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Viibryd withdrawal symptoms: Viibryd Withdrawal & Detox – The Recovery Village Drug and Alcohol Rehab

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Viibryd (Vilazodone) Withdrawal Symptoms: How Long Do They Last?

Viibryd (Vilazodone) is a relatively popular new antidepressant that has been found effective for treating symptoms of major depression. Many people have had success with this antidepressant and tend to not experience as many of the other side effects associated with most SSRI’s such as: weight gain and sexual dysfunction. Although this drug may be slightly different than other medications on the market, some people end up trying it, but find out that it really didn’t work well for them. Others try it and it works, but they don’t want to stay on medication forever.

The majority of people that try Viibryd will end up withdrawing from it at some point. When withdrawing from any psychiatric medication, it is important to know what to expect. By preparing for the withdrawal effects, you will realize that what you are experiencing isn’t “just all in your head” – it’s simply a reality of medication withdrawal. Many people have come off of Viibryd successfully and in general, this medication is regarded as being one of the easier antidepressants to stop taking compared to other SSRI’s.

Factors that influence Viibryd withdrawal

There are a few different factors that play a role in withdrawal from any antidepressant. These include: the length of time for which you took the drug, the amount of medication you took, your individual physiology, as well as how you quit (cold turkey or tapering).

1. Time Span

How long did you take Viibryd? Was it for just a few months to get yourself out of a rut? Or did you take it for a few years to help manage your major depression? In general, the longer you have been on a medication, the more difficult it is going to be for your brain to readapt to life without the drug.

2. Dosage (10 mg, 20 mg, 40 mg)

With the drug Viibryd, most people end up “titrating” their way up to the 40 mg dose. They start at 10 mg, then after a couple weeks bump up to 20 mg, then finally make the final jump to 40 mg. Since 40 mg is the standard therapeutic level for this drug to have an antidepressant effect, most people will be withdrawing from the 40 mg dose.

3. Physiology

Your individual physiology and nervous system will play a role in determining how easy and/or difficult it is for you to stop taking this medication. Certain individuals have bad reactions during the withdrawal process, while others report very minimal symptoms. Everyone has a unique experience with medications – including going on and coming off.

4. Cold turkey vs. tapering

Do you plan on quitting this medication cold turkey or do you have a structured method of tapering? Just like you titrated on the drug, you should also slowly reduce the amount of the drug that gets ingested by your body over the course of weeks. It is not recommended to just quit after taking the 40 mg dose for an extended period of time. Slowly work your way down from 40 mg to 20 mg then 10 mg, and then stop.

Viibryd Withdrawal Symptoms

Below are some of the most commonly reported withdrawal symptoms for the drug Viibryd. In general, the most common symptoms seem to be itching of the skin and vivid dreams (or sleep changes). Do not let anxiety get the best of you during withdrawal. Understand that these are merely withdrawal symptoms and that you are not getting crazier – you will return to normal functioning.

  • Agitation: This is an unpleasant state of arousal that is linked to withdrawal. It’s almost like a tense form of excitement that can go hand-in-hand with irritability. You may feel “edgy” and like you cannot hold back your energy.
  • Anxiety: It is very common to experience anxious thoughts during the withdrawal process. Viibryd works on the serotonin system and discontinuing the medication is thought to result in lower levels of serotonin. This can cause even worse cases of anxiety.
  • Brain zaps: These are like “electric shocks” to the brain – it literally feels like the inside of your head is being zapped by electricity. Understand that these are from the medication and that they will eventually go away. Fortunately these are not quite as common during Viibryd withdrawal, but have been reported.
  • Depression: Think about it, you are taking a medication to help with depression. When you come off of it, you cannot expect your neurochemistry maintain the antidepressant effect of the drug. Therefore many people feel depressed again when withdrawing. Some people may feel even more depressed than usual – this is common.
  • Dizziness: Feeling dizzy is a completely normal response to withdrawal from Viibryd. You may feel incredibly dizzy and/or sensations of vertigo. Do your best do cope with this and understand that it will eventually subside.
  • Fatigue: You may have no energy to do anything throughout the day. Even simple tasks around the house may seem difficult. This is because you are dealing with an incredibly high level of fatigue. Your energy levels should return to normal after a few weeks.
  • Headache: This is yet another common withdrawal symptom. If you experience headaches when you stop Viibryd, you may want to pick up some over-the-counter headache relief.
  • Insomnia: The inability to fall asleep at night or at a normal time is commonly reported. You may be unable to sleep because you are feeling so emotionally wound up and/or crazy. Insomnia is something that can make withdrawal difficult. Do your best to relax and get sleep when you can.
  • Irritability: Every little thing may upset you and/or trigger an anger response. It is common to feel excessively irritable when stopping any antidepressant.
  • Itchiness: Many people notice extreme itching feelings and/or burning sensations when quitting Viibryd. This withdrawal symptom often isn’t spoken of by doctors, but many people withdrawing from the medication experience it. This tends to last at least a few weeks, but will eventually subside. Some people claim that this medication actually gave them a rash.
  • Mood swings: Many have reported mood swings when stopping this particular medication. Some people experience anger one minute, then feel pretty good the next. These temporary swings in mood will eventually come to a halt.
  • Muscle spasms: This is a less common side effect, but some people have reported muscle spasms during the first few weeks of withdrawal. It has been reported that these tend to go away on their own after a week or two.
  • Nausea: It is very common to feel especially nauseated during the first couple weeks of withdrawal.
  • Panic attacks: This is linked to feelings of anxiety when stopping the medication. For some people, the withdrawal triggers a panic response.
  • Sleep changes: You may be unable to sleep at night and/or experience disturbances in your sleep. Your sleep cycle may change and you may find yourself excessively tired throughout the day, yet you aren’t able to sleep at night.
  • Suicidal thoughts: It is pretty common to experience suicidal thinking when coming off of any psychiatric medication. Although these thoughts are less reported by people going through Viibryd withdrawal, some people do experience them.
  • Vomiting: According to the NAMI (National Alliance on Mental Illness), some people experience vomiting when they come off of Viibryd. Vomiting doesn’t seem to be very common though.
  • Vivid dreams: You may experience very vivid dreams and/or “crazy” unusual dreams when stopping this medication or upon reduction of the dose. Others report experiencing “nightmares” and/or consistently bad dreams.
  • Weight changes: If you lost or gained weight on this medication, you can expect your body to reset itself when you come off of it. In other words, if you packed on a bunch of weight, you should lose that weight when stopping. If you lost a bunch of weight, you may gain it all back when you stop the drug.

How long do Viibryd withdrawal symptoms last?

It totally depends on the person. Some people experience very minimal withdrawal symptoms, while others are plagued with symptoms for weeks. In general, most people should be fully recovered from withdrawal symptoms within a couple of months. The majority of major symptoms should subside after about 4 to 6 weeks. After a couple of months, most people notice that their withdrawal symptoms are completely gone.

If you are experiencing withdrawal symptoms after being off of Viibryd for more than a couple months, just realize that it likely isn’t all in your head. Most of these drugs are reported by professionals as being relatively easy to come off of, yet they do not realize what the experience is like from a first person perspective. When I quit Paxil cold turkey, I had withdrawal symptoms that lasted over eight months.

It is thought that if you engage in healthy activities such as: eating good foods, consistent exercise, and socializing with others – that withdrawal should be easier. Do healthy things for yourself like walking outside in the sunlight or going to the gym. Make sure you are eating all of your meals and focus on doing what you can do even if you are feeling the pain of withdrawal. Eventually you will recover and return to how you were pre-Viibryd and the withdrawal symptoms will subside.

Related Posts:

Viibryd Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

See also Warning section.

Diarrhea, nausea, vomiting, dizziness, trouble sleeping, decreased interest in sex, or changes in sexual ability may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: numbness/tingling, tremor, restlessness, inability to keep still, difficulty concentrating, confusion, memory problems, weakness, unsteadiness, pounding heartbeat.

Get medical help right away if you have any serious side effects, including: unusual or severe mental/mood changes (such as agitation, thoughts of suicide), bloody/black/tarry stools, vomit that looks like coffee grounds, easy bruising/bleeding, seizures, eye pain/swelling/redness, widened pupils, vision changes (such as seeing rainbows around lights at night, blurred vision).

This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take (see Drug Interactions section). Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US –

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Antidepressant discontinuation syndrome

CMAJ. 2017 May 29; 189(21): E747.

London Regional Mental Health Care (Sharma), London, Ont.; University of Ottawa (Gabriel), Ottawa, Ont.

Copyright © 2017 Joule Inc. or its licensorsThis article has been cited by other articles in PMC.

Antidepressant discontinuation syndrome is common

About 20% of patients develop antidepressant discontinuation syndrome following an abrupt stoppage of or marked reduction in the dose of an antidepressant taken continuously for one month.1 Symptoms are usually mild and may occur following treatment with any type of antidepressant. Symptoms occur within two to four days after drug cessation and usually last one to two weeks (occasionally may persist up to one year). If the same or a similar drug is started, the symptoms will resolve within one to three days. Sociodemographic and clinical factors associated with increased vulnerability have not been identified.2 Among the serotonin reuptake inhibitors, paroxetine is associated with the highest incidence of the syndrome and fluoxetine with the lowest. Because of venlafazine’s short half-life, the syndrome may occur more frequently following cessation and symptoms may be more severe.1

Symptoms are vague and variable

Failure to recognize antidepressant discontinuation syndrome may result in medical or psychiatric misdiagnosis. The mnemonic FINISH summarizes the symptoms of antidepressant discontinuation syndrome: Flu-like symptoms (lethargy, fatigue, headache, achiness, sweating), Insomnia (with vivid dreams or nightmares), Nausea (sometimes vomiting), Imbalance (dizziness, vertigo, light-headedness), Sensory disturbances (“burning,” “tingling,” “electric-like” or “shock-like” sensations) and Hyperarousal (anxiety, irritability, agitation, aggression, mania, jerkiness). 3

The syndrome needs to be distinguished from relapse

Cessation of antidepressant therapy may increase the risk of relapse of depression or anxiety. Unlike the symptoms of antidepressant discontinuation syndrome, symptoms of relapse usually take more than a few days to appear and to disappear following reintroduction of the antidepressant.4

Patient education may reduce risk

Physicians should be vigilant at times when patients may consider stopping an antidepressant (e.g., during pregnancy). Because not all formulations of the same drug are bioequivalent, there may be an unintended reduction in drug concentration if an antidepressant is switched to another formulation. To minimize risk of the syndrome, patients should be encouraged to consult their physician before stopping an antidepressant. Prescribing an antidepressant with a longer half-life or tapering the medication over six to eight weeks may reduce the risk.4

Treatment of the syndrome needs to be individualized

Management of antidepressant discontinuation syndrome needs to be done on an individual basis because of a lack of specific treatment data (Box 1). 2,3,5

Box 1:

Prevention and management of antidepressant discontinuation syndrome

2,3,5

  • Tapering may not be necessary for patients taking an antidepressant for less than four weeks or those who are taking fluoxetine.

  • Faster tapering may be possible in cases where doses are low.

  • Antidepressants with short half-lives need to be tapered gradually; however, gradual tapering may not prevent the syndrome in all cases.

  • Patients should be reassured that symptoms are reversible, not life-threatening and usually self-limiting.

  • Switching to fluoxetine when considering stopping another antidepressant may be helpful in some cases.

  • If symptoms are severe, the drug should be reintroduced and a slower taper started.

Footnotes

Competing interests: Verinder Sharma has received grants from Assurex, Genome Canada, Neurocrine Biosciences, Stanley Medical Research Institute and Sunovion Pharmaceuticals. No other competing interests were declared.

This article has been peer reviewed.

References

1. Diagnostic and statistical manual of mental disorders. 5th ed
Arlington (VA): American Psychiatric Association; 2013:712–4. [Google Scholar]2. Fava GA, Gatti A, Belaise C, et al.
Withdrawal symptoms after selective serotonin reuptake inhibitor discontinuation: a systematic review. Psychother Psychosom
2015;84:72–81. [PubMed] [Google Scholar]3. Berber MJ.
FINISH: remembering the discontinuation syndrome. Flu-like symptoms, insomnia, nausea, imbalance, sensory disturbances, and hyperarousal (anxiety/agitation). J Clin Psychiatry
1998;59:255. [PubMed] [Google Scholar]4. Warner CH, Bobo W, Warner C, et al.
Antidepressant discontinuation syndrome. Am Fam Physician
2006;74:449–56. [PubMed] [Google Scholar]5. Ogle NR, Akkerman S.
Guidance for the discontinuation or switching of antidepressant therapies in adults. J Pharm Pract
2013;26:389–96. [PubMed] [Google Scholar]

Viibryd (vilazodone) dosing, indications, interactions, adverse effects, and more

  • abametapir

    Serious – Use Alternative (1)abametapir will increase the level or effect of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.

