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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 5 to 29 of 29. Go back in thread:
Posted by jerseygal111 on March 14, 2012, at 16:44:18
In reply to Viibryd (vilazodone) - What is the Verdict?, posted by SLS on March 3, 2012, at 9:14:38
Vibryd did not work for me. It did nothing for my depression, anxiety or obsessive thoughs.
Posted by kagome on March 14, 2012, at 23:48:25
In reply to Re: Viibryd (vilazodone) - What is the Verdict?, posted by jerseygal111 on March 14, 2012, at 16:44:18
Sorry to hear it didn't help but thanks for responding, I've heard so little about it so far.
Posted by SLS on March 15, 2012, at 5:56:32
In reply to Viibryd (vilazodone) - What is the Verdict?, posted by SLS on March 3, 2012, at 9:14:38
> Viibryd has been available for over a year.
>
> Any comments?
>
> How well does Viibrd work to treat:
>
> 1. Depression
> 2. Anxiety
> 3. OCD
>
> What side effects have emerged?
I tried Viibryd last October. The stuff worked pretty well, but only for a week or so. There were no sexual side effects. That Viibryd had any positive effect at all for me is remarkable. I was hoping that this drug would work well for at least some people. At least one person here is having success with using Viibryd to treat OCD.I don't know if the lack of positive reports regarding the use of Viibryd on Psycho-Babble is the result of a lack of efficacy or a lack of of its being prescribed.
Perhaps Viibryd would make a good augmenter to drugs like Wellbutrin or Remeron (drugs that aren't strong SRIs) to treat depression. Viibryd is a fairly potent SRI. Unlike other SRIs, it is a partial agonist of 5-HT1a receptors. Buspar does this, too, and is sometimes reported to be a good augmenter. Of course, this is just wishful thinking on my part. By the way, a number of the newer neuroleptic antipsychotics are partial agonists of the 5-HT1a receptors. These include Abilify, Geodon, Latuda, and cariprazine, a new antipsychotic that will probably be approved soon.
- Scott
Posted by phidippus on March 16, 2012, at 16:28:13
In reply to Re: Viibryd (vilazodone) - What is the Verdict? » SLS, posted by SLS on March 15, 2012, at 5:56:32
I find it curious that many people report it does not work for them.
As for it being a good augmenter, I find it too potent to recommend it as such.
Eric
Posted by SLS on March 17, 2012, at 5:11:41
In reply to Re: Viibryd (vilazodone) - What is the Verdict? » SLS, posted by phidippus on March 16, 2012, at 16:28:13
Hi Eric.
> I find it curious that many people report it does not work for them.
Viibryd did improve my condition transiently. I was hoping that this was an indicator that it would be effective for others.
> As for it being a good augmenter, I find it too potent to recommend it as such.In what ways? What do you experience that leads you to say that? Are you concerned about serotonin syndrome?
- Scott
Posted by phidippus on March 17, 2012, at 19:33:56
In reply to Re: Viibryd (vilazodone) - What is the Verdict? » phidippus, posted by SLS on March 17, 2012, at 5:11:41
Serotonin syndrome is certainly a consideration, as I have already experienced it on the medication-accidently took 80 mg for 3 days straight.
Otherwise, Viibryd is just too replete-I would augment Viibryd with something, but not the other way around.
Eric
Posted by SLS on March 17, 2012, at 20:53:32
In reply to Re: Viibryd (vilazodone) - What is the Verdict? » SLS, posted by phidippus on March 17, 2012, at 19:33:56
> Serotonin syndrome is certainly a consideration, as I have already experienced it on the medication-accidently took 80 mg for 3 days straight.
>
> Otherwise, Viibryd is just too replete-I would augment Viibryd with something, but not the other way around.
>
> Eric
Perhaps Wellbutrin would be complementary.
- Scott
Posted by phidippus on March 17, 2012, at 21:00:48
In reply to Re: Viibryd (vilazodone) - What is the Verdict? » phidippus, posted by SLS on March 17, 2012, at 20:53:32
What dose would you recommend?
Eric
Posted by SLS on March 18, 2012, at 9:14:31
In reply to Re: Viibryd (vilazodone) - What is the Verdict? » SLS, posted by phidippus on March 17, 2012, at 21:00:48
> What dose would you recommend?
>
> Eric
When combining Wellbutrin to Viibryd, I would think about adding a full 300 mg/day dosage of Wellbutrin. I have seen this be necessary numerous times when Wellbutrin is combined with a SRI drug. The two drugs are more complemantary than they are additive with respect to the systems they affect.How much Wellbutrin would one add to Zoloft or Effexor?
I consider this type of complementary combination treatment adjunctive rather than augmentive based upon their mechanisms and clinical effects. I think the semantics are important.
