In This Article
What is Trintellix (Vortioxetine)?
Trintellix, previously called Brintellix, is the brand-name for the drug vortioxetine. It is an FDA approved prescription antidepressant SSRI, or selective serotonin reuptake inhibitor, that directly affects the neurotransmitter serotonin. Serotonin is an essential chemical in your body that allows your nerve cells and brain to function properly.
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.
What Is Trintellix Used For?
Trintellix is used to treat depression or major depressive disorder (MDD).
MDD is another term for clinical depression that affects how a patient may think, feel, or act. MDD 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. MDD 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 (most common in young people), 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.
Trintellix Dosing and Administration
Trintellix 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.
Talk with your healthcare provider before taking Trintellix if you have:
- 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)
- Bipolar disorder (manic depression)
- Previous use of antidepressant drugs and whether they were effective or had any adverse effects
- Liver problems or other serious medical conditions
- Family history of drug abuse and mental illnesses
- 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 Trintellix, 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 common side effects include:
- Constipation
- Diarrhea
- Nausea
- Dizziness/unsteadiness
- High or low blood pressure
- Fast heartbeat
- Vomiting
- Migraine headaches
- Memory changes
- Mood swings
- Racing thoughts
- Sexual dysfunction
- Impulsivity
- Abnormal bleeding or bruising, especially if you also take a blood thinner medication, such as Coumadin®
- Visual problems, such as vision changes, eye pain, and eye swelling/redness
- Low sodium levels
- Itchy skin (uncommon)
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.
Trintellix Warnings and Overdose
The signs of a Trintellix overdose are dizziness, diarrhea, abdominal discomfort, generalized anal itching, drowsiness, and flushing.
If an overdose of Trintellix happens call 911 and seek emergency medical care immediately. Trintellix being an SSRI has lower toxicity when overdose compared to other prescription antidepressant medications.
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 results in death.
If you stop taking Trintellix abruptly, withdrawal-like symptoms can develop. These symptoms include a runny nose, dizziness, irritability, angry outbursts, mood swings, muscle tension, and migraine headaches. Do not discontinue the use of an antidepressant without talking to your healthcare provider first.
Drug Interactions
Mixing Trintellix with other drugs can result in a negative reaction, and Trintellix may not work as well. Certain drug interactions can also cause serious side effects.
Do not drink alcohol while taking Trintellix, as it can worsen the side effects of the drug, including confusion, drowsiness, and dizziness.
Some of these dangerous drug interactions include, but are not limited to:
- Never take MAOIs, monoamine oxidase inhibitors, (these include selegiline, tranylcypromine, phenelzine, and isocarboxazid) as these can cause a possibly fatal reaction
- Medicines used to treat migraine headache made with triptans, like Imitrex
- Other antidepressant medications, including tricyclics, lithium, selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), buspirone, paroxetine, and antipsychotics
- Pain medications, such as Tramadol and fentanyl
- Some antibiotics like rifampicin
- Diuretics
- Some anticonvulsants, such as carbamazepine, 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 helps treat irregular heartbeats
Serotonin syndrome can occur when combining Trintellix with serotonergic antidepressant medications, including SSRIs and SNRIs. It can also develop if you mix the drug with fentanyl, tramadol, triptans, tricyclic antidepressants, St. John's Wort, buspirone, tryptophan, and MAOIs, among others. Serotonin syndrome is extremely dangerous if left untreated, and can result in death.
Trintellix Addiction Treatment
Patients prescribed antidepressants are already under the watchful eye and observation of their doctor. However, if taking higher doses than prescribed becomes a factor, your doctor may reevaluate the necessary treatment going forward. In severe cases, they may suggest inpatient and outpatient options to assist in the recovery process.