  • aldesleukin

    Monitor Closely (1)aldesleukin increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. No dose adjustment needed with mild CYP3A4 inhibitors.

  • almotriptan

    Serious – Use Alternative (1)almotriptan, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • amiodarone

    Serious – Use Alternative (1)amiodarone increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg.

  • amitriptyline

    Serious – Use Alternative (1)amitriptyline, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • apalutamide

    Serious – Use Alternative (1)apalutamide will decrease the level or effect of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.

  • aprepitant

    Serious – Use Alternative (1)aprepitant increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg.

  • aripiprazole

    Monitor Closely (1)vilazodone, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

  • asenapine

    Monitor Closely (1)vilazodone, asenapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

  • atazanavir

    Serious – Use Alternative (1)atazanavir increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase vilazodone plasma levels by 50% – Reduce daily dose to 20 mg.

  • basiliximab

    Monitor Closely (1)basiliximab increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. No dose adjustment needed with mild CYP3A4 inhibitors.

  • betrixaban

    Monitor Closely (1)vilazodone, betrixaban.
    Either increases levels of the other by anticoagulation. Use Caution/Monitor. SSRIs may inhibit platelet aggregation, thus increase bleeding risk when coadministered with anticoagulants.

  • bosentan

    Monitor Closely (1)bosentan decreases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Consider increasing vilazodone dose up to 2-fold (not to exceed 80 mg/day) when coadministered with strong CYP3A4 inducers for >14 days.

  • buspirone

    Serious – Use Alternative (1)buspirone, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • carbamazepine

    Monitor Closely (1)carbamazepine decreases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Consider increasing vilazodone dose up to 2-fold (not to exceed 80 mg/day) when coadministered with strong CYP3A4 inducers for >14 days.

  • cariprazine

    Monitor Closely (1)vilazodone, cariprazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

  • cenobamate

    Monitor Closely (1)cenobamate, vilazodone.
    Either increases effects of the other by sedation. Use Caution/Monitor.

  • chloramphenicol

    Serious – Use Alternative (1)chloramphenicol increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase vilazodone plasma levels by 50% – Reduce daily dose to 20 mg.

  • cimetidine

    Serious – Use Alternative (1)cimetidine increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg.

  • citalopram

    Serious – Use Alternative (1)citalopram, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Combination may increase risk of serotonin syndrome or neuroleptic malignant syndrome-like reactions.

  • clarithromycin

    Serious – Use Alternative (1)clarithromycin increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg.

  • clomipramine

    Serious – Use Alternative (1)clomipramine, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • clonidine

    Monitor Closely (1)clonidine, vilazodone.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration enhances CNS depressant effects.

  • clozapine

    Monitor Closely (1)vilazodone, clozapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

  • cobicistat

    Serious – Use Alternative (1)cobicistat will increase the level or effect of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

  • cocaine

    Serious – Use Alternative (1)cocaine, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • conivaptan

    Serious – Use Alternative (1)conivaptan increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase vilazodone plasma levels by 50% – Reduce daily dose to 20 mg.

  • crofelemer

    Monitor Closely (1)crofelemer increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed.

  • cyclobenzaprine

    Serious – Use Alternative (1)vilazodone and cyclobenzaprine both increase serotonin levels. Avoid or Use Alternate Drug.

  • dabrafenib

    Monitor Closely (1)dabrafenib decreases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Consider increasing vilazodone dose up to 2-fold (not to exceed 80 mg/day) when coadministered with strong CYP3A4 inducers for >14 days.

  • danazol

    Serious – Use Alternative (1)danazol increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg.

  • darunavir

    Serious – Use Alternative (1)darunavir increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg.

  • dasatinib

    Monitor Closely (1)dasatinib increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. No dose adjustment needed with mild CYP3A4 inhibitors.

  • desipramine

    Serious – Use Alternative (1)desipramine, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • desvenlafaxine

    Serious – Use Alternative (1)desvenlafaxine, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • dexamethasone

    Monitor Closely (1)dexamethasone decreases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Consider increasing vilazodone dose up to 2-fold (not to exceed 80 mg/day) when coadministered with strong CYP3A4 inducers for >14 days.

  • dextroamphetamine

    Serious – Use Alternative (1)dextroamphetamine, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • dextromethorphan

    Serious – Use Alternative (1)dextromethorphan, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • diazepam intranasal

    Monitor Closely (1)diazepam intranasal, vilazodone.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may potentiate the CNS-depressant effects of each drug.

  • diltiazem

    Serious – Use Alternative (1)diltiazem increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg.

  • doxepin

    Serious – Use Alternative (1)doxepin, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • dronedarone

    Serious – Use Alternative (1)dronedarone increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg.

  • duloxetine

    Serious – Use Alternative (1)duloxetine, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • efavirenz

    Monitor Closely (1)efavirenz decreases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Consider increasing vilazodone dose up to 2-fold (not to exceed 80 mg/day) when coadministered with strong CYP3A4 inducers for >14 days.

  • elagolix

    Monitor Closely (1)elagolix decreases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak-to-moderate CYP3A4 inducer. Monitor CYP3A substrates if coadministered. Consider increasing CYP3A substrate dose if needed.

  • eletriptan

    Serious – Use Alternative (1)eletriptan, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • elvitegravir/cobicistat/emtricitabine/tenofovir DF

    Monitor Closely (1)elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events.

  • encorafenib

    Monitor Closely (1)encorafenib, vilazodone. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents.

  • enzalutamide

    Monitor Closely (1)enzalutamide decreases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Consider increasing vilazodone dose up to 2-fold (not to exceed 80 mg/day) when coadministered with strong CYP3A4 inducers for >14 days.

  • erythromycin base

    Serious – Use Alternative (1)erythromycin base increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg.

  • erythromycin ethylsuccinate

    Serious – Use Alternative (1)erythromycin ethylsuccinate increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg.

  • erythromycin lactobionate

    Serious – Use Alternative (1)erythromycin lactobionate increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg.

  • erythromycin stearate

    Serious – Use Alternative (1)erythromycin stearate increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg.

  • escitalopram

    Serious – Use Alternative (1)escitalopram, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • eslicarbazepine acetate

    Monitor Closely (1)eslicarbazepine acetate will decrease the level or effect of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Consider increasing vilazodone dose up to 2-fold (not to exceed 80 mg/day) when coadministered with strong CYP3A4 inducers for >14 days

  • etravirine

    Monitor Closely (1)etravirine decreases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Consider increasing vilazodone dose up to 2-fold (not to exceed 80 mg/day) when coadministered with strong CYP3A4 inducers for >14 days.

  • fedratinib

    Monitor Closely (1)fedratinib will increase the level or effect of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary.

  • fenfluramine

    Monitor Closely (1)fenfluramine, vilazodone.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration with drugs that increase serotoninergic effects may increase the risk of serotonin syndrome.

  • fexinidazole

    Serious – Use Alternative (1)fexinidazole will increase the level or effect of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates.

  • fish oil triglycerides

    Monitor Closely (1)fish oil triglycerides will increase the level or effect of vilazodone by anticoagulation. Use Caution/Monitor. Prolonged bleeding reported in patients taking antiplatelet agents or anticoagulants and oral omega-3 fatty acids. Periodically monitor bleeding time in patients receiving fish oil triglycerides and concomitant antiplatelet agents or anticoagulants.

  • fluconazole

    Serious – Use Alternative (1)fluconazole increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg.

  • fluoxetine

    Serious – Use Alternative (1)fluoxetine, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • fluphenazine

    Monitor Closely (1)vilazodone, fluphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

  • fluvoxamine

    Serious – Use Alternative (1)fluvoxamine and vilazodone both increase serotonin levels. Avoid or Use Alternate Drug. Discontinue concomitant therapy immediately if signs and symptoms of serotonin syndrome emerge and supportive sympathomimetic treatment should be initiated

  • fosamprenavir

    Serious – Use Alternative (1)fosamprenavir increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg.

  • fosphenytoin

    Monitor Closely (1)fosphenytoin decreases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Consider increasing vilazodone dose up to 2-fold (not to exceed 80 mg/day) when coadministered with strong CYP3A4 inducers for >14 days.

  • frovatriptan

    Serious – Use Alternative (1)frovatriptan, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • gabapentin

    Monitor Closely (1)gabapentin, vilazodone.
    Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

  • gabapentin enacarbil

    Monitor Closely (1)gabapentin enacarbil, vilazodone.
    Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

  • haloperidol

    Monitor Closely (1)vilazodone, haloperidol. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

  • ibrutinib

    Monitor Closely (1)ibrutinib will increase the level or effect of vilazodone by anticoagulation. Use Caution/Monitor. Ibrutinib may increase the risk of hemorrhage in patients receiving antiplatelet or anticoagulant therapies and monitor for signs of bleeding.

  • idelalisib

    Serious – Use Alternative (1)idelalisib will increase the level or effect of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates

  • iloperidone

    Monitor Closely (2)vilazodone, iloperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

    iloperidone increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4.

  • imatinib

    Serious – Use Alternative (1)imatinib increases effects of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg.

  • imipramine

    Serious – Use Alternative (1)imipramine, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • indinavir

    Serious – Use Alternative (1)indinavir increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase vilazodone plasma levels by 50% – Reduce daily dose to 20 mg.

  • isocarboxazid

    Contraindicated (1)isocarboxazid, vilazodone.
    Either increases toxicity of the other by serotonin levels. Contraindicated. Coadministration with MAO-A inhibitors are contraindicated. Do not prescribe vilazodone within 14 days of discontinuing or starting an MAO inhibitor.

  • isoniazid

    Serious – Use Alternative (2)isoniazid, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

    isoniazid increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase vilazodone plasma levels by 50% – Reduce daily dose to 20 mg.

  • istradefylline

    Monitor Closely (1)istradefylline will increase the level or effect of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates.

  • itraconazole

    Serious – Use Alternative (1)itraconazole increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase vilazodone plasma levels by 50% – Reduce daily dose to 20 mg.

  • ivosidenib

    Serious – Use Alternative (1)ivosidenib will decrease the level or effect of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternative therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.

  • ketoconazole

    Serious – Use Alternative (1)ketoconazole increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase vilazodone plasma levels by 50% – Reduce daily dose to 20 mg.

  • L-tryptophan

    Serious – Use Alternative (1)L-tryptophan, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant use is not recommended.

  • lamotrigine

    Monitor Closely (1)lamotrigine increases toxicity of vilazodone by unspecified interaction mechanism. Modify Therapy/Monitor Closely. CNS depressants may increase the toxic effects of selective serotonin reuptake inhibitors; psychomotor impairment may be enhanced.

  • lanreotide

    Serious – Use Alternative (1)lanreotide increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg.

  • lapatinib

    Serious – Use Alternative (1)lapatinib increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg.

  • lasmiditan

    Monitor Closely (1)lasmiditan, vilazodone.
    Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.

  • lemborexant

    Monitor Closely (1)lemborexant, vilazodone.
    Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.

  • levomilnacipran

    Serious – Use Alternative (1)levomilnacipran, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • linezolid

    Serious – Use Alternative (1)linezolid, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

  • lisdexamfetamine

    Monitor Closely (1)vilazodone, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).Serious – Use Alternative (1)lisdexamfetamine, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • lithium

    Serious – Use Alternative (1)lithium, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • lonafarnib

    Serious – Use Alternative (1)lonafarnib will increase the level or effect of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration with sensitive CYP3A substrates. If coadministration unavoidable, monitor for adverse reactions and reduce CYP3A substrate dose in accordance with product labeling.

  • lopinavir

    Serious – Use Alternative (1)lopinavir increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase vilazodone plasma levels by 50% – Reduce daily dose to 20 mg.

  • lorcaserin

    Serious – Use Alternative (1)vilazodone and lorcaserin both increase serotonin levels. Avoid or Use Alternate Drug.

  • loxapine

    Monitor Closely (1)vilazodone, loxapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

  • loxapine inhaled

    Monitor Closely (1)vilazodone, loxapine inhaled. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

  • lurasidone

    Monitor Closely (2)lurasidone, vilazodone.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.

    vilazodone, lurasidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

  • meperidine

    Serious – Use Alternative (1)meperidine, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • metformin

    Monitor Closely (1)vilazodone increases effects of metformin by pharmacodynamic synergism. Use Caution/Monitor.