- Scott
Posted by phidippus on March 18, 2012, at 19:59:05
In reply to Re: Viibryd (vilazodone) - What is the Verdict? » phidippus, posted by SLS on March 18, 2012, at 9:14:31
I take Latuda, a potent dopamine antagonist. Won't it negate some of the effects of the Wellbutrin?
Eric
Posted by SLS on March 19, 2012, at 6:33:28
In reply to Re: Viibryd (vilazodone) - What is the Verdict? » SLS, posted by phidippus on March 18, 2012, at 19:59:05
> I take Latuda, a potent dopamine antagonist. Won't it negate some of the effects of the Wellbutrin?
Gosh. That's a good question for which I don't know the answer. I guess it's no secret that I don't tend to rely on theoretical thinking to exclude treatment alternatives like this one. I would, on the other hand, use theory to exclude treatment alternatives with when safety and side effects are concerned. On the other hand, I am more likely to incorporate theory when choosing drugs to include as an alternative.
Theoretically, one might argue that a neuroleptic and Wellbutrin might act on different regions and circuits in the brain. They would thus not act antagonistically so as to "cancel each other out". Empirically, it should be noted that the addition of Wellbutrin can make worse OCD and tics. It can also produce irritability and agitation. In your case, I would be wary of the potential for Wellbutrin to worsen OCD. If you opt to try Wellbutrin, it is probably a good idea to abort the trial early if this occurs.
Regarding dosages, I tend to see augmentation and adjunctive treatments as combinations of full therapeutic dosages of the component drugs. Of course, serotonin syndrome is a risk when SRI drugs are combined. I don't know of any statistics or clinical impressions as to how often this occurs, though. It is done. Even the addition of lithium to an SRI can produce serotonin toxicity. However, with the latter combination, I think the potential benefit is worth the relatively small risk.
- Scott
Posted by psychobot5000 on March 27, 2012, at 13:34:14
In reply to Re: Viibryd (vilazodone) - What is the Verdict? » SLS, posted by phidippus on March 18, 2012, at 19:59:05
> I take Latuda, a potent dopamine antagonist. Won't it negate some of the effects of the Wellbutrin?
>
> EricIf you don't mind my asking, do you find Latuda to be beneficial for memory or cognition?
Posted by phidippus on March 28, 2012, at 17:44:59
In reply to Re: Viibryd (vilazodone) - What is the Verdict? » phidippus, posted by psychobot5000 on March 27, 2012, at 13:34:14
I founf Latuda to have a very transparent effect, in other words, I noticed no chnange, good or bad.
Eric
Posted by UGottaHaveHope on July 5, 2012, at 2:59:56
In reply to Re: Viibryd (vilazodone) - What is the Verdict? » psychobot5000, posted by phidippus on March 28, 2012, at 17:44:59
Anybody else?
Posted by nerdmom1959 on August 24, 2013, at 12:18:19
In reply to Re: Viibryd (vilazodone) - What is the Verdict? » SLS, posted by SLS on March 15, 2012, at 5:56:32
I have MDD with anxiety and did well on a very low dose of Lexapro (5mg daily) for years. I was forced to go off "cold turkey" (big mistake) because it was causing long QT. I have been on Viibryd since September 2012. I was able to get by on 20 mg daily until about 6 weeks ago, when job stressors increased my anxiety and my pdoc increased me to 40 mg daily. I also take Concerta 18 mg daily.
PROS: 1. Viibryd controls my depressive symptoms very well -- no tearfulness, hopelessness, apathy, etc. 2. I lost the 15 pounds I was hanging on to while on Lexapro and have not gained it back 3. Viibryd does not affect my QT
CONS: 1. Profound dysgeusia 2. Given my current life events, it does not cover anxiety as well as Lexapro (it is about as effective as Desipramine, which I took back in the day). My pdoc has prescribed clonazepam PRN to get me through the current life issues (she says anyone would have anxiety if they were in my shoes even if they didn't have MDD) but I really hate to take it unless I have to.
So, if I could I would take Lexapro, but I can't, so Viibryd has been a lifesaver (literally) for me.
Posted by psychobot5000 on August 24, 2013, at 12:42:26
In reply to Re: Viibryd (vilazodone) - What is the Verdict?, posted by nerdmom1959 on August 24, 2013, at 12:19:11
From my experience, I think you are right to be wary of the clonazepam. Hopefully these life stressors will pass and it will be no big deal in the long term, but in my experience those medications tend to cause dependence and rebound anxiety, later, so I think you are right to be wary.
I'm glad to hear vilazodone worked well for you. Given that lexapro worked even better, is it possible to supplement it with a small dose of another SSRI? Perhaps one of the others wouldn't give you long Q-T syndrome? Just a thought. Thanks for sharing your experience, and I hope things get better for you soon.
