6. Vilazodone

Various preclinical researches showed the most intense antidepressant effect of levomilnacipran without substantially influencing the animal spontaneous locomotor activity, compared to other antidepressant drugs (venlafaxine, duloxetine) in different experimental animal models of depression, anxiety, and stress (such as forced swim test, tail suspension test, shock-induced

Others Hypersensitivity reactions, fatigue, blurred visions, visual disturbances, mydriasis, eye pain,

Cardiovascular Palpitations, tachycardia, hypertension, hot flushes, orthostatic hypotension, angina pectoris,

difficulty concentrating, memory changes, confusion, weakness tremor, paresthesia disturbance in

decreased libido, erectile dysfunction, ejaculation disorders in men, ejaculation failure, delayed

Gastrointestinal Nausea, vomiting, constipation, sweeting, elevations in serum aminotransferase levels Nervous system Dizziness, headache, sleep troubles, excessive happiness or irritability, reckless behavior,

supraventricular/ventricular extrasystoles

138 Pharmacokinetics and Adverse Effects of Drugs - Mechanisms and Risks Factors

attention, drowsiness, dizziness, suicidal ideation, withdrawal syndrome, hallucinations, serotonin syndrome, seizures, convulsions, extrapyramidal symptoms, encephalopathy

nervousness, anxiety,

ejaculation, testicular pain

Decreased appetite, hyponatremia

Table 5. The most frequent adverse effects of levomilnacipran [68–71].

swelling or redness in or around the eye

Respiratory Upper respiratory tract infection

Short-term clinical trials highlighted the superior efficacy of levomilnacipran on depressive and disability symptoms (especially motivation and energy), and functional improvement of the patient status, compared to placebo, was quantified using the Montgomery-Asberg Depression Rating Scale, respectively, and the Sheehan Disability Scale. Significant superiority to placebo was also demonstrated by improvement of the patient's social activity, work, and family life [71–74]. On the other hand, there were insufficient and irrelevant data, regarding

Literature data indicated some pharmacological differences between these two antidepressant drugs, but the performed clinical studies did not prove considerable advantages of

There are few clinically relevant differences between levomilnacipran and milnacipran consisting of the simplicity of dose regimen, a more selective pharmacodynamic activity, an improved

the efficacy for the relapse prevention in the long-term use of levomilnacipran [75].

5.3. Differences between levomilnacipran and milnacipran

levomilnacipran over milnacipran use in the treatment of MDD.

ultrasonic vocalization) [70].

System and organ Manifestations

Hematologic Abnormal bleeding

Genitourinary Urinary hesitation,

Skin Hyperhidrosis, rash Musculoskeletal Musculoskeletal stiffness

Metabolic and endocrine

Vilazodone, 2-benzofurancarboxamide, 5-[4-[4-(5-cyano-1H-indol-3-yl)butyl]-1-piperazinyl]-, hydrochloride (1:1) [78], is a new multimodal antidepressant drug indicated in the United States for the treatment of MDD in adult patients [79]. Its discovery program began in the mid-1990s, and FDA approved it in January 2011. It also received market authorization in Mexico and Canada for MDD pharmacotherapy. Moreover, it was found that vilazodone improves psychic and somatic symptoms in generalized anxiety disorder [80–82].
