Trintellix: Treatment for More Than Just Depression
If depression prevents you from dragging yourself out of bed or makes you feel like you’re floating through the day, instead of really engaging with life, you’re probably looking for help. You want new ways to cope, faster ways to feel better, and a healthcare provider who listens to your needs and responds appropriately. Trintellix, or vortioxetine, is an antidepressant medication that could be a vital part of your best mental health treatment plan.
You deserve a mental health care provider who is willing to listen to all of your symptoms, determine your needs for care, and take the time to make sure you understand all of your options. At Levelheaded Mind, we understand that patients need to feel empowered to make informed decisions about their mental health care. To help you achieve optimum wellness, we’ve written this guide to Trintellix. We’ll discuss how it works and what it’s used for and give details about drug interactions and side effects so you can decide if vortioxetine is right for you.
What is vortioxetine?
Vortioxetine, known by the brand name Trintellix, is not your typical antidepressant. A multimodal antidepressant, vortioxetine causes different actions on various serotonin receptors and transport systems. It can increase serotonin, norepinephrine, dopamine, glutamate, acetylcholine, and histamine.
Vortioxetine may be the best antidepressant on the market to date. In addition to treating emotional symptoms of depression, it improves cognitive symptoms such as poor memory, lack of focus, and slow processing speed. In fact, a 2021 study of older adults with mild cognitive impairment without depression showed significant improvement in cognitive function. While it won’t make you smarter, the improved memory and attention from vortioxetine can make executive functioning easier.
What is Trintellix used for?
Trintellix is a once-daily tablet approved by the Food and Drug Administration (FDA) for the treatment of major depressive disorder (MDD) in adults. It also has many off-label uses, including:
Generalized anxiety disorder.
Treatment for cognitive symptoms of depression in conjunction with other antidepressant medications.
Geriatric depression with memory impairment symptoms.
Vortioxetine is not approved for use in adolescents or children. Patients with bipolar disorder should avoid treatment with Trintellix due to the risk of inducing manic episodes or hypomania.
How long does Trintellix take to work?
Like many antidepressant medications, Vortioxetine does not work immediately. You should experience relief of depressive symptoms within 2-4 weeks at the therapeutic dose of 10-20 mg. Everyone responds differently to medications, so relief may take a bit longer. Talk with your healthcare provider if you don’t see improvement in 6-8 weeks. They may recommend higher doses or try a different medication.
Is it vortioxetine addicting?
No, Vortioxetine will not cause dependency. In fact, since it has a long half-life of 66 hours, there’s less risk of abstinence syndrome than with other medications. Still, if you wish to stop taking Trintellix, please discuss tapering off with your healthcare provider so they can help you avoid all withdrawal symptoms.
Side effects of Trintellix
Like any medication, vortioxetine has some possible side effects. Most of these side effects are transient and will typically taper off after about a week. If any linger or become bothersome, discuss them with your healthcare provider.
Digestive symptoms like nausea, diarrhea, dry mouth, and constipation are the most common side effects since Trintellix affects the level of serotonin in the gut.
Sexual dysfunction can occur, although it’s less common than with selective serotonin reuptake inhibitors (SSRIs). Most people don’t experience sexual side effects with vortioxetine.
Some young adults or teens experience suicidal thoughts when starting an antidepressant. Stay alert for any new or worsening symptoms, and report them to your doctor.
Many people worry about weight gain with antidepressants. Trintellix doesn’t lead to weight gain because it doesn’t cause cravings like other medications can.
Some patients with certain eye conditions may be at risk of developing glaucoma.
Contact your doctor immediately if you experience any bothersome adverse effects such as eye pain, headache, or digestive problems or develop symptoms of an allergic reaction such as rashes or swelling.
Drug interactions
Two different types of medication commonly interact with antidepressants such as Trintellix.
Inhibitors that may cause higher levels of Trintellix are detailed below.
Inducers that may lower the levels of Trintellix in your body include carbamazepine (Tegretol) and phenytoin (Dilantin). Taking these medications can decrease the efficacy of Trintellix.
Inhibitors may increase the risk of serotonin syndrome, a serious condition with symptoms that include shivering and diarrhea and more severe symptoms like muscle rigidity, fever, and seizures. Severe serotonin syndrome can cause death if not treated. Avoid medications and supplements that can increase serotonin to avoid this potentially life-threatening condition.
Avoid the use of monoamine oxidase inhibitors (MAOIs) within 14 days before or 21 days after discontinuation of vortioxetine.
Exercise caution when taking Trintellix with other antidepressants, such as buspirone, bupropion, and fluoxetine.
Don’t take Trintellix with triptans or migraine medications.
Avoid tramadol or fentanyl.
Avoid supplements such as tryptophan or St. John’s Wort.
In addition to the risk of serotonin syndrome, Trintellix can cause bruising or bleeding if combined with medications that thin your blood. Use caution with blood thinners like warfarin, Coumadin, nonsteroidal anti-inflammatory drugs (NSAIDs), and aspirin.
You should also not take a diuretic or "water pill" because vortioxetine can cause hyponatremia or low blood sodium levels.
This interaction list is incomplete, and many other drugs may interact with vortioxetine. It’s vital to provide your healthcare professional with a complete list of every medication you take before starting Trintellix. This includes prescription drugs and over-the-counter medicines, vitamins, and supplements.
Mental Health Care is a Gift to Yourself
Seeking the right treatment for your mental health needs is a form of self-love. Vortioxetine can be a life-changing tool in your mental health toolbox. Taking the right medication to manage depressive symptoms such as lack of motivation and loss of interest can help you feel like yourself and get back to living the life you want. However, medications alone cannot solve all of your mental health concerns. Learning to manage your thoughts and emotions, eat properly, and move your body in joyful ways can help you achieve long-term relief from mental health symptoms and may even decrease your reliance on medications.
At Levelheaded Mind, we focus on quality mental health care that puts patient education at the forefront. That’s why our YouTube channel contains videos on various mental health topics, most of which are viewer-requested! When you are properly educated about all of your options for care, you will feel empowered to improve your mental health and overall wellness. If you would like 1:1 mental health coaching and education specific to your needs, feel free to schedule an initial mental health coaching session with our expert psychiatric nurse practitioner, Jezel Rosa.
“Disclaimer: All of the information on this website is for educational purposes and not intended to be specific/personal medical advice or substitute for diagnosis and treatment of any conditions discussed herein. Furthermore, watching these videos or getting answers to comments/questions does not establish a provider-patient relationship. Please consult with your own healthcare provider for proper diagnosis and treatment.”
References
Bennabi, D., Haffen, E., & Van Waes, V. (2019). Vortioxetine for Cognitive Enhancement in Major Depression: From Animal Models to Clinical Research. Frontiers in psychiatry, 10, 771. https://doi.org/10.3389/fpsyt.2019.00771
FDA Label (2018). Vortioxetine (Trintellix). Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/204447s017lbl.pdf
Stahl, S. M., Grady, M. M., & Muntner, N. (2021). Stahl's essential psychopharmacology: Neuroscientific basis and practical applications. Cambridge University Press.
Stahl, S. (2017). Stahl’s Essential Psychopharmacology: Prescriber’s Guide, 6th Ed. Cambridge University Press.
Tan, S. N., & Tan, C. (2021). Vortioxetine improves cognition in mild cognitive impairment. International clinical psychopharmacology, 36(6), 279–287. https://doi.org/10.1097/YIC.0000000000000376