> I have MDD with anxiety and did well on a very low dose of Lexapro (5mg daily) for years. I was forced to go off "cold turkey" (big mistake) because it was causing long QT. I have been on Viibryd since September 2012. I was able to get by on 20 mg daily until about 6 weeks ago, when job stressors increased my anxiety and my pdoc increased me to 40 mg daily. I also take Concerta 18 mg daily.
>
> PROS: 1. Viibryd controls my depressive symptoms very well -- no tearfulness, hopelessness, apathy, etc. 2. I lost the 15 pounds I was hanging on to while on Lexapro and have not gained it back 3. Viibryd does not affect my QT
>
> CONS: 1. Profound dysgeusia 2. Given my current life events, it does not cover anxiety as well as Lexapro (it is about as effective as Desipramine, which I took back in the day). My pdoc has prescribed clonazepam PRN to get me through the current life issues (she says anyone would have anxiety if they were in my shoes even if they didn't have MDD) but I really hate to take it unless I have to.
>
> So, if I could I would take Lexapro, but I can't, so Viibryd has been a lifesaver (literally) for me.
>
Posted by nerdmom1959 on August 24, 2013, at 12:51:22
In reply to Re: Viibryd (vilazodone) - What is the Verdict? » nerdmom1959, posted by psychobot5000 on August 24, 2013, at 12:42:26
Sadly, all of the SSRIs, tricyclics and mirtazapine can exacerbate long QT in susceptible individuals. My QT was elongated and I was only on 5 mg of Lexapro (not even considered a "therapeutic dose" but I am a very small person and Viibryd is the only AD that I've taken at what is considered therapeutic for an adult).
I do take clonazepam before going to bed on work nights because I tend to wake up in mid-thought if I don't. Because poor sleep will only make the situation worse (and I don't use it on weekends and only during this "crisis"), I'm willing to take it on this very controlled basis.
The issue of meds that affect QT even in folks who do not have congenital long QT is relatively new, and in some folks it is the combination of some drugs that will set it off. The site is excellent for the latest on long QT and drugs:
http://www.crediblemeds.org/everyone/composite-list-all-qtdrugs/
Thanks for your kind words.
Posted by psychobot5000 on August 24, 2013, at 13:39:43
In reply to Re: Viibryd (vilazodone) - What is the Verdict?, posted by nerdmom1959 on August 24, 2013, at 12:51:22
Hi,
I'm aware of QT problems with antidepressants--had a number of EKGs myself for that reason. I still think that, well, I don't know what your history is, but just because one drug in a class gives you a side-effect for which that class is known, doesn't mean all the others will. Maybe you're doing well enough you don't need to worry about this, but unless you've already tried one or two more SSRIs at least and found that they mess with your heart rhythm unacceptably, it seems to me it still might be worth a try. You never know until you try. Maybe in this case, it could be as simple as taking a single dose, reading a magazine for an hour for it to penetrate into the blood-stream, then going and getting another EKG. An experienced technician (or the machine) might be able to tell you right there whether you're getting long Q-T again. Just a thought, since you're lucky enough to have a medication that actually did work for you quite well (I'm not fan of SSRIs in general--they give me many other nasty side-effects). Obviously, you'd be trying something other than Celexa, since that's almost the same drug as before, but you probably knew that.
All the best. Apologies if I'm meddling. I just wanted to throw the idea out there.
PB> Sadly, all of the SSRIs, tricyclics and mirtazapine can exacerbate long QT in susceptible individuals. My QT was elongated and I was only on 5 mg of Lexapro (not even considered a "therapeutic dose" but I am a very small person and Viibryd is the only AD that I've taken at what is considered therapeutic for an adult).
>
> I do take clonazepam before going to bed on work nights because I tend to wake up in mid-thought if I don't. Because poor sleep will only make the situation worse (and I don't use it on weekends and only during this "crisis"), I'm willing to take it on this very controlled basis.
>
> The issue of meds that affect QT even in folks who do not have congenital long QT is relatively new, and in some folks it is the combination of some drugs that will set it off. The site is excellent for the latest on long QT and drugs:
>
> http://www.crediblemeds.org/everyone/composite-list-all-qtdrugs/
>
> Thanks for your kind words.
Posted by nerdmom1959 on August 24, 2013, at 14:05:20
In reply to Re: Viibryd (vilazodone) - What is the Verdict?, posted by psychobot5000 on August 24, 2013, at 13:39:43
I don't think you're meddling, but I have had symptoms with the other drugs and if you read the QT literature, it actually applies to all members of a certain class, not just one drug, and some have more profound effects than others. This is actually pretty new -- some physicians aren't even aware that so many different classes can have an impact on QT in people who don't have congenital long QT. My internist and cardiologist are adamant -- no SSRI class, no tricyclics, no macrolides, etc.
