Medicines

Trintellix (Vortioxetine) Pros and Cons

 What is Trintellix (Vortioxetine)?

Trintellix is a brand of vortioxetine, a prescription medicine used in adults to treat a certain type of depression called Major Depressive Disorder (MDD). When someone experiences persistent and intense feelings of sadness for extended periods, then they may have a mood disorder such as major depressive disorder (MDD).

MDD, also referred to as clinical depression, is a significant medical condition that can affect many areas of your life. It impacts mood and behavior as well as various physical functions, such as appetite and sleep. MDD is one of the most common mental health conditions in the United States. Data suggests that more than 7.8 percent of U.S. adults experienced a major depressive episode in 2019.

Trintellix comes only as an oral tablet, in strengths of 5 milligrams (mg), 10 mg, and 20 mg. This medication was formerly known as Brintellix. Trintellix is a brand-name drug. It contains the drug vortioxetine. Trintellix is not currently available in a generic form.

How it works

Trintellix works in a unique way and doesn’t fit into other antidepressant classes. Because of this, it’s sometimes classified as an atypical antidepressant, a multimodal antidepressant, or a miscellaneous antidepressant.

Who should not take Trintellix?

Do not start or take Trintellix if you:

•          are allergic to vortioxetine or any of the ingredients in Trintellix

•          take a Monoamine Oxidase Inhibitor (MAOI)

•          have stopped taking an MAOI in the last 14 days

•          are being treated with the antibiotic linezolid or intravenous methylene blue

Do not start taking an MAOI for at least 21 days after you stop treatment with Trintellix.

What should I tell my doctor before taking Trintellix?

Before taking Trintellix, tell your doctor:

•          about all your medical and other health conditions

•          if you are pregnant or plan to become pregnant, since Trintellix may harm your unborn baby. Taking Trintellix during your third trimester may cause your baby to have withdrawal symptoms after birth or to be at increased risk for a serious lung problem at birth. Tell your doctor right away if you become or think you are pregnant while taking Trintellix.

•          if you are breastfeeding or plan to breastfeed since it is not known if Trintellix passes into your breast milk

Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements, since Trintellix and some medicines may cause serious side effects (or may not work as well) when taken together. Especially tell your doctor if you take: medicines for migraine headache called triptans; tricyclic antidepressants; opioids (such as fentanyl and tramadol); lithium; tryptophan; buspirone; St. John’s Wort; medicines that can affect blood clotting such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), warfarin; and diuretics.

Trintellix pros and cons

How to take Trintellix

Take Trintellix exactly as prescribed by your doctor. The typical dose of Trintellix is as follows:

  • Initial dose: 10 mg orally once a day
  • Maintenance dose: 5 to 20 mg orally once a day
  • Maximum dose: 20 mg/day

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. You may take Trintellix with or without food.

You may have withdrawal symptoms if you stop using Trintellix suddenly. Ask your doctor before stopping the medicine.

Trintellix (Vortioxetine) Pros and Cons

There are several benefits of taking Trintellix as there are side effects, in this section, we will outline the pros and cons of Trintellix (Vortioxetine);

Pros

  • Trintellix simple once-daily dosage form promotes adherence to chronic medication therapy.
  • Trintellix works in a unique way, it acts as an agonist at the 5-HT1A receptor and a partial agonist at the 5-HT1B receptor, both of which function as autoreceptors for serotonergic neurotransmission.
  • Trintellix may be taken with or without food.
  • Trintellix is different from other antidepressants currently on the market because it directly affects serotonin receptors as well as inhibits serotonin reuptake.

Cons

  • Some people may experience feeling restless or energized soon after taking a dose of Trintellix, which could lead to trouble sleeping.
  • Trintellix is only used to treat major depressive disorder. It’s not used to treat anxiety, attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), or bipolar disorder.
  • Trintellix can increase the risk of bleeding episodes. These episodes can range from mild nosebleeds to more serious bleeding in the stomach or brain.
  • Trintellix can cause worsening depression symptoms and thoughts of suicide, in people with depression taking the medication.
Trintellix pros and cons

What are the possible side effects of Trintellix?

The most common side effects of Trintellix include:

•          nausea

•          constipation

•          vomiting

Trintellix may cause serious side effects, including:

•          Discontinuation syndrome: Suddenly stopping Trintellix may cause you to have serious side effects including nausea; sweating; changes in your mood; irritability and agitation; dizziness; electric shock feeling; tremor; anxiety; confusion; headache; tiredness; problems sleeping; hypomania; ringing in your ears; seizures.

•          Eye problems: Trintellix may cause a type of eye problem called angle-closure glaucoma in people with certain other eye conditions. You may want to undergo an eye examination to see if you are at risk and receive preventative treatment if you are. Call your doctor if you have eye pain, changes in your vision, or swelling or redness in or around the eye.

•          Increased risk of bleeding: Taking Trintellix with aspirin, NSAIDs, warfarin or blood thinners may add to this risk. Tell your doctor right away about any unusual bleeding or bruising.

•          Low levels of salt (sodium) in your blood: Low sodium levels in your blood that may be serious and may cause death can happen during treatment with Trintellix. Elderly people and people who take certain medicines may be at a greater risk of developing low sodium levels in their blood. Signs and symptoms may include headache; difficulty concentrating; memory changes; confusion; weakness and unsteadiness on your feet which can lead to falls. In more severe or more sudden cases, signs and symptoms include: seeing or hearing things that are not real; fainting; seizures; coma; stopping breathing.

•          Manic episodes: Manic episodes may happen in people with bipolar disorder who take Trintellix. Symptoms may include: greatly increased energy; racing thoughts; unusually grand ideas; talking more or faster than usual; severe problems sleeping; reckless behavior; excessive happiness or irritability.

•          Serotonin syndrome: A potentially life‐threatening problem that can happen when you take Trintellix with certain other medicines. Call your doctor or go to the nearest emergency room right away if you have any of the following signs and symptoms of serotonin syndrome: agitation; seeing or hearing things that are not real; confusion; coma; fast heartbeat; changes in blood pressure; dizziness; sweating; flushing; high body temperature; shaking, stiff muscles, or muscle twitching; loss of coordination; seizures; nausea, vomiting, diarrhea.

•          Sexual problems: Taking antidepressants like Trintellix may cause sexual problems. Symptoms in males may include: delayed ejaculation or inability to have an ejaculation, decreased sex drive, or problems getting or keeping an erection. Symptoms in females may include: decreased sex drive, delayed orgasm, or inability to have an orgasm. Talk to your healthcare provider if you develop any changes in your sexual function or if you have any questions or concerns about sexual problems during treatment with Trintellix.

These are not all the possible side effects of Trintellix. Tell your doctor if you have any side effect that bothers you or does not go away.

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Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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