  • methamphetamine

    Serious – Use Alternative (1)methamphetamine, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • methylene blue

    Serious – Use Alternative (1)methylene blue and vilazodone both increase serotonin levels. Avoid or Use Alternate Drug. Methylene blue may increase serotonin as a result of MAO-A inhibition. If methylene blue must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last methylene blue dose or after 2 weeks of monitoring, whichever comes first.

  • metoclopramide

    Serious – Use Alternative (1)metoclopramide increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase vilazodone plasma levels by 50% – Reduce daily dose to 20 mg.

  • metoclopramide intranasal

    Serious – Use Alternative (1)vilazodone, metoclopramide intranasal.
    Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug.
    Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.

  • midazolam intranasal

    Monitor Closely (1)midazolam intranasal, vilazodone.
    Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.

  • mifepristone

    Monitor Closely (1)mifepristone will increase the level or effect of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce vilazodone to 20 mg/day

  • milnacipran

    Serious – Use Alternative (1)milnacipran, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • mirtazapine

    Serious – Use Alternative (1)mirtazapine, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • mitotane

    Monitor Closely (1)mitotane decreases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Consider increasing vilazodone dose up to 2-fold (not to exceed 80 mg/day) when coadministered with strong CYP3A4 inducers for >14 days.

  • molindone

    Monitor Closely (1)vilazodone, molindone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

  • nafcillin

    Monitor Closely (1)nafcillin decreases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Consider increasing vilazodone dose up to 2-fold (not to exceed 80 mg/day) when coadministered with strong CYP3A4 inducers for >14 days.

  • naratriptan

    Serious – Use Alternative (1)naratriptan, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • nefazodone

    Serious – Use Alternative (2)nefazodone, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

    nefazodone increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg.

  • nelfinavir

    Serious – Use Alternative (1)nelfinavir increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg.

  • nevirapine

    Monitor Closely (1)nevirapine decreases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Consider increasing vilazodone dose up to 2-fold (not to exceed 80 mg/day) when coadministered with strong CYP3A4 inducers for >14 days.

  • nicardipine

    Serious – Use Alternative (1)nicardipine increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase vilazodone plasma levels by 50% – Reduce daily dose to 20 mg.

  • nilotinib

    Serious – Use Alternative (1)nilotinib increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg.

  • nortriptyline

    Serious – Use Alternative (1)nortriptyline, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • octreotide

    Serious – Use Alternative (1)octreotide increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg.

  • olanzapine

    Monitor Closely (1)vilazodone, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

  • oliceridine

    Monitor Closely (1)vilazodone, oliceridine.
    Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely.

  • oxcarbazepine

    Monitor Closely (1)oxcarbazepine decreases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Consider increasing vilazodone dose up to 2-fold (not to exceed 80 mg/day) when coadministered with strong CYP3A4 inducers for >14 days.

  • oxycodone

    Monitor Closely (1)oxycodone increases effects of vilazodone by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Opioids may enhance the serotonergic effects of SSRIs and increase risk for serotonergic syndrome.

  • ozanimod

    Serious – Use Alternative (1)ozanimod increases toxicity of vilazodone by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.

  • paliperidone

    Monitor Closely (1)vilazodone, paliperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

  • paroxetine

    Serious – Use Alternative (1)paroxetine, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • pentobarbital

    Monitor Closely (1)pentobarbital decreases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Consider increasing vilazodone dose up to 2-fold (not to exceed 80 mg/day) when coadministered with strong CYP3A4 inducers for >14 days.

  • perphenazine

    Monitor Closely (1)vilazodone, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

  • phenelzine

    Contraindicated (1)phenelzine, vilazodone.
    Either increases toxicity of the other by serotonin levels. Contraindicated. Coadministration with MAO-A inhibitors are contraindicated. Do not prescribe vilazodone within 14 days of discontinuing or starting an MAO inhibitor.

  • phenobarbital

    Monitor Closely (1)phenobarbital decreases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Consider increasing vilazodone dose up to 2-fold (not to exceed 80 mg/day) when coadministered with strong CYP3A4 inducers for >14 days.

  • phenytoin

    Monitor Closely (1)phenytoin decreases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Consider increasing vilazodone dose up to 2-fold (not to exceed 80 mg/day) when coadministered with strong CYP3A4 inducers for >14 days.

  • pimavanserin

    Monitor Closely (1)vilazodone, pimavanserin. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

  • pimozide

    Monitor Closely (1)vilazodone, pimozide. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

  • posaconazole

    Serious – Use Alternative (1)posaconazole increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase vilazodone plasma levels by 50% – Reduce daily dose to 20 mg.

  • pregabalin

    Monitor Closely (1)pregabalin, vilazodone.
    Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

  • primidone

    Monitor Closely (1)primidone decreases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Consider increasing vilazodone dose up to 2-fold (not to exceed 80 mg/day) when coadministered with strong CYP3A4 inducers for >14 days.

  • protriptyline

    Serious – Use Alternative (1)protriptyline, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • quetiapine

    Monitor Closely (1)vilazodone, quetiapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

  • quinidine

    Serious – Use Alternative (1)quinidine increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase vilazodone plasma levels by 50% – Reduce daily dose to 20 mg.

  • quinupristin/dalfopristin

    Serious – Use Alternative (1)quinupristin/dalfopristin increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase vilazodone plasma levels by 50% – Reduce daily dose to 20 mg.

  • ranolazine

    Monitor Closely (1)ranolazine increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. No dose adjustment needed with mild CYP3A4 inhibitors.

  • rasagiline

    Contraindicated (1)rasagiline, vilazodone.
    Either increases toxicity of the other by serotonin levels. Contraindicated. Coadministration with MAO inhibitors are contraindicated. Do not prescribe vilazodone within 14 days of discontinuing or starting an MAO inhibitor.

  • remimazolam

    Monitor Closely (1)remimazolam, vilazodone.
    Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.

  • ribociclib

    Serious – Use Alternative (1)ribociclib will increase the level or effect of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

  • rifabutin

    Monitor Closely (1)rifabutin decreases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Consider increasing vilazodone dose up to 2-fold (not to exceed 80 mg/day) when coadministered with strong CYP3A4 inducers for >14 days.

  • rifampin

    Monitor Closely (1)rifampin decreases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Consider increasing vilazodone dose up to 2-fold (not to exceed 80 mg/day) when coadministered with strong CYP3A4 inducers for >14 days.

  • rifapentine

    Monitor Closely (1)rifapentine decreases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Consider increasing vilazodone dose up to 2-fold (not to exceed 80 mg/day) when coadministered with strong CYP3A4 inducers for >14 days.

  • risperidone

    Monitor Closely (1)vilazodone, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

  • ritonavir

    Serious – Use Alternative (1)ritonavir increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase vilazodone plasma levels by 50% – Reduce daily dose to 20 mg.

  • rizatriptan

    Serious – Use Alternative (1)rizatriptan, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • ropeginterferon alfa 2b

    Serious – Use Alternative (1)ropeginterferon alfa 2b and vilazodone both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.

  • rucaparib

    Monitor Closely (1)rucaparib will increase the level or effect of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated.

  • saquinavir

    Serious – Use Alternative (1)saquinavir increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg.

  • selegiline

    Contraindicated (1)selegiline, vilazodone.
    Either increases toxicity of the other by serotonin levels. Contraindicated. Coadministration with MAO inhibitors are contraindicated. Do not prescribe vilazodone within 14 days of discontinuing or starting an MAO inhibitor.

  • selegiline transdermal

    Contraindicated (1)selegiline transdermal, vilazodone.
    Either increases toxicity of the other by serotonin levels. Contraindicated. Coadministration with MAO inhibitors are contraindicated. Do not prescribe vilazodone within 14 days of discontinuing or starting an MAO inhibitor.

  • sertraline

    Serious – Use Alternative (1)sertraline, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • stiripentol

    Monitor Closely (2)stiripentol, vilazodone.
    Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.

    stiripentol, vilazodone. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.

  • sumatriptan

    Serious – Use Alternative (1)sumatriptan, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • sumatriptan intranasal

    Serious – Use Alternative (1)sumatriptan intranasal, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • tamoxifen

    Monitor Closely (1)tamoxifen increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. No dose adjustment needed with mild CYP3A4 inhibitors.

  • tapentadol

    Monitor Closely (1)vilazodone and tapentadol both increase serotonin levels. Modify Therapy/Monitor Closely.

  • tazemetostat

    Monitor Closely (1)tazemetostat will decrease the level or effect of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • tecovirimat

    Monitor Closely (1)tecovirimat will decrease the level or effect of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.

  • tedizolid

    Serious – Use Alternative (1)tedizolid, vilazodone.
    Either increases effects of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. both increase serotonin levels; increased risk of serotonin syndrome.

  • thiothixene

    Monitor Closely (1)vilazodone, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

  • tipranavir

    Serious – Use Alternative (1)tipranavir increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase vilazodone plasma levels by 50% – Reduce daily dose to 20 mg.

  • tramadol

    Serious – Use Alternative (1)tramadol, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated.

  • tranylcypromine

    Contraindicated (1)tranylcypromine, vilazodone.
    Either increases toxicity of the other by serotonin levels. Contraindicated. Coadministration with MAO-A inhibitors are contraindicated. Do not prescribe vilazodone within 14 days of discontinuing or starting an MAO inhibitor.

  • trazodone

    Serious – Use Alternative (1)trazodone, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated.

  • trifluoperazine

    Monitor Closely (1)vilazodone, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

  • tucatinib

    Serious – Use Alternative (1)tucatinib will increase the level or effect of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.

  • venlafaxine

    Serious – Use Alternative (1)venlafaxine, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • verapamil

    Serious – Use Alternative (1)verapamil increases levels of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If intolerable adverse effects occur when coadministered with moderate CYP3A4 inhibitors, reduce daily dose to 20 mg.

  • voriconazole

    Serious – Use Alternative (1)voriconazole increases toxicity of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inhibitors may increase vilazodone plasma levels by 50% – Reduce daily dose to 20 mg.

  • vortioxetine

    Serious – Use Alternative (1)vilazodone, vortioxetine.
    Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.

  • voxelotor

    Serious – Use Alternative (1)voxelotor will increase the level or effect of vilazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid.

  • zafirlukast

    Monitor Closely (1)vilazodone increases levels of zafirlukast by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. No dose adjustment needed with mild CYP3A4 inhibitors.

  • ziprasidone

    Monitor Closely (1)vilazodone, ziprasidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

  • zolmitriptan

    Serious – Use Alternative (1)zolmitriptan, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • Viibryd Tapering Help | Professional Weaning and Titration Support

    Trying to Quit Viibryd On Your Own vs Inpatient Care

    Each person is unique. There is no “one-size-fits-all” approach that works best for how to get off Viibryd. But in these extraordinary times of new research and a better understanding of human health and mental wellness, a program can be designed that will attempt to best fit the intricate requirements of each individual enrolled in our Viibryd tapering program.

    A person may have been started on a course of prescription drug(s) to try and find relief from certain symptoms that were troubling and persistent. Quite a large percentage of those who were prescribed antidepressants do not experience the relief they had hoped for. Doctors will call this “treatment-resistant depression,” and this can lead to an all too common scenario, where treatment with prescription drugs becomes a series of failed experiments, first trying one drug and then another, and so on. This practice can lead to not only a worsening of original symptoms, but new symptoms can also emerge both from drug side effects, and the withdrawal symptoms that switching drugs can produce.2,8

    It is not uncommon for these lingering and persistent symptoms to become unmanageable. It may be asking quite a lot for a person when compromised by such things as impaired memory, physical aches and pains, dysfunctional digestion, lack of energy, lack of direction, or a hopeless and darkened mood to then manage one’s own Viibryd tapering. Getting off Viibryd in these circumstances may seem daunting or even impossible. Call us at Alternative to Meds for help, or seek guidance from a prescriber who is familiar with the difficulties you are experiencing.

    A properly managed and administered Viibryd withdrawal program can significantly ease this burden. Our Viibryd tapering program has helped thousands of clients to overcome the challenges of how to get off Viibryd gently, gradually, and in a compassionate environment with medical oversight and 24/7 staff care. The programs at Alternative to Meds Center blend a wide range of therapies designed to significantly unburden the process of stopping Viibryd.

    Authentically Addressing Root Causes for Depression, Anxiety and Other Symptoms

    There may be little benefit to tapering Viibryd if the original symptoms have not been addressed and eliminated or at least greatly reduced. Our focus is extended well beyond simply stopping Viibryd. We help the client discover root causes for their original troubling and lingering symptoms that drug therapy did not resolve. Where ongoing drug treatment has not provided the relief a person was hoping for, Viibryd tapering may be the first step on a path that leads to real and authentic health improvements.

