Vortioxetine (Trintellix): Uses, Mechanism of Action, Dosage, Side Effects
What Is Vortioxetine (Trintellix) And What Does It Treat?
Vortioxetine (Trintellix) is an antidepressant medication that works in the brain. It is approved for the treatment of major depressive disorder (MDD). Depression is a serious mental illness that can interfere with a person’s life. It can cause long-lasting and severe feelings of sadness, hopelessness, and a loss of interest in activities. It can also cause physical symptoms of pain, appetite changes, and sleep problems.
How Vortioxetine (Trintellix) works
Vortioxetine the active ingredient in Trintellix belongs to a class of medications called serotonin modulators. It works mainly by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance. This action helps relieve depressive symptoms.
What Is The Most Important Information I Should Know About Vortioxetine (Trintellix)?
Do not stop taking vortioxetine, even when you feel better. With input from you, your health care provider will assess how long you will need to take the medicine.
Missing doses of vortioxetine may increase your risk for relapse in your symptoms.
Stopping vortioxetine abruptly may result in one or more of the following withdrawal symptoms: irritability, nausea, dizziness, vomiting, nightmares, headache, and/or paresthesias (prickling, tingling sensation on the skin).
Depression is also a part of bipolar illness. People with bipolar disorder who take antidepressants may be at risk for “switching” from depression into mania. Symptoms of mania include “high” or irritable mood, very high self-esteem, decreased need for sleep, pressure to keep talking, racing thoughts, being easily distracted, frequently involved in activities with a large risk for bad consequences (for example, excessive buying sprees).
Medical attention should be sought if serotonin syndrome is suspected. Please refer to serious side effects for signs/symptoms.
What Should I Discuss With My Health Care Provider Before Taking Vortioxetine (Trintellix)?
• Symptoms of your condition that bother you the most
• If you have thoughts of suicide or harming yourself
• Medications you have taken in the past for your condition, whether they were effective or caused any adverse effects
• If you experience side effects from your medications, discuss them with your provider. Some side effects may pass with time, but others may require changes in the medication
• Any other psychiatric or medical problems you have, including a history of bipolar disorder
• All other medications you are currently taking (including over the counter products, herbal and nutritional supplements) and any medication allergies you have
• Other non-medication treatments you are receiving, such as talk therapy or substance abuse treatment. Your provider can explain how these different treatments work with the medication
• If you are pregnant, plan to become pregnant, or are breastfeeding
• If you drink alcohol or use drugs.
How Should I Take Vortioxetine (Trintellix)?
Vortioxetine (Trintellix) is usually taken one time per day without regard to meals.
Typically, patients begin at a low dose of medicine and the dose is increased slowly over several weeks.
The dose usually ranges from 5 mg to 20 mg. Only your health care provider can determine the correct dose for you.
Consider using a calendar, pillbox, alarm clock, or cell phone alert to help you remember to take your medication. You may also ask a family member or friend to remind you or check in with you to be sure you are taking your medication.
What Happens If I Miss A Dose Of Vortioxetine (Trintellix)?
If you miss a dose of vortioxetine, take it as soon as you remember, unless it is closer to the time of your next dose. Discuss this with your health care provider. Do not double your next dose or take more than what is prescribed.
What Should I Avoid While Taking Vortioxetine (Trintellix)?
Avoid drinking alcohol or using illegal drugs while you are taking antidepressant medications. They may decrease the benefits (e.g., worsen your condition) and increase adverse effects (e.g., sedation) of the medication.
How Long Does It Take For Vortioxetine (Trintellix) To Work?
Sleep, energy, or appetite may show some improvement within the first 1-2 weeks. Improvement in these physical symptoms can be an important early signal that the medication is working. Depressed mood and lack of interest in activities may need up to 6-8 weeks to fully improve.
What Happens If I Overdose With Vortioxetine (Trintellix)?
If an overdose occurs, call your doctor or 911. You may need urgent medical care. You may also contact the poison control center at 1-800-222-1222. A specific treatment to reverse the effects of vortioxetine does not exist.
Can a pregnant woman take Vortioxetine (Trintellix)?
