Today, we look back on a decade of research on Velazidone, as this antidepressant goes generic.

Welcome to the Carlythe Psychiatry Podcast, keeping psychiatry honest since 2003.

I'm Chris Aiken, the editor-in-chief of the Carlatte Psychiatry Report.

And I'm Kelly Newsome, Psychiatric MP and a dedicated reader of every issue.

Today, we have the number one most read article from 2023.

Vibrate goes generic. But is it worth prescribing?

This one's by Dr. Aiken, and he has no conflicts to disclose.

You can read all of the Top 15 articles free online through the link in the show notes, or just

Google Top 15 Carlyte Psychiatry Articles of 2023.

After 11 years of market exclusivity, the Lazadone Vibrid lost its patent in June of 2022.

The price of this multimodal antidepressant has fallen to $40 a month.

More patients can afford to take it, but whether we should prescribe more Velazodone is less clear.

Here's how it works. In the brain, Velazadone acts like a combination of an SSRI and

Bustparone. Like an SSRI, it is a potent serotonin reuptake inhibitor, and like Bousparen,

it is a 5HT1A serotonin agonist.

Velazadone's manufacturer hoped this dual mechanism would lead to faster onset, more anxelotic

effects and fewer sexual side effects. At first, those hopes seem to pan out, but today they

only hold up if the data are cherry-picked.

Let's look at those hopes one by one, starting with whether it has a faster onset.

The Lazzadone's clinical efficacy and depression rests on four large, short-term, randomized

controlled trials in major depressive disorder.

In the first trial, Valazadone separated from placebo after just one week, and in another

...