    With so much research on the topics of environmental toxins and other causes for depression that is now available, we can approach the problem in other ways than simply trying to mask symptoms with numbing drugs. We offer an individualized program using alternative approaches to address depression, anxiety, and other symptoms. Based on scientific research, Alternative to Meds has opened the door to vibrant health, authentic and lasting results, without needing to rely on prescription medications.16

    The Alternative to Meds program seeks to not only manage a safe and gradual program for getting off Viibryd, but concurrently, seeks to discover the root causes for troubling symptoms. Once the root causes have been isolated, then these can be addressed in logical ways to provide relief for our client during the process of Viibryd tapering. There are many potential contributors to original unwanted and lingering symptoms, such as environmental toxins, inadequate nutrition, trauma or loss, lack of exercise and sunlight, a dysfunctional microbiome, and others. The pharmaceutical industry does not encourage cures. However, in the world of holistic medicine, the focus is quite different. As Pizzomo so aptly states in his fascinating article published in the 2016 Integrative Medicine: A Clinician’s Journal, “Depression is not caused by a lack of Prozak©.” 17

    Environmental Toxins and Depression

    Regarding environmental toxins, Harvard research has shown that exposure to toxic materials can lead to depression, anxiety, and many other reactions. Toxins can be found just about everywhere, in our homes, places of work, industrial and agricultural settings, and even in our lakes and rivers. Sometimes toxic exposure will present immediate reactions. It is also possible that exposure to chemicals can go on for years before symptoms begin to appear. Therefore, testing for the presence of any accumulations of toxic substances is important. If found, the situation can be resolved by gently eliminating these accumulations. Using non-invasive methods such as low-temperature sauna, nebulized glutathione treatments, bentonite clay, colon hydrotherapy, and other means, these poisons can be removed and this cleansing action tends to take the toxic burden off the central nervous system, allowing it to function more efficiently.7

    Our center uses only non-toxic cleaning agents, soaps, and personal care items, provides fresh and purified air, and utilizes the cleanest, most pure water possible. While getting off Viibryd or other medications, concurrent removal of toxins very commonly results in reports from our clients mentioning better quality, deeper sleep, better appetite, a lift in mood, more energy, and overall feeling brighter and lighter once these toxins have been purged from the body. Stopping Viibryd in a toxin-free environment is mildly therapeutic all in itself. 16,18

    Poor Diet and Depression

    Where other contributors are found to be present, similar results occur when these are also addressed during the client’s stay. Nutritional deficiencies are tested and addressed throughout the entire program. Clean and delicious meals and snacks with a focus on fresh, mostly organic, chemical-free foods, are deliciously prepared and presented, with additional supplements as needed. Withdrawal from Viibryd is further supported by providing adequate, restorative nutrition.7,14,17,18

    Unresolved Trauma and Depression

    Another potential contributor to depression is unresolved past trauma, dysfunctional lifestyle or other matters. These can be addressed for relief and closure through any of the various genres of counseling and coaching, including Equine Assisted therapy, yoga, meditation, Life Coaching, trauma relief counseling, stress reduction techniques, and other forms of counseling that are offered during the client’s Viibryd tapering program. The welcoming and nurturing character of the Alternative to Meds inpatient residential programs also provides comfort within its healing, supportive atmosphere for recovery. All of these factors can play a vital role in how to successfully get off Viibryd or other prescription drugs.

    Education and Wellness

    Education is an incredibly helpful way to empower clients to be able to understand and apply principles of self-care, including neurochemistry support, dietary needs, maintaining a healthy gut, and many other factors that can help keep the body functioning as well and efficiently as possible. This can also help a person change routines and personal care so that problems can be avoided once a client reaches the end of their Viibryd cessation treatment with us. We offer training programs for physicians who are interested in expanding their treatment portfolio, to begin utilizing more natural and holistic ways to help their patients.

    Find Out More About the Alternative to Meds Program

    We are here to help. Please contact us for more detailed information on the various holistic genres of treatment that are used in the Alternative to Meds Programs for successfully tapering Viibryd.

    How to Treat Drug Abuse

    Viibryd is the brand name of the drug Vilazodone. It is used to treat major depressive disorder and other mental health problems such as anxiety. In the United States, around one million prescriptions of this drug are being given by doctors to treat depression. Although this drug is safe and effective if used properly, it is important to know that inappropriate use of it, such as long-term use and missed doses, may cause dangers to health. In this article, information about the drug’s dangers, the risks of addiction, Viibryd abuse, withdrawal symptoms, and treatment options will be provided.

    In the United States, around 40 million adults (18 years old and above) are experiencing anxiety disorders every year.

    What Is Viibryd?

    Viibryd medication, under the generic name Vilazodone, is a prescription medication sold in the United States, and it is designed to treat major depressive disorders. This drug is not a controlled substance. It is manufactured by Allergan and was approved by the FDA for use in January 2011. This medicine is an SSRI, which means it selectively prevents the reuptake of serotonin in the brain. However, it is unique in its class because of its partial agonism of the 5-HT1A receptor. These actions of the drug appear to have a positive impact on the symptoms of major depressive disorders and other mental health problems.

    Viibryd Generic And Brand Names

    Viibryd generic is Vilazodone. Before the FDA had approved the generic Vilazodone, the only brand available was Viibryd medication. Today, in the United States, there is another brand name known, and that is the brand Vilazine. It is important to know that Viibryd generic is the same as the new brand Vilazine. A doctor may prescribe a Viibryd generic or other brands depending on the available brands in the country. In India, for instance, Vilazodone is available under the brand names Valz, Vilano, Zovane, Vilarest, Vilamid, and Neuvilaz.

    Viibryd Dosage Strengths And Forms

    Vilazodone is a prescription medication approved for the treatment of major depressive disorders but also used off-label for other conditions. Viibryd dosage is available in three strengths: 10mg, 20mg, and 40mg film-coated tablets. However, doses of this drug can vary based on the reason for treatment and the individual needs of the patient. Also, all Viibryd dosage strengths come in the form of a tablet, and all tablets are oval in shape. Below is a chart about the Viibryd dosage strengths might look like:

    DOSAGE COLOR IMPRINT
    10MG Pink “10” on one side
    20MG Orange “20” on one side
    40MG Blue “40” on one side

    Do not self-medicate. The Viibryd dosage strength to be used will be determined and prescribed by a doctor.

    Vilazodone Mechanism of Action And Drug Class

    The drug class and mechanism of action of Viibryd medication are something every user should understand. Not only does it make it clear what the medication is meant to treat, but it also reveals how the medication works and how it is accessed. Vilazodone falls into the class of antidepressant drugs called serotonin modulators. Specifically, it is an (SSRI) partial serotonin agonist and reuptake inhibitor. The mechanism of action of this drug is to stop the body from fully re-uptaking serotonin in the brain, leaving more of the feel-good chemical present while also functioning as an activator of the 5-HT1A receptor. This differs from SRIs, which are not selective in how they prevent reuptake and do not interact with the 5-HT1A receptor.

    Like most antidepressant drugs, the exact manner in which Vilazodone works is unknown. However, there are some assumptions that have been made regarding its mechanism of action. Users should fully understand this before taking the drug for any Vilazodone uses.

    How Fast Does Viibryd Work?

    Antidepressant drugs are slow-acting medications, so it refers to Vilazodone as well. In some cases, patients will start to show small improvements within one to two weeks of starting the medication. These tend to be smaller symptoms, such as improving appetite and sleep. Within eight weeks, most patients will be able to feel the full effects of the drug.

    Vilazodone Uses

    The major and labeled indication of Vilazodone is for the treatment of major depressive disorders. However, this drug is also used for off-labeled indications and other mental health problems or disorders. Off-label use means a drug is approved to treat other conditions aside from its main indication. Some of this drug’s off-label uses are for the treatment of anxiety disorders, bipolar disorders, chronic pain, vasomotor disorders, and post-traumatic stress disorder.

    Viibryd For Depression

    Viibryd medication falls into the drug class of antidepressants – specifically, SSRI. It is cleared by the FDA strictly for the treatment of major depressive disorders. In this treatment, it is considered a safe and effective option. However, Vilazodone is not suited to treating all forms of depression. For mild to moderate depression, its effects have not even been studied. It has also not been studied in the treatment of depression combined with mania, also known as bipolar disorder.

    When compared to other forms of depression treatment, it is generally equally effective in major depressive disorders. However, side effects and other symptoms of use may mean that other medications are better suited to the patient.

    Viibryd Off-Label Uses

    While they are not among the Vilazodone indications, this drug can be used to treat other conditions or disorders. These are called off-label uses because they have yet to be given FDA approval. In some cases, these Vilazodone hydrochloride uses may not have been studied in an official capacity. Instead, doctors prescribe them for these uses based on past observations by themselves and their colleagues or because other drugs within the serotonin reuptake inhibitors have been shown to treat these conditions.

    Viibryd For Anxiety

    The most common off-label use of Vilazodone is for the treatment of anxiety. Limited studies seem to show that adults with a generalized anxiety disorder who are given the drug can see improvement. However, this is limited strictly to GAD and cannot be extrapolated to other forms of anxiety, such as social anxiety.

    Viibryd For OCD

    A less common Vilazodone use is the treatment of obsessive-compulsive disorder or OCD. However, this has not been well-studied at this time. This means that there could be an unknown risk in its use. Users should weigh this when considering a use not part of the Vilazodone indications.

    When there is Viibryd abuse, the risk of having addictive behavior, which implies the inability to control oneself in the use of a drug, increases.

    Vilazodone Half-Life And How Long Does it Stay in the System?

    For those using Vilazodone, it is essential to know how long the drug remains in the system. The Vilazodone half-life is quite long when compared to other antidepressants. While most have a half-life of around a day or even less, Vilazodone does not hit half-life for 140 hours in the average patient. Those with slow metabolisms or impairment of the hepatic or renal systems may take even longer to reach this point.

    Below Is Some Information about How Long This Drug Stays in the Blood, Urine, Saliva, and Hair:

    • Blood – up to 3 days
    • Urine – up to 4 days
    • Saliva – up to 4r days
    • Hair – up to 3 months

    This information is most important when it comes to taking other medications or using various substances, such as alcohol and marijuana. Some users might want to consider it when it comes to drug testing as well. While standard tests will not look for antidepressant medications, some of these medications will result in false positives. At this time, there is no data showing that Vilazodone drug tests may cause false positives, but it is possible that studies could reveal such a link in the future.

    Overview of Viibryd Abuse And Addiction

    There is a risk for antidepressants to cause addiction and abuse. Regarding Vilazodone, it is less likely to cause abuse and addiction compared to other antidepressants, and there have been no reports about Viibryd abuse and addiction today. However, Viibryd abuse may be caused by physical tolerance and dependence, which makes it harder for a person to stop using the drug.

    What Makes Viibryd Addiction And Abuse Possible?

    Addiction is a condition where a person is compulsive with the use of substances despite the harmful effects. Individuals may have Viibryd abuse and addiction due to different reasons. Below is some information about what causes these individuals to abuse this drug:

    • Individuals have a prior substance abuse – This factor is related to social stressors. A person who is exposed to stress at an early age has the possibility to use substances at an early age. Eventually, the earlier a person begins to use drugs increases the chance for that person to become addicted later on. Additionally, a person who has prior substance abuse may experience relapse and this is a factor for that person to become addicted to other drugs again.
    • Misuse in the administration of the drug – Misuse includes the following: modifying the doses in order to achieve the effect faster, taking someone else’s prescription, consuming larger doses than prescribed, and simply not following the recommendations of the prescriber.
    • Peer influence – Interaction and influence from peers with addictive and risky behaviors is another factor why Vilazodone abuse and addiction are possible. This factor is most common for teens.

    When there is Viibryd abuse, the risk of having addictive behavior, which implies the inability to control oneself in the use of a drug, increases. Drug addiction is harmful, but it can be prevented as long as there is self-discipline and openness for help from other people, especially from healthcare professionals.

    Who Is Most At Risk Of Addiction?

    A person may suffer anxiety disorders which may lead to depression. In the United States, around 40 million adults (18 years old and above) are experiencing anxiety disorders every year. In the United Kingdom, around 7.3 million are diagnosed with depression. These individuals with anxiety and depression are most at risk of Viibryd addiction and other antidepressant addiction.

