| Major Depressive Disorder
Spravato vs Viibyrd
Side-by-side clinical, coverage, and cost comparison for major depressive disorder.Deep comparison between: Spravato vs Viibryd with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsViibryd has a higher rate of injection site reactions vs Spravato based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Viibryd but not Spravato, including UnitedHealthcare
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Category
Spravato
Viibryd
At A Glance
Intranasal
Twice weekly to every 2 weeks
NMDA receptor antagonist
Oral
Daily
SSRI / 5-HT1A partial agonist
Indications
- Depressive Disorder, Treatment-Resistant
- Major Depressive Disorder
- Major Depressive Disorder
Dosing
Depressive Disorder, Treatment-Resistant Induction (Weeks 1-4): 56 mg or 84 mg intranasally twice weekly; Maintenance (Weeks 5-8): 56 mg or 84 mg once weekly; Week 9 and after: 56 mg or 84 mg every 2 weeks or once weekly, individualized to the least frequent dosing to maintain remission/response.
Major Depressive Disorder 84 mg intranasally twice weekly for 4 weeks in conjunction with an oral antidepressant; dose may be reduced to 56 mg twice weekly based on tolerability.
Major Depressive Disorder Start at 10 mg once daily with food for 7 days, then increase to 20 mg once daily; may increase up to 40 mg once daily after a minimum of 7 days between dosage increases; target dose is 20-40 mg once daily with food.
Contraindications
- Aneurysmal vascular disease (including thoracic and abdominal aorta, intracranial, and peripheral arterial vessels) or arteriovenous malformation
- History of intracerebral hemorrhage
- Hypersensitivity to esketamine, ketamine, or any excipient
- Concomitant use or within 14 days of stopping MAOIs, including linezolid or intravenous methylene blue, due to increased risk of serotonin syndrome
Adverse Reactions
Most common (>=5%) dissociation, dizziness, nausea, sedation, vertigo, hypoesthesia, anxiety, lethargy, blood pressure increased, vomiting, feeling drunk
Serious sedation, dissociation, respiratory depression, blood pressure increase, cognitive impairment, impaired ability to drive and operate machinery, ulcerative or interstitial cystitis, embryo-fetal toxicity
Postmarketing bradycardia, respiratory depression (including respiratory arrest), hypotension
Most common (>=5%) Diarrhea, nausea, vomiting, insomnia
Serious Suicidal thoughts and behaviors, serotonin syndrome, increased risk of bleeding, activation of mania or hypomania, discontinuation syndrome, seizures, angle-closure glaucoma, hyponatremia, sexual dysfunction
Postmarketing Irritability, sleep paralysis, hallucinations, suicide attempt, suicidal ideation, rash, urticaria, drug eruption, acute pancreatitis, anosmia, hyposmia
Pharmacology
Esketamine is the S-enantiomer of racemic ketamine and a non-selective, non-competitive NMDA receptor antagonist; the mechanism by which it exerts its antidepressant effect is unknown.
Vilazodone is a selective serotonin reuptake inhibitor (SSRI) and 5-HT1A receptor partial agonist thought to enhance serotonergic activity in the CNS through selective inhibition of serotonin reuptake; its exact mechanism in treating major depressive disorder is not fully understood.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Spravato
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (0/12)
Viibryd
- Covered on 5 commercial plans
- PA (4/12) · Step Therapy (9/12) · Qty limit (1/12)
UnitedHealthcare
Spravato
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (6/8) · Qty limit (3/8)
Viibryd
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Spravato
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (1/3) · Qty limit (1/3)
Viibryd
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
$10/fillfill
Spravato with Me Savings ProgramCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Viibryd.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.