Psy-World

Vilazodone is effective and well tolerated with a rapid onset in the treatment of major depressive disorder.

Vilazodone, which combines properties of a selective serotonin reuptake inhibitor with 5-hydroxytryptamine-1A partial agonist activity, has been tested in major depressive disorder (MDD) in a randomized, double-blind, placebo-controlled trial. The 410 MDD patients, aged 18 to 65 years, received either vilazodone or placebo for 8 weeks. Vilazodone was titrated from 10 mg to 40 mg once a day over the course of 2 weeks. The Montgomery-Asberg Depression Rating Scale (MADRS), 17-item Hamilton Rating Scale for Depression (HAMD-17), and Hamilton Rating Scale for Anxiety (HAMA) were used to assess efficacy by change from baseline to week 8. The MADRS, HAMD-17, and Clinical Global Impressions-Severity of Illness (CGI-S) and -Improvement (CGI-I) scales were used to determine response rates at week 8. Sexual function was measured using the Arizona Sexual Experience Scale (ASEX) at baseline and week 8. A modified last-observation-carried-forward method in the intention-to-treat (ITT) sample was used for data analysis. Compared to the placebo group, after 8 weeks the vilazodone group had greater mean improvements from baseline on the MADRS (p = 0.001) and the HAMD-17 (p = 0.022). The treatment group was already demonstrating significant improvements on both scales after the first week of treatment. At endpoint the vilazodone-treated subjects had significantly higher response rates on the MADRS (p = 0.007), the HAMD-17 (p = 0.011), and the CGI-I scale (p = 0.001). The ASEX scores at the end of treatment were similar in both groups for either gender. Most treatment-related side effects, diarrhea, nausea, and somnolence, were mild or moderate. Vilazodone appears to be an effective and well tolerated treatment for MDD in adults, with the advantage of presenting symptom relief from the first week. Rickels K, Athanasiou M, Robinson DS, Gibertini M, Whalen H, Reed CR (2009). Evidence for efficacy and tolerability of vilazodone in the treatment of major depressive disorder: a randomized, double-blind, placebo-controlled trial. J Clin Psychiatry 70:326-333. Updated June 2009