    Below Is a Piece of Additional Information About the Risk of Addiction of Individuals With Respect to Some Characteristics:

    • Male sex – 11 out of 12 males have substance use disorder which makes these individuals more addicted to those substances compared to females with 6 out of 12 statistics record.
    • Individuals with personality problems – Personality problems such as Borderline Personality Disorder, Antisocial Personality Disorder, Narcissistic Personality Disorder, Avoidant Personality Disorder, OCD Personality Disorder, and Dependent Personality Disorder.
    • Individuals with prior substance abuse – Individuals with prior substance abuse are prone to relapse and this may cause them to go back to their addictive lifestyle either in the use of drugs or alcohol.
    • Patients incorrectly diagnosed with depression causing them to take unnecessary antidepressant medications.

    In another study, it was reported that childhood maltreatments are a risk factor for individuals to use substances such as drugs and alcohol at an earlier age and this may cause them to be more at risk of addiction.

    When antidepressant drugs, including Vilazodone, are taken inappropriately, such as during misuse or abuse,  danger of withdrawal aside from addiction may occur.

    Symptoms and Signs of Addiction

    Antidepressant drugs, including Vilazodone medication act in the brain. Therefore, addiction to the drug may affect the psychological/behavioral, and physical abilities of a person. A person’s signs and symptoms of addiction differ from one another. Below are the symptoms and signs of addiction with regards to psychological/behavioral and physical changes of a person:

    Psychological & Behavioral Symptoms And Signs of Addiction

    When a person has used a drug inappropriately, addiction and dependence may occur. Factors of these addiction and dependence are loss of control in the use of the drug and continued use of it despite the consequences.

    Below Are the Following Symptoms and Signs Which a Person May Exhibit during Viibryd Addiction:

    • Losing interest in life and favorite activities
    • Obsession with taking and obtaining the drug
    • Going to different doctors to get prescriptions of the drug
    • Secretive about activities
    • Financial problems
    • Interest in conversations using Vilazodone and other drugs as the topics

    There is also a risk of having emotional changes aside from behavioral ones. Examples of emotional signs and symptoms of addiction are blaming, denial, and defensiveness. If someone is struggling with substance abuse and showing the psychological/behavioral signs above, it is important to seek help immediately.

    Physical Symptoms and Signs of Addiction

    Aside from the psychological/behavioral symptoms and signs of addiction, physical changes may also be seen in a person with Viibryd addiction. It is important to understand that addiction is progressive, and as time passes, a person struggling with Vilazodone addiction will show more physical changes. Some of these changes are the following:

    • Unable to function normally when the drug is not taken
    • Seizures
    • Irritability
    • Tingling sensation
    • Change in eating habits
    • Compulsiveness

    The symptoms and signs listed above are dangerous. That is why it is important to always get the guide of a doctor when taking this medicine in order to prevent misuse, abuse, addiction, and even other undesired symptoms and signs.

    Possible Dangers of Vilazodone Use And Abuse

    When antidepressant drugs, including Vilazodone, are taken inappropriately, such as during misuse or abuse, possible dangers aside from addiction may occur. Below is information about Viibryd withdrawal, interaction of Viibryd and alcohol, and overdose.

    Viibryd Withdrawal

    It is common for users to want to stop using Vilazodone at some point. This could be due to negative side effects, feeling addicted, or just wanting to try living a medication-free life. It is a must for users to talk with a doctor before stopping Vilazodone usage to discuss whether they should try cold turkey or taper off the medicine:

    • Cold Turkey. Stopping the use of this drug suddenly, also known as going cold turkey, is a dangerous method of quitting the medication. This can trigger a condition called antidepressant discontinuation syndrome. In most cases, the physical symptoms are mild, but the major concern is with the mental health of the patient. Suddenly stopped drugs could cause depression symptoms to return quickly and be felt more greatly. This also means the risk of suicidal thoughts and tendencies is higher. Users should never go cold turkey unless it is what their doctor recommends. Even then, they should be carefully supervised.
    • Tapering. Tapering off Vilazodone is considered the safer option. This means that the patient will slowly reduce their doses and possibly space them out further until they are no longer taking the drug. While this can still trigger antidepressant discontinuation syndrome, it is less likely to, and when it does, the effects tend to be milder. Users should still be monitored, though, as some side effects, especially those related to mental health, are still possible.
    Viibryd Discontinuation Symptoms

    Viibryd withdrawal symptoms can mimic a relapse in depression, so users should be carefully monitored after stopping or reducing the drug. Among the Vilazodone Withdrawal Symptoms Are:

    • Lethargy and fatigue
    • Headaches
    • Muscle aches
    • Sweating
    • Difficulty sleeping
    • Vivid dreams
    • Nightmares
    • Auditory hallucinations
    • Dizziness and light-headedness
    • Vertigo
    • Burning and tingling sensations
    • Electric sensations, such as brain zaps
    • Anxiety
    • Irritability
    • Aggression
    • Mania

    If someone has stopped taking the medication and has begun experiencing these symptoms, they should notify a doctor.

    How Long Does Viibryd Withdrawal Last?

    There is no exact time when talking about how long the Viibryd withdrawal symptoms last.  However, medical intervention and detox can ease or stop the symptoms sooner. The duration of the withdrawal symptoms depends on the following:

    • Length of time in taking the drug
    • How many doses have been taken
    • Diet and other medications being taken

    In most cases, starting a new antidepressant will stop withdrawal within days. However, users should never do this on their own, as starting another antidepressant too close to stopping Vilazodone could result in serotonin syndrome, which can be deadly.

    Viibryd And Alcohol Interaction

    When it comes to any drugs, there might be an interaction. These interactions may be food-drug and drug-drug, and may be considered mild, moderate, or severe. Viibryd and alcohol fall under the food-drug interactions. Alcohol can affect the mood of a person and may interfere with drug treatment. Taking Viibryd and alcohol together can make the side effects of the former more severe. This means a user will feel very drunk off of less alcohol, and the side effects of the medicine, such as lethargy, will become greater. As a result, users should avoid taking Vilazodone and alcohol together, as it can compromise their safety.

    Viibryd Overdose

    As with any other medication, a Vilazodone medication overdose is possible, and this may cause a risk. In most cases, an overdose is unintentional when a patient takes more than prescribed (exceeding the maximum daily dose) to manage the symptoms faster. It also can be a result of a missed dose, when a patient takes a double one; or if a patient forgets when the last dose has been taken. No matter the reason, overdose may be uncomfortable.

    Users Should Be Mindful Of the Signs of a Vilazodone Overdose, Which Include:

    • Nausea
    • Vomiting
    • Blurred vision
    • Dilated pupils
    • Confusion
    • Headache
    • Drowsiness
    • Fever
    • Lack of motor control
    • Changes in respiration
    • Rapid or very slow heartbeat
    • Hallucinations
    • Seizures
    • Coma

    A Vilazodone overdose can occur at a lower dose when other medications or substances are used at the same time. These can include prescription medications or alcohol. If someone experiences an overdose on Vilazodone, it is pivotal to go to a doctor and seek emergency medical attention at once.

    Getting Help: Viibryd Addiction And Abuse Treatment Options

    Vilazodone addiction is not easy to overcome alone that is why treatment, support, and help should be given. Getting is a way for a person to manage undesired signs and reduce other withdrawal symptoms. Below are some treatment options for Viibryd addiction and abuse:

    Vilazodone Detox

    The first step in kicking out Viibryd addiction is by doing medical detox. Detox includes tapering down or lowering the dose of Vilazodone gradually. This process will help a patient to avoid experiencing withdrawal symptoms.

    Drug Rehabilitation Programs

    After Vilazodone medical detox, it is important to consider drug rehabilitation programs. When choosing between in-patient or out-patient rehabilitation programs, it is a must to consider the needs of the patient as this can help make the process easier.

    In-patient rehabilitation program

    In this program, a patient will live on campus for a specific time to safely recover from addiction. Additionally, group and individual counseling services will be provided in this program.

    Out-patient rehabilitation program

    This is another treatment option where a patient may choose to live at home and attend a scheduled treatment whenever there is. It is also possible to attend an in-patient rehabilitation program and then attend an out-patient rehabilitation program after.

    Sobriety Support Group

    Joining a sobriety support group is another help option as well. Usually, a group of people recovering from addiction will have to meet once or twice a week to give support to one another.

    Aside from the support options above, a person struggling with Vilazodone addiction may reach out to health care professionals for help.

    Find the best treatment options. Call our free and confidential helpline

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    Page Sources

    1. Boinpally, R., Alcorn, H., Adams, M. H., Longstreth, J., & Edwards, J. (2013). Pharmacokinetics of Vilazodone in Patients with Mild or Moderate Renal Impairment. Clinical Drug Investigation, 33(3), 199–206.
    2. Cruz, M. (2012). Vilazodone HCl (Viibryd). Pharmacy and Therapeutics, 37(1), 28–31.
    3. Durgam, S., Gommoll, C., Forero, G., Nunez, R., Tang, X., Mathews, M., & Sheehan, D. V. (2016). Efficacy and Safety of Vilazodone in Patients With Generalized Anxiety Disorder. The Journal of Clinical Psychiatry, 77(12), 1687–1694.
    4. Gabriel, M., & Sharma, V. (2017). Antidepressant discontinuation syndrome. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne, 189(21), E747.
    5. Gandhimathi, R., & Balammal, G. (2013). SSRI Discontinuation Syndrome – A Review. International Journal of Medicinal Chemistry & Analysis, 3(1), 43–48.
    6. Gazewood, J., Parker, S., & DeGeorge, K. (2013). Vilazodone (Viibryd) for the Treatment of Depression. American Family Physician, 88(4)
    7. Gommoll, C., Forero, G., Mathews, M., Nunez, R., Tang, X., Durgam, S., & Sambunaris, A. (2015). Vilazodone in patients with generalized anxiety disorder. International Clinical Psychopharmacology, 30(6), 297–306.
    8. Haddad, P. (1999). Do antidepressants have any potential to cause addiction? European Neuropsychopharmacology, 9, 231.
    9. Harmer, C. J., Duman, R. S., & Cowen, P. J. (2017). How do antidepressants work? New perspectives for refining future treatment approaches. The Lancet Psychiatry, 4(5), 409–418.
    10. Heise, C. W., Malashock, H., & Brooks, D. E. (2017). A review of vilazodone exposures with focus on serotonin syndrome effects. Clinical Toxicology, 55(9), 1004-1007.
    11. Hellerstein, D. J., & Flaxer, J. (2015). Vilazodone for the treatment of major depressive disorder: an evidence-based review of its place in therapy. Core Evidence, 49.
    12. National Institute on Drug Abuse. (2016). Sex and gender differences in substance use.
    13. Schwartz, T., & Singh, M. (2012). Clinical utility of vilazodone for the treatment of adults with major depressive disorder and theoretical implications for future clinical use. Neuropsychiatric Disease and Treatment, 123.
    14. Sullivan, M., & Evans, E. (2014). Abuse and misuse of antidepressants. Substance Abuse and Rehabilitation, 107.
    15. Whitesell, M., Bachand, A., Peel, J., & Brown, M. (2013). Familial, social, and individual factors contributing to risk for adolescent substance use. Journal of addiction, 2013, 579310.

    Published on: February 25th, 2020

    Updated on: July 6th, 2021

    Dr. Roger Weiss is a practicing mental health specialist at the hospital. Dr. Weiss combines his clinical practice and medical writing career since 2009. Apart from these activities, Dr. Weiss also delivers lectures for youth, former addicts, and everyone interested in topics such as substance abuse and treatment.

    8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.

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    Viibryd withdrawal.

    The F.D.A. estimates 10% of the people withdrawing
    off an antidepressant will not be able to succeed
    due to withdrawal side effects. Viibryd is not
    different. If you are one of the lucky 90% that can
    do a successful Viibryd withdrawal you still need to
    rebuild your body once off Viibryd. This site
    provides information what to do for Viibryd
    withdrawal and after Viibryd withdrawal if you were
    able to succeed on your own.

    Let’s take at how to have a successful Viibryd
    withdrawal first.

    There are two parts that make a successful Viibryd
    withdrawal possible.

    How you reduce the Viibryd during withdrawal and
    taking a few supplements that will help eliminate
    any Viibryd withdrawal side effects.

    It does not matter what dosage of Viibryd you are
    taking or how long you have used Viibryd; the
    reduction of Viibryd is the same.

    You want to reduce Viibryd by no more than 10% and
    only reduce by an additional 10% every 2 weeks. This
    is the safest and most successful way to become
    Viibryd free and not suffer during withdrawal.

     

    Check with your pharmacist for compounding the
    Viibryd and the best option. The next best method is
    to use a pill slicer and a milligram scale. Get a 7
    day pill holder and once a week cut your pills for
    the coming week.

