Lexapro vs. Viibryd

See how Lexapro and Viibryd compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Both drugs carry a boxed warning for suicidal thoughts in children, teens, and young adults, and both require a gradual dose increase before reaching maintenance.

  • Lexapro is also FDA-approved for generalized anxiety disorder and for depression in teens 12 to 17, while Viibryd's approval covers only adult depression.

  • Viibryd must be taken with food for the medication to absorb properly and carries a higher risk of diarrhea, while Lexapro's most common side effect is nausea.

Lexapro vs. Viibryd Drug Summary

Lexapro

Lexapro (escitalopram) is a selective serotonin reuptake inhibitor (SSRI) approved for major depressive disorder and generalized anxiety disorder in adults, and for depression in adolescents 12 to 17. It comes as a tablet or oral solution taken once daily, usually starting at 10 mg with a possible increase to 20 mg after two weeks.

Viibryd

Viibryd (vilazodone) is a serotonin partial agonist and reuptake inhibitor (SPARI) approved for major depressive disorder in adults. It's a once-daily tablet that must be taken with food, starting at 10 mg and titrating up to a 40 mg maintenance dose over two weeks.

Lexapro vs. Viibryd Side Effects

Lexapro

Most common
Nausea (up to 15%)
Insomnia (up to 9%)
Ejaculation disorder (up to 9%)
Somnolence (up to 6%)

Viibryd

Most common
Nausea (up to 23%)
Insomnia (6% to 7%)
Diarrhea (up to 28%)
Vomiting (up to 5%)

Lexapro vs. Viibryd Dosage

Lexapro

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 10 mg once daily Week 1
Maximum dose 20 mg once daily Week 2 onward
Dose changes 1 increase Every week

Viibryd

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 10 mg once daily Days 1-7
Maximum dose 40 mg once daily Day 15 onward
Dose changes 2 increases Every 7 days

Lexapro vs. Viibryd Indications

Lexapro

Lexapro is FDA-approved to treat major depressive disorder in adults and adolescents ages 12 to 17, as well as generalized anxiety disorder in adults. It is not approved for depression in children under 12 or for anxiety in any pediatric age group.

  • Major depressive disorder in adults

  • Major depressive disorder in adolescents 12-17

  • Generalized anxiety disorder in adults

  • Not approved for pediatric generalized anxiety disorder

Viibryd

Viibryd is FDA-approved only for major depressive disorder in adults. It has not been studied or approved for pediatric depression or for any anxiety disorder.

  • Major depressive disorder in adults

  • Not approved for pediatric major depressive disorder

  • Not approved for any anxiety disorder

  • No pediatric dosing established

Lexapro vs. Viibryd Pros and Cons

Lexapro

Lexapro has a long track record since its 2002 approval and is available as a low-cost generic, escitalopram. Its label is broader than Viibryd's, covering both depression and generalized anxiety disorder, though sexual side effects are common.

Pros

  • Generic escitalopram available at much lower cost

  • Also approved for generalized anxiety disorder

  • Approved for depression in adolescents 12 to 17

Cons

  • Sexual side effects, including ejaculation disorder, are common

  • Not approved for anxiety in adolescents or children

  • Nausea is the single most common side effect

Viibryd

Viibryd's dual mechanism, serotonin reuptake inhibition plus partial 5-HT1A agonism, offers a newer approach approved in 2011. Its label is narrower, covering only adult depression, and no widely available generic exists, though the distinct mechanism may suit some patients.

Pros

  • Combines serotonin reuptake inhibition with partial 5-HT1A agonism, unlike Lexapro

  • May be considered when other SSRIs haven't worked well

  • Offers a newer treatment class approved in 2011, distinct from older SSRIs

Cons

  • No generic version widely available, unlike Lexapro

  • Must be taken with food or absorption drops significantly

  • Higher rates of diarrhea and nausea than many SSRIs

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