Lexapro vs. Viibryd: What’s The Difference And Which One Should I Take?

Lexapro and Viibryd are selective serotonin reuptake inhibitors (SSRIs) commonly prescribed to treat major depressive disorder and generalized anxiety disorder. They work by increasing the availability of serotonin in the brain to balance brain chemistry and regulate mood. 

Though both medications are FDA-approved and prescribed to treat the same conditions, they differ in dosage, how they work, and who should take them. In this article, we’ll compare Lexapro and Viibryd to so that you can have an informed discussion with your healthcare provider to determine if either is right for your symptoms. 

If you suffer from anxiety or depression and wonder whether Lexapro or Viibryd would be right for you, Klarity can help. You can see a licensed healthcare provider within 48 hours who can determine which medication, if any, is right for you. Schedule your appointment today!

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This article discusses suicide, suicidal ideation, and self-harm. If you or someone you know is experiencing suicidal thoughts or is in crisis, contact the Suicide Prevention Lifeline immediately at 800-273-8255.

What Is Lexapro?

Lexapro is the brand name for escitalopram — an SSRI used to treat major depressive disorder in adolescents and adults and generalized anxiety disorder in adults. Both the brand name and generic medication are available via prescription. 

Lexapro is effective as an initial treatment for both conditions it’s approved to treat. However, those taking it long-term should be periodically reevaluated to ensure its continued effectiveness. 

Lexapro Forms and Doses

Lexapro is available in liquid and tablet form. Tablets are round, white, and film-coated, with the dosage printed on each. They’re also scored down the center. The liquid suspension comes in a dark-colored, clearly labeled bottle. It contains natural peppermint flavoring to improve the taste.  

The typical dosage for both forms is 10 mg daily in the morning or evening, with or without food. Your medical provider will work with you to determine the correct dose.

Conditions Lexapro Treats

The FDA has approved Lexapro to treat the following, though it can also be prescribed in an off-label capacity. 

• Major depressive disorder
• Generalized anxiety disorder

Symptoms of Anxiety Lexapro Can Treat

When prescribed for anxiety disorder, Lexapro helps alleviate the following symptoms: 

• Feelings of restlessness
• Chronic fatigue 
• Difficulty focusing 
• Irritability
• Muscle tension
• Disturbed sleep or insomnia

Symptoms of Depression Lexapro Can Treat

When prescribed for depression symptoms, Lexapro treats the following symptoms:

• Chronic sadness or hopelessness
• Feeling worthless or helpless
• Brain fog 
• Loss of appetite
• Suicidal ideation

Off-Label Uses for Lexapro

Off-label use occurs when a healthcare provider prescribes medication that’s shown to be an effective treatment for a condition the FDA has not approved. FDA approval requires extensive testing and resources that prevent every medication’s use from being approved. 

Off-label prescriptions are only done at the discretion of your provider and are ethically and medically safe to treat your symptoms. Medical professionals may prescribe Lexapro or escitalopram off-label to treat: 

• Obsessive-compulsive disorder (OCD)
• Binge-eating disorder
• Bulimia nervosa
• Post Traumatic Stress (PTSD)
• Premenstrual dysphoric disorder
• Panic disorder
• Insomnia

Lexapro Costs

Before insurance, Lexapro generally costs $8.34 per tablet and $250.22 for a 30-day supply. Under Medicare, the cost drops to between $11.00 and $15.00. Escitalopram, the generic form of Lexapro, typically costs between $15.00 and $120.00 for a 30-day supply without insurance. 

With insurance coverage, escitalopram may be less than $15.00 or free, depending on your provider. Insurance is far more likely to cover generic escitalopram.

Lexapro Side Effects

You may notice some side effects when taking Lexapro. These often dissipate as your body acclimates to the medication, but if they persist or worsen, you must contact your healthcare provider immediately. 