     

    Roughly 90% of you will be able to complete a
    Viibryd withdrawal using the method above. However,
    you will most likely experience flu like symptoms,
    headache, brain zaps, anxiety, and insomnia or in
    some cases extreme fatigue. These symptoms will
    normally last 1 or 2 weeks.

    In early 1999, we began investigating the use of
    natural supplements to help ease withdrawal
    symptoms. Over the past 20 plus years we have
    continued to improve this approach and our success
    rate is rather high.

    With Viibryd withdrawal, you should take 4
    supplements. JNK Formula Complete, Neuro Day, Neuro
    Night and Omega 3 Supreme. In 2018, we researched
    the use of THC Free CBD Oil and have found it to be
    of great benefit as an additional supplement. We
    sourced one CBD oil made in the United States, made
    in an F.D.A. registered facility, a higher amount of
    CBD per serving than most and surprisingly the
    lowest price by far. It is called Harper Drops
    Supreme.

    You can read How to Start for all chapters of the
    bestselling book, How to Get Off Psychoactive Drugs
    Safely, or just follow the instructions on each
    bottle to know when to take each supplement.

    Take the supplements for 1 full week before reducing
    the Viibryd and then you can begin your Viibryd
    withdrawal reduction. It really can be this simple.

    If you are located in the United States Canada,
    Great Britain
    Click here

    If you are located in Europe

    Click here

    What is Viibryd

    Viibryd is a
    prescription medication used to treat depression and
    anxiety. It belongs to a class of drugs known as
    selective serotonin reuptake inhibitors (SSRIs).

    The
    medication takes some time to build up in the body,
    which is why it can take a few weeks before people
    begin noticing a reduction in symptoms of depression
    or anxiety. If you suddenly stop taking Viibryd,
    however, you may experience symptoms of withdrawal.
    In the United States this withdrawal is known as
    Viibryd Discontinuation Syndrome but in Europe is
    known as Viibryd Withdrawal.

    Antidepressants are among the
    most commonly prescribed medications in the United
    States. Of the more than 60 million people who take
    them in a given month, about one quarter have been
    taking them for more than 10 years.
    Often, long-term use is linked to fear of relapse of
    their symptoms or withdrawal. We have found length
    of time taking Viibryd WILL NOT determine how easy
    or difficult it will be for you to accomplish a
    Viibryd withdrawal.

    People
    experience symptoms of Viibryd withdrawal because of
    the way SSRI’s work in the brain. SSRIs affect the
    levels of serotonin, a type of mood-regulating
    neurotransmitter in the brain. When you abruptly
    stop taking your medication, it doesn’t give the
    brain enough time to adjust to the sudden change.

    Whether
    you are stopping Viibryd because it is not working
    for you or you are better and you’ve decided with
    your doctor that it makes sense to come off your
    medication, the quitting process needs to be slow
    and gradual.

    Signs & Symptoms

    Recent research has found that the severity of SSRI
    withdrawal is much worse than previously believed.
    On average, about 46% of people experiencing SSRI
    withdrawal symptoms describe them as severe.
    Severe symptoms indicate
    that withdrawal can potentially interfere with your
    ability to meet responsibilities at home and at
    work.  It was also found that 10% of the people
    attempting antidepressant withdrawal, 10% quit the
    Viibryd withdrawal due to a withdrawal side effect
    known as brain zaps. The Omega 3 Supreme used during
    Viibryd withdrawal is formulated to ease this severe
    withdrawal side effect.

    The most common symptoms of Viibryd
    withdrawal—occurring in more than one in four
    people—are as follows:

    • Dizziness
    • Muscle tension 
    • Chills
    • Confusion
    • Trouble concentrating
    • Trouble remembering things
    • Crying

    The most common symptoms of Viibryd withdrawal are
    dizziness, muscle tension, and chills, which each
    affect about 44% of users. Many people also
    experience confusion and difficulty concentrating.
    Once again, the supplements have been formulated to
    help with these symptoms.

    Complete Symptoms

    The following is a more complete list of symptoms
    associated with withdrawal:

    • Changes in motor control:
      Temors, muscle tension, restless legs, unsteady
      gait, or difficulty controlling speech and
      chewing movements

    • Digestive issues:
      Nausea, vomiting, cramps, diarrhea, or appetite
      loss

    • Flu-like symptoms:
      Headache, muscle pain, weakness, and tiredness.

    • Instability:
      Dizziness, lightheadedness, difficulty walking

    • Mood changes:
      Anxiety, agitation, panic, suicidal ideation,
      depression, irritability, anger, mania, or mood
      swings

    • Sleep problems:
      Nightmares, unusual dreams, excessive/vivid
      dreams, or insomnia

    • Unusual sensations:
      Brain zaps (like an electrical shock or shiver
      in your brain), pins and needles, ringing in the
      ears, strange tastes, or hypersensitivity to
      sound

    Viibryd withdrawal can take a real toll on your
    life, both physically and emotionally.
    Antidepressants like Viibryd work by increasing
    serotonin levels in your brain. When you stop taking
    them, it takes your brain a while to get used to the
    drug’s absence. Unfortunately, the amount of time
    this takes can vary widely.

    Viibryd withdrawal symptoms typically arrive one to
    three days after your last dose. It can start sooner
    (within hours) or later (more than a week). This is
    why most inpatient facilities fail with Viibryd
    withdrawal. Insurance may pay only 9 days of
    treatment and by the time you are off the plane near
    your city, Viibryd withdrawal is back and in full
    effect. Viibryd withdrawal should never be rushed.

    Coping & Relief

    The best way to find relief from Viibryd withdrawal
    is to use the supplements mentioned above, reduce
    the Viibryd gradually and only continue to reduce
    when you are feeling very well. If you are still
    experiencing symptoms of depression, definitely send
    us an e-mail and we will help you adjust supplements
    and assist you in finding

    the
    cause.

    Taper Off Medication Slowly

    In
    1999, our founder, Jim Harper, published a guideline
    for reducing medications. That guideline has been
    adapted to all psychoactive medications by the drug
    manufacturers. The most effective way to minimize
    symptoms of withdrawal is to slowly taper off your
    medication.

    “Reduce the medication slowly. If
    withdrawal symptoms begin go back up to the last
    dosage you were doing fine at, stay at that dosage
    until all withdrawal has subsided. When you continue
    with withdrawal reduce the medication slower than
    the previous reductions.”

    Viibryd should only be reduced by
    10%. Some people will need to reduce the Viibryd by
    5%.

    Reductions of the Viibryd can be
    made every 7 days or in some cases every 14 days.
    Slow and steady wins this race.

    Tapering involves adjusting your
    dose by a small amount, gradually decreasing until
    your body gets used to lower levels of the
    medication. Talk to your doctor who can then create
    a dose schedule and carefully monitor the process to
    avoid severe symptoms.

    Practice Good Self-Care

    Taking
    good care of your health as you stop taking Viibryd
    can also help you to better manage any withdrawal
    symptoms that you experience. Some steps you can
    take that might help you cope with withdrawal
    symptoms include:

    • Do not change your diet when tapering. This can
      alter metabolism rater of the Viibryd and create
      a withdrawal symptom
    • Follow your doctor’s taping recommendations
    • Get plenty of rest
    • Get regular mild exercise
    • Get support from family, friends, or support
      groups

    If you or someone you love shows any of the
    following signs or symptoms after stopping or during
    a Viibryd taper, get help:

    • Becoming preoccupied with death, dying, or
      violence
    • Engaging in risky or self-destructive
      activities, such as driving drunk
    • Feeling hopeless or trapped
    • Gathering the means to commit suicide, such as
      bullets or pills
    • Getting affairs in order or giving away
      belongings
    • Having intense mood swings
    • Planning how you would commit suicide if you
      were going to do it
    • Saying goodbye to people as if it were the last
      time 
    • Talking or thinking about suicide more than
      normal, for example, “I wish I were dead”

    Withdrawal symptoms: Symptoms, Diagnostics, Symptoms | doc.ua

    Types of abstinence

    • Alcoholic
    • Nicotine
    • Narcotic

    Symptoms

    Alcohol withdrawal

    It manifests itself in different ways depending on the stage of alcoholism.

    In the second stage, the cessation of drunkenness leads to overexcitation at the physical and mental level. Fingers, tongue, eyelids tremble, weakness is noted. The face, neck, shoulders turn red, sweating is increased (hot sweat appears), the amount of urine decreases, and edema occurs.Pupils dilate. A gray coating covers the tongue, nausea and vomiting torment. There is no desire to eat anything. Feel headaches, pain in the heart, liver. Human behavior is disturbed, ideas of jealousy overwhelm him, they become pronounced.

    In the third stage of drunkenness, alcohol withdrawal syndrome looks different. Basically, the patient lies or sits motionless, lethargic. Pallor is noted, the limbs have a bluish tint, cold sweat appears. The facial features are pointed, the eyes are sunken.Independent movement is difficult or even completely impossible, since coordination is impaired.

    Nicotine withdrawal

    Occurs when smoking cessation or the absence of such an opportunity for a long time. Nerve cells that have receptors that are sensitive to nicotine get used to it very quickly. And they give their signals if they don’t get another dose of nicotine. This is expressed in poor health. Headache, dizziness, tinnitus make it difficult to live as usual.Pain in the heart, palpitations, general weakness not only interfere with life, but also inspire fears for their health. Nausea, decreased appetite, changes in the nervous system are unpleasant: nervousness, trembling of hands, deterioration of mood, sleep disturbance. All of the above withdrawal symptoms are due to physical dependence. They are especially pronounced in the first 48 hours, and then it becomes easier.

    Withdrawal symptoms when smoking in all people manifests itself differently, has its own characteristics.The above symptoms may not appear all at once, but be in different combinations, one symptom or some others may be present.

    Narcotic withdrawal syndrome

    It usually occurs on the first day of the absence of a drug in the body with an increased attraction to it. Initially, there is salivation, yawning, runny nose, sneezing, tears flow. Then, on the second day, the condition worsens. Chills, muscle tension and pain, joint pain, hot flashes and sweating appear, the person becomes restless.On the third day, if the drug is not delivered, dyspepsia and convulsions, up to generalized, develop. Acute psychosis develops.

    Children born to mothers who have used alcohol or drugs, have abused tranquilizers or antidepressants before childbirth, develop withdrawal symptoms, the symptoms of which appear immediately after birth or in the next two days. Children are restless, shrill screams, they have increased sensitivity to touch, harsh sounds and bright light.In such children, convulsive readiness is increased, convulsions are often periodically noted.

    Newborns do not suck well, regurgitate, “choke”, vomiting is noted. The nervous and cardiovascular systems suffer: the heart rate increases or slows down, sleep disorders and vegetative-vascular disorders are noted in the form of “marbling” of the skin, a symptom of Harlequin. The whole body suffers, shortness of breath or tachypnea appears, apnea attacks periodically occur, the temperature may rise to high numbers.Children do not gain weight well. Withdrawal symptoms can last for days or weeks, and symptoms gradually subside.

    Diagnostics

    The diagnosis is based on anamnesis (information about the use of alcohol, nicotine or drugs) and examination data by a narcologist. In addition to somatic changes during abstinence, one must also remember about the possibility of developing concomitant diseases (hypertension, coronary artery disease, COPD, pneumonia, etc.) simultaneously with it. The data of additional laboratory and instrumental examination make it possible to assess the severity of pathological changes in the body.

    Help with withdrawal

    Removal of withdrawal symptoms in a newborn provides oral administration of phenobarbital, with severe syndrome and seizures, relanium (seduxen) is administered intramuscularly or intravenously.

    In adults, the development of the syndrome also requires emergency care to relieve unpleasant and painful symptoms. Excitation is stopped by sedatives (seduxen, diazepam, phenazepam).

    Detoxification therapy is carried out with the aim of neutralizing and removing toxic substances from the body.It should be carried out under the supervision of doctors; intravenous infusion of glucose-saline solutions with components is effective.

    Treatment

    It is important not only to relieve withdrawal symptoms, treatment must be continued for a long time. And it is advisable not to give up inpatient treatment. Drugs used to treat drug withdrawal are prohibited for home use.

    In patients suffering from any addiction, especially alcoholism and drug addiction, almost all organs are affected.The liver, which performs detoxification functions, the brain, and the heart are especially affected. In addition, exacerbations of chronic diseases occur. Therefore, against the background of ongoing sedative therapy, other diseases are also being treated. This ultimately relieves withdrawal symptoms.

    Symptomatic therapy is in progress. Reception of Essentiale, Carsil, Milk thistle meal relieves the condition of the liver. Taking vitamins is a must for all types of withdrawal symptoms.

