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Hi Doc, I Am Looking For Some Help On A

Posted on Thu, 11 Oct 2018

Question: Hi Doc, I am looking for some help on a few things. I have been on a slew of different antidepressants over the past five years and i really need one that works for me. I feel better mentally with them, they ease my anxiety, my negative thoughts, and my bad reactions with my husband. However, i cannot seem to get one that doesnt cause massive side effects. I have tried everyhign under the sun and a month ago i started a medication called Viibryd. So it has been def working pretty well! with limited side effects. however, the past few days, ive been feeling super anxious out of nowhere, and tired, with headaches, and negative self image. I am confused that this would happen like a month into the medication especially if it was working well for a while. I am on 10 mg. I know this is a low dose but im sensitive to meds. Is 20 mg or even 15 still considered a low dose?

Additionally, my husband and i are going to try and get pregnant soon so i want to stay on a small dose.

Please get back to me !!

Answered by Dr. Seikhoo Bishnoi (1 hour later)

Brief Answer:
The dose should be increased to 20 mg.

Detailed Answer:
Hello thanks for using ask a doctor service

I can understand your concern. Viibryd or Vilazodone is relatively newer drug. The drug has less side effects comparable to conventional SSRI drugs. The sexual side effects too are also less.

10 mg dose of this drug is really low and the dose should be increased to 20 mg. If you are sensitive to drugs then you can go to 15 mg and after some time increase the dose to 20 mg. For good efficacy and results at least 20 mg dose would be needed.

The drug is newer so there are not much studies on its safety in pregnancy. If you are planning to get pregnant then Zoloft or Sertraline would be better. The drug is safest antidepressant in pregnancy.

Thanks.

Please let me know if you need more assistance.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Seikhoo Bishnoi (10 minutes later)

Yes I was on Zoloft for a while and gained too much weight so I couldn’t stay on.

I am hoping that since it’s such a low dose medication that I should be ok even if I fall pregnant.

Answered by Dr. Seikhoo Bishnoi (6 minutes later)

Brief Answer:
The drug falls in category C

Detailed Answer:
Hello again

If we consider Vilazodone then the drug is in FDA category C for use in pregnancy. Zoloft too in same category. This means the risk can't be ruled out, but final decision if the drug should be used or not depends upon treating doctor. Risk benefit are assessed.

In one case report the drug was used in 40 mg dose and no serious birth defects were observed in baby. But this is only a case report.

Proper controlled studies are not yes available.

In low dose the drug can be used if you are doing good.

Thanks.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Raju A.T