DangerousContraindicated
5-HTP
5-HTP can increase serotonin production and may precipitate serotonin syndrome with vilazodone.
Recommendation: Avoid 5-HTP during vilazodone treatment.
Vilazodone
Prescription ·Strong evidence ·Reviewed May 2026
Vilazodone is an oral antidepressant approved for major depressive disorder in adults. It inhibits serotonin reuptake and partially activates 5-HT1A receptors, so supplement combinations that increase serotonin can be hazardous. It must be taken with food for adequate absorption and carries the antidepressant boxed warning for suicidal thoughts and behaviors in younger patients.
What it's good for
The bottom line
Evidence rating strong. Most-documented uses: treatment of major depressive disorder in adults, improvement in depressed mood, interest, and anxiety symptoms associated with mdd, once-daily dosing after titration. 3 sources indexed (2011–2025), with 4 interaction records on file.
The science
How it works, mechanistically.
Core mechanism
Vilazodone selectively inhibits the serotonin transporter and acts as a partial agonist at 5-HT1A receptors. The combined action increases serotonergic neurotransmission and may contribute to antidepressant efficacy. It is metabolized mainly by CYP3A4, so strong CYP3A4 inhibitors raise vilazodone exposure and strong CYP3A4 inducers can reduce exposure.1,2
Class
SSRI and 5-HT1A partial agonist antidepressant
Absorption
Water-soluble; take with food
Dosing
Dosing & protocol.
Common range
10 mg once daily for 7 days, then 20 mg once daily for 7 days, then 40 mg once daily with food as tolerated. Do not exceed 20 mg once daily with strong CYP3A4 inhibitors.
Recommended form
Oral tablet taken once daily with food
Food substantially increases vilazodone exposure. Taking it fasting can lower absorption and may reduce antidepressant effect.2
Safety
Full safety detail.
Side effects
- Diarrhea
- Nausea
- Vomiting
- Insomnia
- Dizziness
- Sexual dysfunction
- Serotonin syndrome with serotonergic combinations
- Bleeding risk
- Hyponatremia
- Activation of mania or hypomania
Interactions
Interaction records.
DangerousContraindicated
L-Tryptophan
L-Tryptophan supplements can increase serotonin synthesis and add to vilazodone's serotonergic effect.
Recommendation: Avoid supplemental L-Tryptophan while taking vilazodone.
DangerousContraindicated
St. John's Wort
St. John's Wort has serotonergic effects and can also induce CYP3A4, making both toxicity and loss of antidepressant control possible.
Recommendation: Do not combine St. John's Wort with vilazodone.
ModerateCaution
Ginkgo Biloba
Vilazodone can increase bleeding risk through platelet serotonin effects; ginkgo may also increase bleeding tendency in susceptible patients.
Recommendation: Use cautiously and avoid the combination around surgery or when taking anticoagulants, antiplatelets, or frequent NSAIDs.
Sources
Sources, by evidence tier.
Numbered references. Citations throughout the page link here.
Reviews & position papers
1- 1Vilazodone: a review in major depressive disorderNeeds reviewNo linkCitrome L · International Journal of Clinical Practice · 2012
Review describes vilazodone pharmacology, clinical trial efficacy, and common gastrointestinal adverse effects.
Reference material
2- 2VILAZODONE HYDROCHLORIDE tablets, US Prescribing InformationNeeds reviewURLU.S. National Library of Medicine · DailyMed · 2025
Labeling specifies titration to 40 mg daily with food, MAOI contraindications, CYP3A4 dose limits, and the suicidal thoughts and behaviors boxed warning.
- 3VIIBRYD (vilazodone hydrochloride) tablets, US Prescribing InformationNeeds reviewNo linkForest Laboratories LLC · FDA Label · 2011
Original labeling documents reduced exposure when vilazodone is taken without food.
Keep exploring
Deep dives & adjacent profiles.
This page is educational. Do not start, stop, or change a supplement or medication based on it without checking with a qualified healthcare professional.
Use this with your stack
Vilazodone in NutriStack.
Add it to your stack, see how it interacts with everything else you take, and get a Stack Score that updates the moment it does.