    Hangover

    Hangover is a post-intoxication state due to alcohol abuse, accompanied by 90,058
    unpleasant psychological and physiological effects such as headache, irritability, dryness in
    mouth, sweating, nausea.

    In Russian-language literature, it is often confused with the concept of “alcohol withdrawal syndrome, which is incorrect.

    Withdrawal syndrome (from Latin abstinentia – abstinence), withdrawal syndrome, withdrawal state; jarg.
    withdrawal, – a group of symptoms of various combinations and severity that occur when the drug is completely discontinued
    psychoactive substance or its dose reduction after repeated, usually prolonged and / or high doses,
    use.There is a time frame during which withdrawal symptoms can occur and continue,
    but they strongly depend on the type of psychoactive substance taken by the patient and its dose, directly
    preceding abstinence.

    Hangover is a post-intoxication state due to alcohol abuse, accompanied by unpleasant psychological and physiological effects, such as headache, irritability, dry mouth, sweating, and nausea.

    In Russian-language literature, it is often confused with the concept of “alcohol withdrawal syndrome, which is incorrect.

    Withdrawal syndrome (from Latin abstinentia – abstinence), withdrawal syndrome, withdrawal state; jarg. withdrawal is a group of symptoms of various combinations and severity that occur when the drug is completely stopped or its dose is reduced after repeated, usually prolonged and / or high doses, use. There are time frames during which withdrawal symptoms can occur and continue, but they are highly dependent on the type of psychoactive substance taken by the patient and its dose immediately preceding abstinence.

    Withdrawal symptoms are an integral part of addiction. As a rule, the symptoms of withdrawal symptoms are opposite to those of acute intoxication. In withdrawal symptoms, alcohol withdrawal symptoms are often identified as the most studied.

    The reasons for the hangover are not exactly known. Ethanol causes increased urine production (increased urine output), which leads to headaches, dry mouth and a feeling of fatigue, prostration, and dehydration.

    Withdrawal syndrome (withdrawal symptoms) in drug addicts.Help

    Every addict unmistakably feels the approach of withdrawal. The first withdrawal symptoms begin to appear 8-12 hours after the last dose.

    Here is how heroin withdrawal syndrome is described in the book of medical psychologist Dili Yenikeeva “How to prevent alcoholism and drug addiction in adolescents”: “This is one of the most severe abstinence options among other forms of drug addiction and substance abuse. 8-12 hours after the injection of heroin or inhalation of its powder through the nose, pupil dilation, lacrimation, runny nose, sneezing, chills occur, periodically “goose bumps” appear.Appetite disappears, craving for drugs is intense, a state of emotional stress, anxiety, anxiety arises. The patient cannot sleep. Then the chill is replaced by a feeling of heat, there are bouts of weakness and sweating. A feeling of discomfort appears in the muscles of the back, neck, arms, legs. There is muscle tension, a desire to stretch, stretch the muscles. This condition is likened by addicts to the sensation that occurs when you “sit a leg”, but it spreads to most of the skeletal muscles.There is pain in the masticatory muscles and intermaxillary joints, aggravated when the patient tries to eat or even at the thought of food.

    Then all the symptoms that were there are intensified. “Goose bumps”, chills become constant, pupils are wide, almost do not react to light. Sneezing becomes paroxysmal, 50-100 times in a row. From yawning “jaws”. Strong salivation appears. By the end of the second day, the most difficult period begins. There are severe pains in the back, legs, neck. Drug addicts describe them like this: “pulls” muscles, “twists”, “pulls”.Due to intense pain, the addict does not find a place for himself, then gets up, then lies down again, turns in bed, rubs his muscles, pulls his knees to his chin. It seems to him that when moving, the pain will become less, and he gets out of bed. But the pain doesn’t go away. The addict experiences a painful state of agitated anxiety, pathological restlessness. Periodically cramps occur in the calf muscles. The patient becomes angry, aggressive. Craving for drugs is irresistible, in this state the addict is capable of any violence, crime, lie, just to get the drug.For 3-4 days, vomiting and diarrhea are added to the already existing sensations. Diarrhea and vomiting can be repeated, up to 10-15 times a day with cramping pain in the intestines. The body temperature rises. Patients cannot eat anything, they lose 10-12 kilograms in weight. They do not sleep at night, falling into oblivion only for a short time during the day. In patients taking intravenous drugs, there is severe itching along the veins. Outwardly, the patients look exhausted, as during a serious illness. The expression on the face is suffering.The eyes are dull, deeply sunken. The skin is dry, pale, or earthy gray.

    The duration of withdrawal symptoms in general varies and is determined by the duration of anesthesia, doses of opiates and a number of other factors, including the “mindset to refuse or to continue taking drugs.” On average, the duration of withdrawal symptoms without treatment is 2 weeks, but it can be longer.

    After the disappearance of acute symptoms of withdrawal symptoms, residual effects are observed in the form of an irresistible craving for a drug, low mood, dysphoria (a mood disorder characterized by a tense, maliciously melancholy affect with pronounced irritability, reaching outbursts of anger with aggressiveness), mental discomfort, asthenia (painful a condition manifested by increased fatigue and exhaustion with extreme instability of mood), sleep disorders (delayed period of withdrawal syndrome).During this period, the craving for the drug is easily actualized, which affects the behavior of patients. They again become hysterical, angry, demand discharge under any pretext, disorganize work in the department (if they are in the hospital). For a minor reason, their mood decreases, suicidal tendencies arise, which requires timely adequate therapeutic measures. The period of delayed manifestations of withdrawal symptoms can last from 2 to 5 weeks after the disappearance of acute symptoms.At this time, spontaneous relapses of the disease are frequent.

    The withdrawal symptoms completely disappear only after a few months.

    The material was prepared on the basis of information from open sources

    Private psychiatry | Training | ROP

    Pathogenesis

    neurotransmitters (primarily GABA agonists). As a mechanism
    compensation is enhanced synthesis of catecholamines and suppression of activity
    enzymes of their metabolism, primarily monoxidase and
    dopamine-β-hydroxylase, which controls the conversion of dopamine to norepinephrine.An accelerated circulation of catecholamines is formed. On termination
    taking surfactants, the increased release of catecholamines from the depot stops, but
    their synthesis remains accelerated. Due to changes in the activity of enzymes in
    biological fluids and tissues (mainly in the brain) occurs
    accumulation of dopamine. It is this process that determines the development of the main
    clinical signs of AS.

    Blood dopamine level
    clearly correlates with the clinical severity of AS: exceeding its baseline
    indicators are twice combined with the picture of a severe AS, when exceeding three
    times, as a rule, an acute psychotic state develops.Excess Dopamine
    causes overexcitation of the sympathetic division of the autonomic nervous system and
    excess production of adrenal hormones, which determines the diversity
    clinics.

    CLINICAL OPTIONS

    1. Neurovegetative – basic
    an option that takes place in any case of alcoholic AU, but capable of “overgrowing”
    additional symptoms: poor sleep, asthenia, lethargy, sweating,
    swelling of the face, poor appetite, thirst, dry mouth, increase or decrease
    BP, tachycardia, tremors of the fingers.

    2. Cerebral – neurovegetative
    violations are accompanied by severe headache with nausea, dizziness,
    hyperacusis, sudden flinching, fainting, epileptiform seizures.

    3. Visceral – abdominal pain prevails,
    nausea, vomiting, flatulence, loose stools, subicteric sclera, angina pectoris, cardiac
    arrhythmia, shortness of breath.

    4. Psychopathological – presence
    significantly pronounced mental disorders: suicidal thoughts and behavior,
    anxiety, fear, depression, dysphoria, ideas of attitude and guilt, total
    insomnia, hypnagogic hallucinations, auditory and visual illusory
    deceptions, vivid “adventure” dreams, subsonic states with a temporary
    disorientation in the environment.

    In some cases, severe anxiety in AAS
    causes the onset of generalized anxiety disorder or
    panic disorder, and this causes the formation of spontaneous remission of AZ due to
    the appearance of a phobia to alcohol intake.

    Severity AAS

    Severity

    Clinical manifestations

    Light

    heart rate up to 100 beats / min; BP diastolic up to 100 mm Hg.

    Vegetative manifestations predominate: sweating, headache,
    nausea, thirst, unexpressed (weak) craving for alcohol.

    Medium

    heart rate 100-120 beats / min; BP diastolic 100-110 mm Hg; t ° C – up to
    38 ° C.

    Autonomic disorders: sweating, chilling, headache,
    pain in various parts of the gastrointestinal tract, nausea, vomiting, tachycardia,
    tachyarrhythmia.

    Neurological disorders: tremor, ataxia.

    Mental disorders: insomnia, anxiety, psychomotor
    excitement, craving for alcohol.

    Heavy

    heart rate more than 120 beats / min; BP diastolic more than 110 mm Hg; t ° C – from
    38 ° C and above.

    Autonomic disorders: hyperhidrosis, chills, nausea, vomiting, pain
    different localization, tachycardia, tachyarrhythmia, arrhythmia, other disorders
    cardiac activity.

    Neurological disorders: tremor, ataxia, possible development
    convulsive seizures.

    Mental disorders: insomnia, anxiety, psychomotor
    excitement, craving for alcohol, transient illusions and hallucinations.

    High likelihood of developing complications: alcoholic delirium,
    alcoholic hallucinosis, alcoholic paranoid, acute encephalopathy
    Gaje-Wernicke, seizures.

    The ICD-11 will
    the allocation of 4 types of AAS is provided:

    1.AAS uncomplicated (6C40.1)

    2. AAS with perceptual impairments (i.e., the presence of visual and
    tactile illusions and hallucinations without breaking reality testing and
    other signs of delirium) (6C40.2)

    3. AAS with seizures (i.e. with generalized clonic-tonic
    convulsions) (6C40.3)

    4. AAS with perceptual disturbances and seizures (6C40.1)

    Withdrawal Syndrome: Medicines Used in Treatment

    Withdrawal syndrome is a complex of somatic, neurological and mental disorders that occur in a patient with alcoholism when he stops drinking alcohol or when the doses taken are abruptly reduced, and these disorders are relieved or alleviated by taking alcoholic beverages.

    General

    A person who abuses alcohol for a long time will sooner or later come to the point that he will develop a real addiction. It is very difficult to recognize the presence of a problem in such cases, since the person himself does not see the difference between alcoholism and just regular alcohol abuse. But when the classic alcohol withdrawal syndrome appears, then obviously we are talking about a more serious problem than it might seem at first glance.

    A standard hangover can last within 24 hours, it quickly stops if an adequate drinking regimen is observed, and an improvement in well-being usually occurs after lunch.How long does withdrawal symptoms last? Usually at least three to five days. However, it often ends because of the intake of a new portion of alcohol. If this does not happen, then the remnants of toxic substances are gradually removed from the body and the main clinical picture is smoothed out. But since alcoholism is characterized by dependence, after a while the person drinks again or goes into a binge, after which the next withdrawal syndrome occurs.

    A feature of the withdrawal syndrome is that its intensity is quite large.In this case, a person loses the ability to work due to the severity of physical and psycho-emotional manifestations. Therefore, treatment of withdrawal symptoms is often required, since a person cannot get out of this state on his own. Auditory and visual hallucinations are especially dangerous, which can lead to additional aggression.

    Causes of withdrawal symptoms

    Withdrawal symptoms occur due to the fact that, as a result of prolonged alcohol consumption, ethanol breakdown products accumulate in the blood.These are toxic compounds that are formed in the liver and intestines as a result of the breakdown of the ethanol molecule. In a healthy body, special enzymes are produced that neutralize the formed toxins. But if alcohol is supplied in excess, and the liver has already suffered significantly from the regular use of alcohol, then there are not enough enzymes and there are a lot of toxins. They spread through the vessels and enter various organs.

    First of all, the central nervous system suffers, as it is most sensitive to the action of harmful substances.After the binge ends, alcohol is gradually broken down in the liver, the decay products enter the bloodstream and affect the nerve fibers, as well as the brain. Relief of withdrawal symptoms is aimed at restoring the function of the nervous system. Excitement disappears, trembling in hands decreases, hallucinations disappear. It is important to start treatment on time in order to prevent a significant deterioration in the condition or a new binge.

    Symptoms

    Alcohol withdrawal syndrome occurs due to alcohol withdrawal.Its severity depends on how long the binge was, and how much ethanol entered the body during this period.