The most common side effects of Lexapro include:

• Dizziness and drowsiness
• Weakness, shakiness, or sweating
• Insomnia
• Loss of appetite or nausea
• Dry mouth
• Constipation 
• Unexplained weight changes
• Sexual dysfunction
• Difficulty having an orgasm

The following side effects are less common but more serious. If you experience any of these side effects, contact your healthcare provider immediately: 

• Abdominal pain or bleeding
• Allergic reaction
• Blurred or tunnel vision
• Abnormal dreams or decreased focus
• Chest pain or irregular heartbeat
• Eye pain, swelling, or halos around lights
• Euphoria, depression, or unusual behavior
• Headache, confusion, or slurred speech
• Heartburn or vomiting
• Hot flashes
• Severe weakness or dizziness
• Feeling unsteady or uncoordinated
• Sweating and tremors
• Rigid muscles 

Lexapro Warnings for Use

Individuals with certain conditions or the potential for specific conditions should use extreme caution when taking Lexapro. The most common contraindicated conditions include: 

• Liver or kidney problems
• Heart problems
• Seizures or convulsions
• Bipolar disorder
• Low sodium levels in the blood
• High blood pressure 
• History of stroke
• Bleeding problems

If you experience new or worsening thoughts of self-harm or suicide, contact the Suicide Prevention Lifeline at 988 immediately, and inform your provider. 

Taking Lexapro along with other serotonin-altering medications can sometimes result in serotonin syndrome. This is a drug reaction that occurs when there’s too much serotonin in your brain. It can be life-threatening if it goes unaddressed, so contact your healthcare provider immediately if you notice any of the following symptoms:

• Restlessness
• Insomnia or trouble sleeping
• Confusion
• Rapid heart rate 
• Dilated pupils
• Loss of muscle coordination
• High blood pressure
• Muscle rigidity
• Heavy sweating
• Diarrhea
• Headache
• Shivering
• Goose bumps

Additionally, those who are pregnant or may become pregnant should not take Lexapro. Discuss your entire medical history with your medical provider so they can decide if Lexapro is right for you.

Lexapro Drug Interactions

Lexapro is contraindicated for use alongside certain medications and supplements, including: 

• Monoamine oxidase inhibitors (MAOIs)
• Non-steroidal anti-inflammatory drugs (NSAIDs)
• Aspirin 
• St. John’s Wort
• Tryptophan
• Opioid-based painkillers
• Anti-psychotics
• Alcohol

Tell your healthcare provider about all medications, substances, and supplements you take before starting Lexapro to avoid adverse side effects.

What Is Viibryd?

Viibryd is the brand name for vilazodone — an SSRI used to treat anxiety and depression in adults 18 and over. It is not FDA-approved for anyone under the age of 18. The brand name is currently available via prescription, and the generic version is expected to be available in late 2022. 

It’s effective as an initial and long-term medication for depression and has some off-label uses. However, everyone reacts to medications differently. If you’re taking Viibryd and you feel it’s not working for you, or if you experience severe symptoms, contact your healthcare provider immediately. 

Viibryd Forms and Doses

Viibryd is available in tablet form and in several dosage amounts. The typical daily dosage is 40 mg, taken with food. However, most patients start with 10 mg for seven days, then increase to 20 mg for seven days before taking the full 40 mg dose based on your provider’s recommendation. 

If you need to stop taking Viibryd, discuss it with your healthcare provider, as you’ll need to gradually taper down from 40 mg to 20 mg, then to 10 mg before stopping completely. 

Each dosage is color-coded as follows: 

• 10 mg: pink, oval tablet imprinted with “10”
• 20 mg: orange, oval tablet imprinted with “20”
• 40 mg: blue, oval tablet imprinted with “40”

Conditions Viibryd Treats

The FDA has approved Viibryd to treat major depressive disorder (MDD). It’s often used in combination with therapy to help individuals manage symptoms. 

Symptoms of Depression Viibryd Can Treat

When prescribed for major depressive disorder, Viibryd treats the following symptoms:

• Chronic sadness or hopelessness
• Feeling worthless or helpless
• Reduced interest in activities you enjoy
• Changes in sleep patterns and appetite
• Low energy or nervous energy
• Difficulty concentrating
• Suicidal thoughts or behaviors

If you’re having thoughts of suicide, contact the Suicide and Crisis Lifeline at 988.

Symptoms of Anxiety Viibryd Can Treat

When prescribed off-label for anxiety disorder, Viibryd may help alleviate the following symptoms: 

• Trouble focusing or racing thoughts
• Fatigue and trouble sleeping
• Irritability and restlessness
• Feelings of nervousness

Off-Label Uses for Viibryd

Medical professionals may prescribe Viibryd or vilazodone off-label to treat: 

• Generalized anxiety disorder (GAD)
• Obsessive-compulsive disorder (OCD)
• Bulimia nervosa
• Panic disorder
• Insomnia

Viibryd Costs

Without insurance, Viibryd costs about $300 for a 30-day supply. Under Medicare, the cost drops to between $1.00 and $11.00. Private insurance or insurance through an employer may also cover the price, depending on your plan. Physician referrals and coupons may also reduce the cost—talk with your healthcare provider about alternatives. 

