Tips for tapering off Viibryd (vilazodone)

[Altostrata]

Viibryd is a new antidepressant taken by very few people. It is an SSRI and 5-HT1A receptor partial agonist with a half-life of about 25 hours. It is metabolized mainly by the liver enzyme P450 CYP3A4 (eating grapefruit or drinking grapefruit juice will interfere with its metabolism). It may be a moderate inhibitor of CYP2C19 and CYP2D6.

The above information and that below is from US official information at http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=4c55ccfb-c4cf-11df-851a-0800200c9a66

5.6 Discontinuation of Treatment with VIIBRYD

There have been reports of adverse events occurring upon discontinuation of serotonergic antidepressants, particularly when discontinuation is abrupt, including the following: dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g., paresthesia, such as electric shock sensations), anxiety, confusion, headache, lethargy, emotional lability, insomnia, hypomania, tinnitus, and seizures. While these events are generally self-limiting, there have been reports of serious discontinuation symptoms.

Monitor patients for these symptoms when discontinuing VIIBRYD. Reduce the dose gradually whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, consider resuming the previously prescribed dose. Subsequently, the dose may be decreased, but at a more gradual rate [see Dosage and Administration, (2.4)].

....
2.4 Discontinuing Treatment

Discontinuation symptoms have been reported with discontinuation of serotonergic drugs such as VIIBRYD. Gradual dose reduction is recommended, instead of abrupt discontinuation, whenever possible. Monitor patients for these symptoms when discontinuing VIIBRYD. If intolerable symptoms occur following a dose decrease or upon discontinuation of treatment, consider resuming the previously prescribed dose and decreasing the dose at a more gradual rate [see Warnings and Precautions (5.6)].

3 DOSAGE FORMS AND STRENGTHS

VIIBRYD Tablets are available as 10 mg, 20 mg and 40 mg immediate-release, film-coated tablets.

10 mg pink, oval tablet, debossed with 10 on one side

20 mg orange, oval tablet, debossed with 20 on one side

40 mg blue, oval tablet, debossed with 40 on one side

When Viibryd was released, it was promoted as not causing sexual dysfunction like other SSRIs. This proved not to be true. Reports on the Web indicate Viibryd can cause hair loss as well.

Reduce by 10% per month to start
The 10% rule holds for Viibryd, just like other psychiatric drugs: Reduce by 10% per month, calculated on the last dosage. (The amount of the reduction gets progressively smaller.)

See Why taper by 10% of my dosage?

Cutting up tablets
Viibryd is not timed-release. This and many reports on the Web indicates the tablets can be split. Cut them up with a pill cutter, available at any drug store.

Precisely weighing tablet pieces or crushed tablets with an electronic digital scale
You may wish to precisely measure your dosage with an electronic scale that measures milligrams. These are available for under $30 US.

Have a compounding pharmacy make up capsules of smaller dosages
A compounding pharmacy will accurately weigh small doses and put them into capsules for you. See http://survivingantidepressants.org/index.php?/topic/235-tapering-techniques/page__p__3001#entry3001

Make your own liquid
Like other non-timed-release drugs, one might make a Viibryd liquid out of tablets and water for more precise titration. See How to make a liquid from tablets or capsules

From http://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022567Orig1s000ClinPharmR.pdf (PDF):

Vilazodone has relatively high aqueous solubility (water: 32 mg/100 mL)....

 

Using a combination of tablets or capsules and liquid

Rather than switch directly to an all-liquid dose, you may wish to take part of your dose in liquid and part in lower-dose tablets or capsules, gradually converting to all liquid as you get to lower dosages. This can be very convenient and reduce any problems switching from one form of the drug to another.

 

If your doctor prescribes compounded liquid and tablets or capsules at the same time, most likely he or she will have to indicate "divided doses" in the prescriptions to get the drugs covered by insurance.

Edited June 10, 2015 by Altostrata
updated

[ccb73]

I tried dissolving Viibryd in water but t only dissipates and rushes to the bottom very quickly.

 

Any other ideas how to slow taper?

 

I'm on 20 but my insurance won't allow taking 2 tens per day.

 

If yes, I'd divide a pill in 4 getting approximately 10%; gettinh 10% from remaining will be almost impossible though.

 

Please asist.

 

Thanks,

CB

[brassmonkey]

If you want to go the liquid route than getting suspension medium to use instead of water would probably work.  They are made to be thicker than water so the powder doesn't settle out.  The popular one on line is called OraPlus.  I have heard that it tastes pretty nasty though.

 

The other method would be to get an electronic scale and some gel caps.  Then crush the tablets and weight out the required amount of powder and put it into the gel caps.  We have complete instructions here:

 

Using a digital scale to measure doses

[Rabe]

I am leery to interject because I am learning from all of you...I just wanted to share, and get feedback,  that when I talked to the compounding pharmacist he said that Viibryd could not be crushed, and because of the patent they cannot get it in powder form to compound with????

[Altostrata]

Did you read post #1? The tablets are not timed-release. They can be split.

 

For example:

 

https://www.healthtap.com/user_questions/1334011-can-the-40-mg-of-viibryd-vilazodone-hydrochloride-tablets-be-split-and-be-effective-they-are-not

 

https://www.justanswer.com/pharmacy/8xxvn-viibryd-time-released-med-ok-split-40mg.html

 

Quote

Vibryd is not a time released medicine and you can split it.