Vortioxetine (Trintellix) - TOP 5 Things You Need to Know

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Summary:

  1. Nature and Mechanism:

    • Vortioxetine, also known as Trintellix, is an antidepressant with multi-modal action. It affects various serotonin receptors and transport systems, leading to increased levels of neurotransmitters like serotonin, norepinephrine, dopamine, glutamate, acetylcholine, and histamine.
    • It has pro-cognitive effects, improving cognitive symptoms such as memory, focus, attention, and processing speed, outperforming other antidepressants in these areas.

  2. Uses:

    • FDA approved in 2013 for treating major depressive disorder in adults.
    • Off-label, it's used for generalized anxiety disorder and alongside other antidepressants to address cognitive symptoms of depression. It's particularly effective for geriatric depression, addressing symptoms like pseudo dementia.

  3. Efficacy and Dependency:

    • Typically takes 2-4 weeks to show effects at a therapeutic dose of 10-20 milligrams.
    • It's not addictive, doesn't cause dependency, and has a long half-life of 66 hours, reducing withdrawal symptoms. However, tapering off is still recommended.

  4. Side Effects and Weight Impact:

    • Common side effects include nausea, diarrhea, dry mouth, dizziness, and potential sexual dysfunction. Most side effects are transient and resolve within a week.
    • Unlike many antidepressants, Trintellix doesn't significantly impact body weight or increase cravings.

  5. Drug Interactions:

    • Vortioxetine is metabolized by the CYP2D6 substrate, so dosing adjustments might be needed if taken with inhibitors or inducers of this substrate.
    • Avoid using with MAOI antidepressants due to a high risk of serotonin syndrome. Also, caution is advised when taken with medications that increase serotonin, blood thinners, aspirin, and NSAIDs due to increased bleeding risk. Always inform your provider about all medications and supplements you're taking.