Trintellix (vortioxetine) Indications
Trintellix is a medication that requires a prescription and is indicated for the treatment of Major Depressive Disorder (MDD), a specific form of depression, in adults.
Trintellix Uses and Dosage
The recommended starting dose of Trintellix is 10 mg, to be taken orally once a day, regardless of meals.
- If tolerated well, the dose may be increased to 20 mg per day.
- For patients who cannot tolerate higher doses, a lower dose of 5 mg per day may be considered.
- Trintellix can be discontinued abruptly; however, it is recommended that doses of 15 mg or 20 mg per day be reduced to 10 mg per day for one week prior to complete discontinuation, if possible.
- The maximum recommended dose is 10 mg per day in persons who are poor metabolizers of CYP2D6, an enzyme involved in the metabolism of a number of drugs, including antidepressants.
Trintellix Side Effects
The most common side effects associated with Trintellix are:
Serious side effects associated with Trintellix include:
- Serotonin syndrome: A potentially life-threatening condition that may occur with medications that affect levels of serotonin, a chemical that carries messages between nerve cells in the brain and throughout your body and plays a role in mood, sleep, and other bodily functions. Seek immediate medical attention if you experience any of the following signs and symptoms of serotonin syndrome: agitation, seeing or hearing things that are not real (hallucinations), confusion, rapid heartbeat, blood pressure changes, dizziness, sweating, flushing, high body temperature, shaking, muscle stiffness or twitching, seizures, nausea, vomiting, diarreha.
- Increased bleeding risk: Taking Trintellix with aspirin, non-steroidal inflammatory drugs (NSAIDs), warfarin, or other blood thinners may increase the risk of bleeding. Notify your healthcare provider right away if you experience unusual bleeding or bruising.
- Manic episodes: Manic episodes may occur in people with bipolar disorder who take Trintellix. Notify your healthcare provider if you have bipolar disorder and experience any of the following while taking Trintellix: increased energy, racing thoughts, grandiosity, excessive talking, sleep disturbances, reckless behavior, or significant mood.
- Discontinuation syndrome: Discontinuing Trintellix suddenlymay cause you to experience certain side effects. Notify your healthcare provider if you experience the following: nausea, sweating, mood changes, irritability, dizziness, electric shock sensations, tremors, anxiety, confusion, headache, fatigue, sleep disruptions, hypomania, ringing in the ears, or seizures.
- Eye problems: Trintellix may cause a type of eye problem called angle-closure glaucoma in people with certain eye conditions. Contact your healthcare provider if you have eye pain, vision changes, or swelling/redness in or around the eye.
- Low levels of salt (sodium) in your blood: Low sodium levels in your blood can be serious and life-threatening, and elderly people and those who take certain medications may be at greater risk for this problem. Watch for signs of low sodium levels, including headaches, difficulty concentrating, memory changes, confusion, weakness, and unsteadiness. In more severe or more sudden cases, signs and symptoms of this problem include hallucinations, fainting, seizures, coma, stopping breathing.
- Sexual problems: Taking antidepressants likeTrintellix may cause sexual problems in both males and females. Symptoms in males may include decreased sex drive, problems getting or keeping an erection, and delayed ejaculation or inability to have an ejaculation. Symptoms in females may include decreased sex drive and delayed orgasm or inability to have an orgasm. If you develop any changes in your sexual function, talk to your healthcare provider about related questions and concerns.
These are not all the possible side effects associated with Trintellix. Consult your healthcare provider if you experience any other side effects of concern.
- Following are important precautions and considerations when taking Trintellix: Trintellix and other antidepressant medications may increase suicidal thoughts and actions in some people 24 years of age and younger, especially within the first few months of treatment or when the dose is changed.
- Pay close attention to any changes, especially sudden changes in your mood, behavior, thoughts, or feelings and report any such changes to your healthcare provider.
- Keep all follow-up visits with your healthcare provider and contact him/her if you develop suicidal thoughts/
- Inform your healthcare provider about all your medical conditions, including seizures; bleeding problems; a family history of bipolar disorder, mania, or hypomania; gluacoma; and low sodium levels in your blood.
- If you are pregnant or planning to become pregnant, Trintellix may potentially harm your unborn baby. Taking Trintellix during the third trimester may lead to withdrawal symptoms or an increased risk of a serious lung problem in the newborn. Notify your healthcare provider immediately if you become pregnant or suspect you are pregnant while taking Trintellix.
- If you are breastfeeding or planning to breastfeed, it is unknown whether Trintellix passes into breast milk.
- Tell your healthcare provider about all medications you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Certain medications, when combined with Trintellix, can cause serious side effects or may affect its effectiveness. Tell your healthcare provider if you take medications for migraine headaches (called triptans), tricyclic antidepressants, opioids (such as fentanyl and tramadol), lithium, tryptophan, buspirone, St. John’s Wort, blood clotting medications like aspirin and NSAIDs, warfarin, or diuretics.
Trintellix Form and Strengths
Trintellix is available in the following formulation and strength:
- Trintellix coated tablet:
How does Trintellix work?
Experts believe that MDD results when certain chemicals in the brain are out of balance. These chemicals, called neurotransmitters, send messages from one brain cell to another by acting at specific receptors. Although not fully understood, Trintellix is thought to work by increasing the activity of a neurotransmitter called serotonin in the brain by blocking its reuptake, meaning more serotonin is available to pass messages between nearby nerve cells. The function and effect of Trintellix is thought to be related to the inhibition or blocking of serotonin reuptake.
How long does it take for Trintellix to start working?
The therapeutic effect of Trintellix was generally seen starting at week 2, while the full antidepressant effect was generally not seen until week 4, or later. Since individual results may vary, it is very important to follow the treatment plan directed by your healthcare provider.
Who should not take Trintellix?
You should not start or take Trintellix if you:
- Have a known allergy to vortioxetine or any of the components present in Trintellix
- Are currently taking a Monoamine Oxidase Inhibitor (MAOI)
- Have stopped taking an MAOI within the past 14 days
- Are being treated with the antibiotic linezolid or intravenous methylene blue.
Additionally, it is important to wait at least 21 days after discontinuing Trintellix before starting an MAOI.