.
Posted by bearfan on January 22, 2011, at 17:29:40
In reply to Re: New antidepressant just approved. Vilazodone, posted by Conundrum on January 22, 2011, at 14:08:12
I believe this could be a very relevant treatment. What Vilazodone has got going for it is its lack of weight gain and sexual dysfunction (as shown in its clinical test against placebo). Almost all antidepressant treatments have this sort of side effect, and Viibyrd is 'broad acting' in which is should be useful for not only depression, but anxiety spectrum disorders due to the primary action on serotonin. What is not apparent is its 'true' efficacy in the real world. As far as a I know reading through the clinical trials, it was compared to citalopram and placebo. It may end up not have the efficacy of some other treatments such as venlafaxine, but if it doesn't cause those adverse side effects as in other treatments, it could prove very useful for not only 1st line treatments, but for patients that can augment it with other options. For example, what good is an effective treatment for depression if the user eventually gains intolerable weight gain or cannot perform in a sexual situation? It eventually causes med non-compliance. I also think Vilazodone is particularly appealing in a Primary Care environment. For instance, "Hey Doc, I'm suffering from depression symptoms, but worried about sexual side effects and/or weight gain associated with them." Doctor hears about Viibyrd and Rx's it due to his understanding of good tolerbility and lack of those concerns.
I personally am very interested in it, and hoping it is very similar in effects with current treatments without those side effects.
http://www.reuters.com/article/idUSN2111362920110122
Posted by linkadge on January 22, 2011, at 20:20:19
In reply to New FDA Approval for MDD Viibyrd (Vilazodone), posted by bearfan on January 22, 2011, at 17:29:40
>What Vilazodone has got going for it is its lack >of weight gain and sexual dysfunction (as shown >in its clinical test against placebo).
Heh, premarketing trials of celexa showed a 'low rate of sexual dysfunction'. It really doesn't matter what the drug companies claim. Clinical experience will be needed to determine whether it is any less likely to cause sexual dysfunction /
weight gain than other SSRIs.Linkadge
Posted by SLS on January 22, 2011, at 20:30:38
In reply to Re: New antidepressant just approved. Vilazodone, posted by Conundrum on January 22, 2011, at 14:08:12
> > ,
>
> Pharmacologically, it looks unimpressive. Why would you want 5 HT1A partial agonism if you have serotonin acting as a full agonist. Isn't that the way serotonerigic drugs are though to work, by activating and downregulating that receptor? The only advantage I can see, from a pharmacological standpoint, is that the partial agonist might work more like an antagonist, and keep serotonin output higher than on a normal SSRI.Signal-to-noise ratio.
- Scott
Posted by mrtook on January 23, 2011, at 13:01:05
In reply to Re: New antidepressant just approved. Vilazodone, posted by Conundrum on January 22, 2011, at 14:08:12
So this med is similar to taking an SSRI and buspar together? I think some people have results with this.
MrTook
Posted by linkadge on January 23, 2011, at 13:37:05
In reply to Re: New antidepressant just approved. Vilazodone, posted by mrtook on January 23, 2011, at 13:01:05
The herb dong quai inhibits serotonin reuptake in addition to 5-ht1a agonism.
Linkadge
Posted by bearfan on January 23, 2011, at 14:31:40
In reply to Re: New FDA Approval for MDD Viibyrd (Vilazodone), posted by linkadge on January 22, 2011, at 20:20:19
Viibyrd's unique method of action is what mitigates the weight gain and sexual side effects. Even if it doesn't work quite as well as some of the existing treatments, if the weight gain and sexual side effects are truly clinical less, I'd be glad to make the switch.
Posted by morgan miller on January 23, 2011, at 15:21:23
In reply to Re: New FDA Approval for MDD Viibyrd (Vilazodone), posted by bearfan on January 23, 2011, at 14:31:40
> Viibyrd's unique method of action is what mitigates the weight gain and sexual side effects. Even if it doesn't work quite as well as some of the existing treatments, if the weight gain and sexual side effects are truly clinical less, I'd be glad to make the switch.
I believe if one is disciplined enough, there are ways to at least take care of the weight gain issue for most people. The sexual side effects may be a more difficult obstacle to overcome.
I wonder if someone is in great shape, eats great, and loses weight, they might also regain some of their sex drive. Just a thought.
Posted by linkadge on January 23, 2011, at 15:35:43
In reply to Re: New FDA Approval for MDD Viibyrd (Vilazodone), posted by bearfan on January 23, 2011, at 14:31:40
>Viibyrd's unique method of action is what >mitigates the weight gain and sexual side >effects.
purportedly
Linkadge
Posted by digger7 on January 25, 2011, at 6:31:55
In reply to Re: New antidepressant just approved. Vilazodone » Conundrum, posted by SLS on January 22, 2011, at 20:30:38
What would be the ideal antidepressant if the F.D.A would approve it?
RJR7
Posted by ed_uk2010 on January 25, 2011, at 13:43:09
In reply to Re: New antidepressant just approved. Vilazodone, posted by digger7 on January 25, 2011, at 6:31:55
> What would be the ideal antidepressant if the F.D.A would approve it?
At the moment, no such product exists.