Personally, I'm holding out for Ketamine :-)
Posted by psychobot5000 on August 24, 2013, at 20:44:14
In reply to Re: Viibryd (vilazodone) - What is the Verdict?, posted by nerdmom1959 on August 24, 2013, at 14:05:20
> I don't think you're meddling, but I have had symptoms with the other drugs and if you read the QT literature, it actually applies to all members of a certain class, not just one drug, and some have more profound effects than others.
I'm not arguing that QT effects are not found all across the class--merely that the fact that QT effects are found in a given individual with a certain member of that class does not mean that all other members of the class will manifest the same negative side-effect in that same individual. They won't. Your odds are worse, of course, if you've had that effect with the first drug, but it's entirely probable that one or more of the others won't--even if they all cause a statistically significant increase in the likelihood of long QT syndrome. A single positive finding doesn't mean they'll all have the same effect ON A GIVEN INDIVIDUAL, even if they're all known to increase the chances. It just doesn't. Everyone reacts differently to every individual drug, and the only way to tell is trial and error.
The downside, of course, is that the others might not have the same positive effects, either. I'm glad Viibryd has offered you partial relief.
Best,
PB
Posted by Chris O on August 29, 2013, at 23:34:46
In reply to Viibryd (vilazodone) - What is the Verdict?, posted by SLS on March 3, 2012, at 9:14:38
Took it for 8 months. It did absolutely nothing for me--still depressed, anxious, de-energized all the time.
Posted by nerdmom1959 on August 30, 2013, at 6:25:07
In reply to Re: Viibryd (vilazodone) - What is the Verdict? » SLS, posted by Chris O on August 29, 2013, at 23:34:46
Actually, I have been on the maximum dose (40 mg) for 6 weeks and I have noticed in this past week my anxiety is starting to taper off and I don't need to augment with clonazepam hardly at all. It's kind of like Buspar -- takes forever and the change is so gradual you don't really notice it at first. I am not anxiety free, so I hope I see more improvement before I hit my new baseline.
Posted by porkpiehat on June 17, 2014, at 23:27:01
In reply to Re: Viibryd (vilazodone) - What is the Verdict? » SLS, posted by Chris O on August 29, 2013, at 23:34:46
I'm switching off Brintellix to Viibryd right now. We were trying to get the Buspar effect in me without the nasty irritability from Buspar metabolites.
Brintellix was great for my sex drive and anxiety/concentration/cognition. TERRIBLE for my mood and motivation. It seemed to "turn down" most of my interests and drives, and "turn up" my metacognition, or the voice this is always watching, narrating, and judging what I do. It was kind of creepy.
My doc said Viibryd has less post-synaptic action so that weird boxed-in feeling should go away.
So I'm tapering off the Brintellix as I'm adding Viibryd, which I have been doing for the past five days. My moods are great already and that boxed in feeling is gone, BUT....
I am sleepy as hell all day long, and the loss in cognitive skill is stark. Can't really read or fill out paperwork. Ready to abort I think.
Posted by Chris O on June 17, 2014, at 23:39:02
In reply to Re: Viibryd (vilazodone) - What is the Verdict? » Chris O, posted by porkpiehat on June 17, 2014, at 23:27:01
It is god awful confounding how differently all of these drugs affect us. For me, Viibryd did little or nothing over an 8-ish month period. And I believe I was taking a high dose. It's funny that you say Brintellix was great for your sex drive because for me, it's completely dampened my sex drive. It has somewhat helped my anxiety, definitely less tense in my body, but it's still not a robust enough antidepressant/antianxiety effect to get me functioning the way I need to. I'm still pretty much living off my wife's ability to bring home most of the bacon, with monthly screaming bouts when she becomes too stressed out. It's really humiliating. I've been on Brintellix 2+ months now (30mg a day) and it's okay (better than Viibryd) but still not enough. The addition of 300mg of Wellbutrin doesn't seem to help that much either. So, live and learn.
Chris
Posted by porkpiehat on August 6, 2014, at 21:28:15
In reply to Re: Viibryd (vilazodone) - What is the Verdict? » phidippus, posted by psychobot5000 on March 27, 2012, at 13:34:14
> > I take Latuda, a potent dopamine antagonist. Won't it negate some of the effects of the Wellbutrin?
> >
> > Eric
>
> If you don't mind my asking, do you find Latuda to be beneficial for memory or cognition?
>
I found Latuda HUGELY beneficial for cognition! Brintellix was also pretty good. I want to augment my Viibryd with one of them.
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