As of August 2022, vilazodone—Viibryd’s generic counterpart—is FDA-approved but is not yet available for purchase. Check with your medical provider to learn if the generic is available.

Viibryd Side Effects

The most common side effects of Viibryd include: 

• Nausea and vomiting
• Diarrhea
• Insomnia or disturbed sleep
• Sexual dysfunction
• Dizziness
• Dry mouth
• Fatigue

The following side effects are less common but more serious. If you experience any of these side effects, contact your healthcare provider immediately: 

• Seizures
• Blurred or tunnel vision
• Eye pain or swelling
• Seeing halos around lights
• Unusual bleeding or easily bruised
• Lower inhibitions, risk-taking
• Racing thoughts or headache
• Sudden euphoria or depression
• Headache 
• Confusion and slurred speech
• Severe weakness
• Loss of coordination

Viibryd Warnings for Use

Your healthcare provider will consider your medical history to determine if Viibryd is right for you. Individuals with certain conditions or the potential for specific conditions should use extreme caution when taking Viibryd, including:

• Elderly individuals
• Glaucoma patients
• Individuals with a history of bipolar disorder
• Intestinal or stomach ulcers
• Individuals who are or may become pregnant

Viibryd can also result in serotonin syndrome, which occurs when there’s too much serotonin in your brain. This usually happens if you’re taking more than one serotonin-altering medication at the same time and can be fatal if left untreated. Symptoms of serotonin syndrome include:

• Restlessness
• Insomnia or trouble sleeping
• Confusion
• Rapid heart rate 
• Dilated pupils
• Loss of muscle coordination
• High blood pressure
• Muscle rigidity
• Heavy sweating
• Diarrhea
• Headache
• Shivering
• Goosebumps

If you experience any of those symptoms, contact your healthcare provider immediately. 

Viibryd Drug Interactions

Viibryd should not be used with certain medications, supplements, or substances, including: 

• Monoamine oxidase inhibitors (MAOIs)
• Non-steroidal anti-inflammatory drugs (NSAIDs)
• Aspirin and medications that thin the blood
• St. John’s Wort
• Diuretic medications
• Antibiotics
• Antifungals
• HIV medications 
• Opioid analgesics
• Alcohol

Tell your healthcare provider about all medications, substances, and supplements you take before starting Viibryd.

Which Is Better for Anxiety and Depression? Viibryd or Lexapro?

Both medications are SSRIs that increase serotonin in the brain, reducing or eliminating many symptoms of anxiety and depression. Viibryd has fewer side effects, most of which may also occur with Lexapro. Both medications are contraindicated for alcohol consumption and may adversely affect pregnancy.

Lexapro is FDA-approved to treat anxiety and depression, while Viibryd is approved for depression and prescribed off-label for anxiety. Both medications are expensive without insurance, but insurance, referrals, and prescription programs may be able to significantly reduce the price. 

Each medication comes with benefits and downsides. When choosing the right one for you, it’s important for your healthcare provider to know your medical history, other medications you’re taking, and how you’ve reacted to similar medications in the past to determine the best treatment for you.

Struggling with Anxiety or Depression? Klarity Can Help.

If you’re struggling to access anxiety or depression treatment, Klarity is here for you. We’ve helped over 30,000 people nationwide get exemplary online mental healthcare — and we’re ready to do the same for you. 

Our online portal gives you access to real-time telehealth appointments with a board-certified healthcare provider who can: 

• Evaluate your symptoms
• Diagnose your condition
• Prescribe medications, if applicable

All care takes place online, nixing the expenses associated with brick-and-mortar offices. We pass those savings onto you by offering fairly-priced treatment plans—no insurance needed. 

Are you ready to begin your journey to better mental health? Schedule your appointment today and your healthcare provider will help you determine which medication, if any, is right for your symptoms. 

Frequently Asked Questions About Viibryd and Lexapro

How Does Viibryd Make You Feel?

Individuals who are taking Viibryd report having more energy, an increased ability to focus, fewer mood swings, less irritability, and more motivation to engage in activities and with loved ones. It also seems to have the fewest sexual side effects with a moderate to low impact on libido.