    The main withdrawal symptoms are:

    • Psychomotor agitation, or vice versa, severe weakness and fatigue. Arise due to chronic intoxication.
    • Shaking hands, eyelids. In severe cases, this symptom cannot be hidden, there is a tremor of the whole body.
    • Vomiting. Appears only in severe cases.With an average degree of intoxication, vomiting in alcoholics is absent due to the weakening of the gag reflex. Withdrawal symptoms always vary and depend on the health of the patient.
    • Headaches. They arise due to vasospasm or increased intracranial pressure. Can be very intense.
    • Insomnia. Sleep disorders are always present, since the process of falling asleep suffers, the duration of sleep is shortened. Withdrawal symptoms in alcoholism are often accompanied by nightmares that lead to a deterioration in the general condition.
    • Thinking, attention, concentration are impaired. Depression begins with a predominance of anxiety, apathy, obsessive phobias.
    • Auditory and visual hallucinations. There are in severe cases with prolonged binge drinking. Withdrawal symptoms in such cases should be treated only within the hospital with the use of sedatives.

    Recovery from withdrawal symptoms occurs in alcoholics at different times. Moreover, in this case, there is no relationship between the amount of alcohol consumed and the rate of rehabilitation.Of greater importance is how long a person has been suffering from alcoholism and how severe changes already exist in the brain. If withdrawal symptoms are treated, then rehabilitation proceeds faster. Then there is a more rapid detoxification and release of the body from ethanol metabolic products.

    What can you do with withdrawal symptoms

    Stop drinking and seek medical advice.

    What a doctor can do

    The doctor will examine the patient and begin treatment.

    Attention! Symptom chart is for educational purposes only. Do not self-medicate; for all questions regarding the definition of the disease and methods of treatment, contact your doctor. Our site is not responsible for the consequences caused by the use of information posted on it.

    Withdrawal symptoms: the reverse side of temporary pleasure – what are, types, signs, treatment

    Nature has endowed man with an organism with incredible reserves, reliable systems, interchangeable and interacting with each other, with inexhaustible abilities of compensation and adaptation.The realization of the capabilities of our body depends on the lifestyle, behavior, habits

    … Unfortunately, not everyone knows how to use this priceless gift called health. Every day we damage our health without thinking about the consequences, and sometimes without even realizing it. Leading positions in the detrimental effect on our health are occupied by such habits that are harmful and dangerous not only for health, but also for life, such as alcoholism, drug addiction, smoking tobacco and other products. Refusal to use alcoholic beverages, cigarettes, drugs is accompanied by a complex of the most unpleasant symptoms, in everyday life this condition is called “withdrawal”, and according to medical terminology, this phenomenon is called “withdrawal symptoms” (AS).

    What is withdrawal symptoms?

    Withdrawal syndrome (withdrawal syndrome) is a complex of pathological symptoms of a psychological and physical nature that occurs after the cancellation or a sharp decrease in the dose of alcohol, nicotine, narcotic and psychoactive substances, antidepressants and medications, after their repeated and active consumption. Basically, this condition is due to the body’s attempts to independently achieve the state that a person had while taking this or that remedy.Withdrawal symptoms are accompanied not only by severe physical and mental symptoms, but also often lead to death.

    Types of withdrawal symptoms

    Depending on the type of bad habit, there are types of withdrawal symptoms, consider three main ones: up to 10 days.Alcohol withdrawal is typical for the second and third stages of alcoholism. At the third stage of alcoholism, AS is very often manifested in the form of delirium or, speaking in the popular language, “delirium tremens”. Alcoholism leads to inhibition of the functions of the brain (dementia, dementia, personality degradation, etc.), the cardiovascular system, the gastrointestinal tract, kidneys, liver and other vital organs and systems. Signs of alcohol withdrawal:

    • Nausea, vomiting, lack of appetite, diarrhea
    • Headache, dizziness
    • Chills, sweating
    • Irrepressible craving for alcohol
    • Tremor, convulsions
    • Urination

    • Sleepiness
    • Amnesia

    • Sleepiness
    • Amnesia

    • Hallucinations, visions, delirium
    • Fear of death, panic, anxiety
    • Suicidal attempts

    Narcotic withdrawal cider – develops within a few hours after taking the drug.Drugs mainly have a negative effect on the human nervous system, namely, on the transmission of nerve impulses. Neurotransmitters in the brain are responsible for transmitting signals between nerve cells, and a drug that enters the human body replaces some important neurotransmitters, as a result of which the body loses the ability to produce them on its own. Thus, communication between cells of the nervous system and other organs and systems of the body becomes impossible due to the absence of neurotransmitters.During drug withdrawal, the body is no longer a single well-coordinated mechanism, but just a collection of cells. Withdrawal from drug withdrawal can last from several hours to several weeks, but the average is about ten days. During the withdrawal period, the body learns again to independently produce the necessary neurotransmitters to restore metabolic processes. Taking narcotic drugs deprives the body of vitamins, minerals, trace elements and nutrients that are vital for the body to restore lost functions.For this reason, it is almost impossible to get rid of withdrawal symptoms at home; you should always seek professional help in order to avoid irreparable consequences. Signs of drug withdrawal:

    • The first symptoms may resemble a cold
    • Runny nose, weakness, malaise, sneezing
    • Sweating
    • Deterioration of health, uncomfortable sensations throughout the body
    • Sudden changes from a state of fever
    • chills

    • Blood pressure surges, tachycardia
    • Dilated pupils
    • Drooling
    • Bad mood, withdrawal
    • Irritability, outbursts of anger, aggression
    • Feeling of anxiety
    • Unexplained anxiety, inability to sit still
    • accompanied by severe pain

    • Pain in joints and bones, convulsions
    • Confusion of consciousness
    • Insomnia, nightmares
    • Unpredictable behavior, rage
    • Hallucinations, inability to distinguish between imaginary demons s from real people, even the closest ones
    • Uncontrolled aggressive actions
    • Suicidal attempts

    Nicotine withdrawal syndrome.When quitting smoking, the human body experiences stress, the first symptoms of nicotine withdrawal appear after a few hours. The duration can last from several weeks to several months, depending on the experience of the smoker, health status, smoking regimen, etc. Nicotine is absorbed into the bloodstream in the very first seconds of inhalation. The toxins are quickly transported to the central nervous system, where they trigger the release of dopamine. As a result, the smoker is in mild euphoria and feels relaxation.Over time, the body needs an increasing dose of nicotine to stimulate the production of the hormone of joy, a persistent and powerful addiction is formed. Smoking reduces immunity, has a pronounced negative effect on the central nervous system, cardiovascular, respiratory systems, gastrointestinal tract and many others. Symptoms of withdrawal symptoms in nicotine addiction are most pronounced in the first week after giving up the addiction. Signs of nicotine withdrawal:

    • Hot temper, irritability
    • Anxiety, anxiety
    • Sleep disturbances
    • Arrhythmia, tachycardia, shortness of breath
    • Cough
    • Headaches
    • Deterioration of the mood
    • Depression
    • Depression
    • Sweating
    • Decreased alertness and efficiency
    • Strong desire to smoke

    Treatment of withdrawal symptoms

    Only a few manage to overcome the severe symptom complex of withdrawal symptoms on their own, especially with regard to alcohol and drug withdrawal.With painful signs of withdrawal symptoms, you should seek professional help. IsraClinic, a private psychiatric clinic in Israel, has been providing effective treatment for withdrawal symptoms and all kinds of addictions for more than 15 years. Our medical center employs the best specialists with many years of experience, authors of the latest treatment methods and scientific works, professors of prestigious universities. The key to high-quality treatment is an integrated approach involving a wide range of doctors, such as a narcologist, psychotherapist, psychologist, nutritionist, neurologist, rehabilitologist, physiotherapist and others, a thorough diagnosis of the patient is carried out.Treatment tactics are selected individually for each patient, taking into account personal characteristics. As a rule, the first stage in the treatment of withdrawal symptoms is detoxification (droppers with saline solutions, blood purification apparatus), as well as enrichment of the body with vitamin complexes, nutrients, taking medications, antidepressants, sedatives and hypnotics. Refusal of pathological hobbies is accompanied by depressive conditions that cause suicidal thoughts in the patient.Throughout the course of therapy, the patient is provided with psychological support. There is no compulsory treatment in IsraClinic, the main task of the center’s specialists is to arouse desire and support a person’s desire for healing and rehabilitation, to realize the negative consequences of bad habits. In addition to medical and psychological assistance, the treatment program includes physiotherapy, occupational therapy, cognitive-behavioral therapy, diet selection, group therapy, balneotherapy and much more, patients visit theaters, museums, Dead Sea recreational resorts and attractions in Israel.A significant advantage of IsraKlinik is the absence of a language barrier, all medical personnel are fluent in Russian. Every year patients from all over the world turn to us for help, they trust us. 90,000 Relief of withdrawal symptoms in alcoholism. Experience in the use of TES therapy.

    Withdrawal symptoms with alcoholism in everyday life are called a hangover. This is a very serious condition, characterized by a rapid heartbeat, increased excitability, nausea, vomiting and other painful physical and mental conditions.Treatment for alcohol dependence is impossible during withdrawal symptoms, therefore, first of all, narcologists stop alcohol withdrawal symptoms, removing all painful conditions of the body.

    Treatment of alcohol dependence is a long-term process that includes the treatment of the patient’s physical and psychological condition. TES therapy is indispensable at the stage of relief of withdrawal symptoms in alcoholism, as well as in the subsequent stages of patient rehabilitation.

    Below is a scientific article on the use of TES-therapy in the republican narcological dispensary of the Republic of Chechnya. Experience has shown that this method is very effective for the relief of withdrawal symptoms in alcoholism and drug addiction.

    In this article, treatment with professional TRANSAIR devices is considered, but I would like to note that the TPP center produces analogs of these devices for home use. Thus, relief of alcohol withdrawal syndrome is possible at home using the apparatus “Doctor TES-03”

    Experience of using TES-therapy in the complex treatment of abstinence in patients suffering from alcohol and heroin addiction

    Dalsaev M.A. 1 , Tataev H.L. 2

    1 State Institution Republican Narcological Dispensary, Ministry of Health of the Chechen Republic,

    2 Chechen State University, Grozny.

    Introduction.

    The introduction of non-drug methods of treatment into clinical practice, along with traditional ones, was dictated by the search for an increase in the effectiveness of therapy. In this direction in narcology, methods of stimulating CNS neurons synthesizing endogenous opiates, which include transcranial electrical stimulation (TES-therapy), which are actively introduced into clinical practice by V.V. Lebedev, are of particular importance.P.

    Materials and Methods.

    The effectiveness of treatment was studied in 25 patients: 10 people who were addicted to drugs (heroin) and 15 from alcohol. We used the Transair-01P device (in the mode without frequency modulation) as an additional therapy. Efficacy was assessed using a four-point self-report scale of patients according to a specially developed map and somatovegetative symptoms of withdrawal symptoms in alcoholism and drug addiction.

    The dynamics of withdrawal symptoms and the degree of the patient’s attraction to psychoactive substances (PAS) were assessed.The duration of heroin use was on average three years, the duration of alcoholism was 5 years. The average age of drug addicts was 30 years, and those with second stage alcoholism were 42 years old. Abuse of psychoactive substances preceded the withdrawal syndrome before the patient was admitted to the hospital. TES therapy began on the first day of withdrawal symptoms.

    The control group consisted of alcohol and heroin addicts (10 patients each) who did not receive TES therapy.The duration of TES therapy was at least five sessions and was carried out daily. TES therapy in all cases was used in combination with drug therapy, and not as monotherapy.

    Results.

    As a result of the study, it was found that the effectiveness of relief of withdrawal symptoms when used as an additional therapeutic factor TES-therapy was slightly higher both in patients suffering from heroin addiction and alcohol.At the same time, on the second day, the patients themselves noted that after the session they feel much better.

    One patient suffering from heroin addiction with an unexpressed attitude towards treatment, who was treated several times in different clinics in the country, noted that he did not feel any noticeable changes, while the others, on the contrary, believed that the effect of reducing the craving for the drug appeared immediately after the session. There was also a marked decrease in pain syndrome in drug addicts in the group receiving additional TES therapy.All patients with drug addiction and alcoholism by the end of the session noted some drowsiness.

    In the group of patients with alcohol dependence and receiving TES-therapy, there was not a single psychotic attack, while in the control group, two patients developed psychosis on the third day of admission to the hospital of the republican narcological dispensary. Anxiety (assessed on the Spielberger scale) was completely reduced by the third session in patients suffering from alcoholism, while in the control group it persisted up to 4-5 days.

    In general, relief of withdrawal symptoms in patients with alcoholism and drug addiction proceeded more easily in groups of patients who received additional TES-therapy. Based on the studies carried out, an assumption arose, taking into account the mechanism of action of TES therapy (Lebedev, Malygin, 2002; Lebedev, 2006), that endorphins play a certain role in the pathogenesis of alcoholic delirium, and TES therapy can help prevent this psychosis.