Vilazodone
Atypical antidepressants
Atypical antidepressants
An antidepressant that blocks serotonin reuptake and is also a 5-HT1A partial agonist. It is taken with food, and diarrhoea and nausea are common.
Quick facts
- Group
- Atypical antidepressants
- Target
- Serotonin transporter (SERT); also 5-HT1A receptor (partial agonist)
- Used for
- Major depressive disorder in adults
- Key effects
- Diarrhoea · Insomnia · Sexual dysfunction
- Monitor
- Mood and suicidal thoughts · Sodium in older people
- ATC
- N06AX24
No doses: the clinician sets them by the current guideline.
Mechanism of action
The figure shows vilazodone bound to the human serotonin transporter in its outward-open state (with an antibody fragment used for the structure).
Vilazodone selectively inhibits serotonin reuptake through SERT, like an SSRI, and is also a partial agonist at serotonin 5-HT1A receptors. The SERT block raises synaptic serotonin; the role of the 5-HT1A action in its antidepressant effect is not known. It has little effect on noradrenaline or dopamine transporters.
- Vilazodone blocks SERT: more synaptic serotonin
- Also partly activates 5-HT1A receptors
- Antidepressant effect over weeks
- Gut serotonin: diarrhoea and nausea are common
Indications
- Major depressive disorder in adults Major depressive disorder →
Adverse effects
Common
- Diarrhoea, nausea and vomiting
- Insomnia
- Sexual dysfunction
Contraindications
- MAO inhibitors now or within the previous 14 days
Key interactions
- MAO inhibitors, triptans, tramadol, other serotonergic drugs
- Serotonin syndrome
- Aspirin, NSAIDs, warfarin and other anticoagulants
- More bleeding
- Strong CYP3A4 inhibitors or inducers
- Inhibitors raise and inducers lower vilazodone levels; the amount is adjusted
What is monitored
- Mood and suicidal thoughts
- Symptoms of serotonin syndrome
- Sodium in older people
Administration and safety
- Given with food; without food, levels may be too low to work
- Stopped gradually to avoid discontinuation symptoms
Pregnancy and breastfeeding
Use in the third trimester may raise the risk of persistent pulmonary hypertension and withdrawal symptoms in the newborn.
Nursing care
- Checks that each dose is taken with a meal
- Asks about diarrhoea, nausea and sleep
- Teaches the patient and family to report new suicidal thoughts, agitation or unusual mood elevation
- Asks about painkillers and anticoagulants that add bleeding risk
Pharmacokinetics
- Absorption
- By mouth with food; bioavailability about 72% with food and much lower when fasting
- Metabolism
- Extensive, mainly CYP3A4 among the CYP enzymes
- Half-life
- About 25 hours
Test yourself
Think of the answer, then tap the question to see it.
Which two actions does vilazodone combine?
Serotonin reuptake inhibition (SERT) and partial agonism at 5-HT1A receptors.
Why is vilazodone given with food?
Fasting lowers its absorption so much that it may not work.
What are its most common side effects?
Diarrhoea, nausea, vomiting and insomnia.
Connections
← Back to the class: Atypical antidepressants
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: DailyMed - VILAZODONE HYDROCHLORIDE tablet (DailyMed (U.S. National Library of Medicine), 2026); Vilazodone: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.