Posted by bearfan on January 25, 2011, at 16:22:37
In reply to Re: New FDA Approval for MDD Viibyrd (Vilazodone), posted by linkadge on January 23, 2011, at 15:35:43
I audited a presentation from Clincial Data and big name investors (WeedBush etc.). The folks at Clinical Data seemed very happy (almost elated) at the potential of this drug. From the conversation, a big strong point was the tolerability with lack of cardio and hepatic side effects. Weight gain and sexual dysfunction was also not apparent. My guess is the efficacy is near or possibly lower than some existing treatments, but can be useful for patients in a more stable period who wish to drop side effects for a medicine less strong. Cymbalta and Lexapro go off-patent in a year or two and the new approval will give it patent protection for quite some time.
Posted by Cecilia on January 26, 2011, at 3:16:52
In reply to New antidepressant just approved. Vilazodone (nm), posted by roscopeeco on January 22, 2011, at 2:07:52
From the information I have been able to find, Vilazodone sounds like a combination of an SSRI and buspirone (a combination many of us have tried without astounding results). Anyone know if this true or are there any other differences that make it worth considering? I just wish the drug companies would actually do some research on new drugs, instead of tweaking the old ones to increase their profits!
Posted by bearfan on January 26, 2011, at 15:35:44
In reply to Re: New antidepressant just approved. Vilazodone, posted by Cecilia on January 26, 2011, at 3:16:52
I don't think it's just that simple. Many people can't tolerate Buspar or SSRIs for that matter. The Partial agonist property is what helps prevent the bad side effects like weight gain and sexual dysfunction. There was just a conference with clinical data and investment firms and the folks that developed the drug were glowing with enthusiasm. I am sure they are aware with the clinical trial studies and know the potential of this medication. I have a hunch that Viibryd will be on par with existing SSRIs (with regards to efficacy) but a much less incidence of serious side effects. That being the case, this drug has big potential as a 1st line treatment. Plus there is always augment options for people not getting enough of an effect.
Posted by Cecilia on January 28, 2011, at 23:42:14
In reply to Re: New antidepressant just approved. Vilazodone, posted by bearfan on January 26, 2011, at 15:35:44
Yes, half the stuff I've been able to find on google about it is about the financial advantages the drug company and investors are hoping to gain from it now that most other AD's have gone generic. They didn't think it would be approved so quickly and are thrilled with the potential profits. What I haven't been able to find anything about is how exactly it is different from other SSRI's. Maybe the added partial agonist property will prevent some side effects but I'm sure there are plenty of other side effects still to be discovered. I've tried so many useless meds, just would like to know what there is, if anything, about this one that is different enough to make it worth trying.
Posted by Cecilia on January 29, 2011, at 1:47:19
In reply to Re: New antidepressant just approved. Vilazodone, posted by Cecilia on January 28, 2011, at 23:42:14
Plus there were only 400 patients in the study. That seems unbelievable to me. Do most drug studies have such a small number of patients? With half of them in the placebo group that means only about 200 got the actual drug. I don't understand the FDA; they will turn down a drug that's been safely used in other countries for many years with many thousands of patients and then turn around and approve a drug that was only tried on 200 people. Makes no sense to me.
Posted by 49er on January 29, 2011, at 9:30:05
In reply to Re: New antidepressant just approved. Vilazodone, posted by Cecilia on January 26, 2011, at 3:16:52
Personally, I would be very skeptical as if you all recall, Prozac was supposed to be side effect free and the new wonder drug. It didn't happen for many people.
This isn't an issue of being pro-meds vs. anti-meds as I have this skepticism with all meds. Eight weeks isn't nearly enough time to be able to test thoroughly for all side effects and efficiency.
Personally, if I were still taking psych meds, I wouldn't touch it for a few years just to see what problems people had that I should be concerned about.
Obviously, your mileage will vary.
49er
Posted by bearfan on January 30, 2011, at 0:39:46
In reply to Re: New antidepressant just approved. Vilazodone, posted by Cecilia on January 29, 2011, at 1:47:19
This is incorrect; based on the studies from clinicaltrials.gov/, nearly 3,000 patients participated in the trial with a year of drug exposure.
Posted by ed_uk2010 on January 30, 2011, at 13:24:44
In reply to New FDA Approval for MDD Viibyrd (Vilazodone), posted by bearfan on January 22, 2011, at 17:29:40
I suspect that vilazodone is going to be promoted extensively based on the alleged absence of weight gain and sexual side effects. To what extent these adverse effect occur in the real world remains to be seen. SSRIs were initially advertised as causing zero weight gain, but we now know that some patients do gain weight during long term treatment. Rates of reported sexual side effects were often quite low during SSRIs trials, which is in contrast to the real world experience with these drugs. I don't think patients were correctly assessed for these side effects.
Posted by phillipa on January 30, 2011, at 19:09:57
In reply to Marketing, posted by ed_uk2010 on January 30, 2011, at 13:24:44
Ed trials only weeks long. PJxx
Posted by rogerk on January 31, 2011, at 1:51:24
In reply to Re: Marketing » ed_uk2010, posted by phillipa on January 30, 2011, at 19:09:57
trazodone is an easy go to sleeping helper. but for what it lacks in is the cadiovascular side effects. it doesn't affect you're weight too much, or sexually too much.
but it would always affect my heart.
hopefully, vilazodone, is in this aspect better than the old ones of serzone and the others. and being an antidepressant would help for sleepl.
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