Some may experience mild to moderate side effects—such as nausea, diarrhea, and headaches—for up to two weeks after starting Viibryd. However, these symptoms generally subside as your body becomes accustomed to the medication.  

How Does Lexapro Make You Feel?

People taking Lexapro for anxiety or depression report feeling more positive and in control of their emotions within one to four weeks. Many say they have more energy, feel more interested in daily activities, have a less volatile temper, sleep better, and have an overall improved outlook on life. Most patients feel the positive effects of Lexapro after four to eight weeks of regular use.

Most individuals found Lexapro’s side effects to be mild, and they typically subsided within a few weeks. However, if your condition worsens, contact your healthcare provider immediately. In rare cases, people have experienced suicidal thoughts. If you have thoughts of self-harm, call the Suicide and Crisis Lifeline at 988 immediately.

Which Causes More Weight Gain: Viibryd or Lexapro?

Lexapro has been linked to weight gain in about 41% of individuals who take it, while Viibryd has been associated with weight gain in 3% to 7% of patients. This happens because serotonin plays a role in appetite, as do anxiety and depression. 

If you had little appetite before, the increase in serotonin and relief from your condition might cause you to eat more often, resulting in weight gain.  In both cases, the weight gain is often temporary and tapers off after a few weeks or months. Regular exercise can help reduce or reverse weight gained from taking Viibryd or Lexapro.

How Fast Does Viibryd Start Working? Lexapro?

Viibryd usually begins working in two to four weeks, reaching its full effects within several months. Lexapro typically begins working within four to eight weeks, though you may start to feel relief sooner.  

Which Is Better for Sleep—Lexapro or Viibryd?

Both Lexapro and Viibryd are prescribed off-label for insomnia, as increased serotonin levels help regulate circadian rhythms, often leading to better sleep. However, both drugs may also have sleep-related side effects, including insomnia and sleep disturbances. Lexapro may also cause excessive drowsiness. 

Talk to your healthcare provider about possible solutions if you notice increased daytime sleepiness or increased difficulty sleeping after beginning either medication.

Can I Drink Alcohol On Viibryd? On Lexapro?

Drinking alcohol while taking an SSRI increases your chance of experiencing side effects, even if you haven’t experienced them in the past. Additionally, SSRIs amplify the effects of alcohol, which may cause extreme drowsiness, sedation, impaired cognitive ability, and reduced ability to concentrate and focus. 

Alcohol is a depressant that can increase symptoms of depressive disorder. If you are taking Viibryd or Lexapro, you should avoid alcohol. 

Which Is Better For Anxiety—Viibryd or Lexapro?

Which drug is right for you depends on your medical history, other medications or supplements you’re taking, body chemistry, and which symptoms are the most severe. Lexapro is FDA-approved to treat anxiety, while Viibryd is only available off-label. However, both medications may effectively alleviate anxiety disorder symptoms by balancing your brain chemistry. 

Which Is Better For Depression—Viibryd or Lexapro?

Both Lexapro and Viibryd are FDA-approved to treat the symptoms of major depression. Both medications are SSRIs, which balance serotonin levels in the brain to improve mood and increase energy. 

SSRIs affect everyone differently; some react better to certain medications than others. 

Choosing the right medication depends on your medical history, other medications and supplements, and your body chemistry. Your psychiatric healthcare provider will assess your situation to determine whether Viibryd, Lexapro, or another medication will work best for you. 

Can Viibryd Affect Pregnancy? Can Lexapro?

There hasn’t been much research on the safety of taking Lexapro during pregnancy, meaning you should only do so if necessary while under a healthcare provider’s supervision. 

Viibryd may be safer, but there is a significant risk of developing persistent pulmonary hypertension in the 20th week of pregnancy. As with Lexapro, you should only take Viibryd during pregnancy under the careful supervision of a healthcare provider.  

Can Viibryd Cause Birth Defects? Can Lexapro?

Studies show that there is a chance that fetuses exposed to Lexapro and other SSRIs late in the third trimester may develop respiratory or other complications requiring prolonged hospital care and tube feeding. 

Though Viibryd has not been shown to cause birth defects, newborns exposed to Viibryd in the womb may become dependent on it. This means they’ll have to be weaned off the medication after birth. If you’re pregnant, your healthcare provider will analyze your medical history to determine the right medication to help you.