Trintellix: Uses, Effects & Addiction Risks

What is Trintellix?

Trentellix is also known generically as vortioxetine. It is an FDA approved prescription antidepressant SSRI, or selective serotonin reuptake inhibitor, that directly affects the neurotransmitter serotonin. A neurotransmitter's job is to send messages from the brain to the neurons. The neurons then absorb the serotonin that sent the transmission. 

While depression does not directly correlate to low levels of serotonin, higher levels show improved moods. 

SSRIs work by selectively affecting serotonin and restraining neurons from reabsorbing the serotonin once the message reaches the neuron. Therefore, SSRIs increase the amount of available serotonin in the brain. Increased levels of serotonin in the brain prepare the brain to send more messages.

What is Trintellix Used to Treat?

Trintellix is effectively used to treat cases of depression or Major Depressive Disorder (MDD). MDD is another term for clinical depression that affects how a patient may think, feel, or act. MMD can cause a loss of interest in everyday activities and can lead to physical and emotional problems that may seem beyond the patient’s control.

Most patients experience extreme sadness and a lack of interest in their day to day and may struggle with why they should continue living. MMD is not simply weakness or laziness and requires lifelong treatment that can include medication, talk therapy, and building better habits and routines.

Although depression may occur only once during your life, people typically have multiple episodes. During these episodes, symptoms occur most of the day (nearly every day) and may include:

• Feelings of sadness, tearfulness, emptiness, or hopelessness
• Angry outbursts, irritability or frustration, even over small matters
• Loss of interest or pleasure in most or all normal activities, such as sex, hobbies, or sports
• Sleep disturbances, including insomnia or sleeping too much
• Tiredness and lack of energy, so even small tasks take extra effort
• Reduced appetite and weight loss or increased cravings for food and weight gain
• Anxiety, agitation, or restlessness
• Slowed thinking, speaking, or body movements
• Feelings of worthlessness or guilt, fixating on past failures or self-blame
• Trouble thinking, concentrating, making decisions, and remembering things
• Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts, or suicide
• Unexplained physical problems, such as back pain or headaches

While Trintellix cannot completely rid the patient of all these symptoms, the increased serotonin levels can help combat several of these symptoms to give the patient the ability to create healthier habits and thought patterns in their daily lives.

Dosing and Administration

Trentellix is taken one time per day without regard to meals. Doctors begin patients on a low dose while under observation and slowly increase the dosage over several weeks.

Dosages can range from 5 mg, 10 mg, 20 mg, and depends on recommendation from a doctor. 

When discussing if Trintellix is the right medication for a patient, a doctor must consider whether or not the following variables qualify the patient as a candidate for the drug. A doctor will take into account several combinations of these variables and the patient’s current lifestyle and treatment processes before prescribing Trintellix. 

Some of the variables a doctor will observe are:

• Symptoms of depression that considerably affect the patient and their quality of life 
• Thoughts of suicide or harming oneself, which is high among people with major depressive disorder (MDD).
• Previous antidepressant medications and whether they were effective or had any adverse effects
• Side effects from previous antidepressant medications as specific side effects may require a medication change
• Other psychiatric or medical problems
• A patient's previous history of bipolar disorder
• All prescription and over the counter medications the patient may be regularly taking
• Whether or not the patient is also seeking other therapeutic methods for their depression (e.g., talk or art therapy)
• If planning to become pregnant, are pregnant, or are breast-feeding
• If the patient is a regular user of alcohol or illegal substances

Side Effects of Trintellix

There are a few low-risk side effects associated with taking Trentellix, the main side effect being potential weight gain. However, weight gain is a common side effect for most antidepressants.

It may be that the patient is taking more interest in food now that their serotonin levels have increased, whereas, in the past, they may have had less interest in food for pleasure or even sustenance. 

Other side effects include:

• Constipation
• Diarrhea
• Nausea 
• Dizziness
• Vomiting
• Sexual dysfunction  

Weight gain is the main side effect of nearly all antidepressant medication, and SSRIs, in particular, are more likely the cause of weight gain in patients. Increased levels of serotonin create an increased mood and may increase appetite. This weight gain is best managed by controlling caloric consumption, good sleep routines, and creating healthy, active habits.

Patients will be more likely to embark on and stick to healthy habits due to elevated moods, but weight gain may still be a factor. 

Sticking to an eating and sleeping schedule, paired with an awareness of caloric consumption, may be the only method to control potential weight gain. It is essential to plan and pair these healthy regimens along with taking prescription antidepressant medications.

Warnings and Overdose

If an overdose of Trintellix happens call 911 and seek emergency medical care immediately. Trentellix being an SSRI has lower toxicity when overdose compared to other prescription antidepressant medications. 

The signs of a Trintellix overdose are dizziness, diarrhea, abdominal discomfort, generalized anal itching, drowsiness, and flushing.

Very high overdoses, in certain SSRIs, more than 75 times the standard daily dose can result in more severe adverse events, including ECG changes, seizures, and decreased consciousness. Overdose in SSRIs rarely occurs in death.

Dangerous Drug Interactions

Mixing Trintellix with other drugs may result in a negative reaction, and Trintellix may not work as well. Certain drug interactions can also cause serious side effects. Some of these interactive medications include, but are not limited to:

• Never take MAOIs, monoamine oxidase inhibitors, these include selegiline, tranylcypromine, phenelzine, isocarboxazid as these can cause a possibly fatal reaction
• Medicines used to treat migraine headache made with triptans, like Imitrex
• Other medicines used to treat mood, anxiety, psychotic, or thought disorders, including tricyclics, lithium, selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), buspirone, or antipsychotics 
• Pain medications like Tramadol or fentanyl
• Some antibiotics like rifampicin  
• diuretics 
• Some anticonvulsants like carbamazepine or phenytoin used to prevent seizures
• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen
• Some over the counter pain medications
• Warfarin, which is used to prevent blood clots
• Phenytoin, an anti-epileptic drug that works by slowing down impulses in the brain that cause seizures
• St. John's Wort, an over the counter supplement
• Quinidine, which aids to decrease irregular heartbeats

Treatment Options for Addiction

Patients prescribed antidepressants are already under the watchful eye and observation of their doctor. However, if overdosing or incorrect dosage becomes a factor, the doctor may reevaluate the necessary treatment going forward. In severe cases, they may suggest inpatient and outpatient options to assist in the recovery process.