If you are planning on becoming pregnant, notify your health care provider to best manage your medications. People living with MDD who wish to become pregnant face important decisions. Untreated MDD has risks to the fetus, as well as the mother. It is important to discuss the risks and benefits of treatment with your doctor and caregivers.
For mothers who have taken SSRIs during their pregnancy, there appears to be less than a 1% chance of infants developing persistent pulmonary hypertension. This is a potentially fatal condition that is associated with the use of the antidepressant in the second half of pregnancy. However, women who discontinued antidepressant therapy were five times more likely to have a depression relapse than those who continued their antidepressant. If you are pregnant, please discuss the risks and benefits of antidepressant use with your health care provider.
Can a breastfeeding woman take Vortioxetine (Trintellix)?
Regarding breastfeeding, caution is advised since some amount of vortioxetine passes into breast milk. Although the amount of vortioxetine in milk is low. If vortioxetine is required by the mother, it is not a reason to discontinue breastfeeding. However, until more data are available, vortioxetine should be used with careful infant monitoring during breastfeeding.
What Are The Possible Side Effects Of Vortioxetine (Trintellix)?
Vortioxetine (Trintellix) may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
• changes in sexual desire or ability
• constipation
• diarrhea
• dizziness
• dry mouth
• gas
• nausea
• unusual dreams
• vomiting
Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:
• coma (loss of consciousness for a period of time)
• confusion
• difficulty breathing or swallowing
• difficulty concentrating
• fainting
• fever, sweating, confusion, fast or irregular heartbeat, and severe muscle stiffness
• hallucinations
• headache
• hives
• hoarseness
• itching
• memory problems
• nosebleed
• rash
• seizures
• swelling of the eyes, face, lips, tongue, or throat
• unsteadiness
• unusual bruising or bleeding
• weakness
Vortioxetine (Trintellix) may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
Is Vortioxetine (Trintellix) a safe medication?
This medication is safe when used as prescribed. However, Vortioxetine (Trintellix) can cause low sodium blood levels (symptoms of low sodium levels may include headache, weakness, difficulty concentrating and remembering), teeth grinding, angle-closure glaucoma (symptoms of angle-closure glaucoma may include eye pain, changes in vision, swelling or redness in or around the eye), Serotonin syndrome (symptoms may include shivering, diarrhea, confusion, severe muscle tightness, fever, seizures, and death), seizure
SSRI antidepressants including sertraline may increase the risk of bleeding events. Combined use of aspirin, nonsteroidal anti-inflammatory drugs (e.g., ibuprofen, naproxen), warfarin, and other anti-coagulants may increase this risk. This may include gums that bleed more easily, nose bleed, or gastrointestinal bleeding. Some cases have been life-threatening.
Are There Any Risks For Taking Vortioxetine (Trintellix) For Long Periods Of Time?
To date, there are no known problems associated with the long-term use of vortioxetine. It is a safe and effective medication when used as directed.
What Other Medications May Interact With Vortioxetine (Trintellix)?
Vortioxetine (Trintellix) should not be taken with or within 2 weeks of taking monoamine oxidase inhibitors (MAOIs). These include phenelzine (Nardil®), tranylcypromine (Parnate®), isocarboxazid (Marplan®), and selegiline (Emsam®).
Although rare, there is an increased risk of serotonin syndrome when vortioxetine is used with other medications that increase serotonin, such as other antidepressants, migraine medications called “triptans” (e.g., Imitrex®), some pain medications (e.g., tramadol (Ultram®), and the antibiotic linezolid (Zyvox®).
Vortioxetine (Trintellix) may increase the effects of other medications that can cause bleeding (e.g., ibuprofen (Advil®, Motrin®), warfarin (Coumadin®) and aspirin)
The following medications may increase the levels and effects of vortioxetine: bupropion (Wellbutrin®), fluoxetine (Prozac®), paroxetine (Paxil®), quinidine.
The following medications may decrease the levels and effects of vortioxetine: rifampin (Rifadin®), carbamazepine (Tegretol®), phenytoin (Dilantin®).
