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Trintellix

Trintellix, the brand name for vortioxetine, is a serotonin modulator used to treat major depressive disorder (MDD) in adults. It works by affecting multiple serotonin receptors and inhibiting the reuptake of serotonin, which helps improve mood, energy levels, and overall mental health. Trintellix is part of a class of medications known as serotonin modulators and stimulators (SMS). It is designed to help alleviate the symptoms of depression, including feelings of sadness, loss of interest in activities, and changes in appetite or sleep.

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Frequently Asked Questions

How long does it take for Trintellix to work?
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It may take 2 to 4 weeks to start feeling the effects of Trintellix, with full therapeutic benefits typically seen after 6 to 8 weeks of consistent use.

Can I drink alcohol while taking Trintellix?
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It is best to avoid alcohol while taking Trintellix, as alcohol can increase the risk of side effects such as dizziness, drowsiness, and impaired judgment.

What should I do if I miss a dose of Trintellix?
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If you miss a dose, take it as soon as you remember. If it’s close to your next scheduled dose, skip the missed dose and take your next dose at the regular time. Do not double up on doses.

Can Trintellix cause weight gain?
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Weight gain is not a common side effect of Trintellix. Some patients may experience slight weight changes, but significant weight gain is rare.

Can Trintellix be used for anxiety?
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Trintellix is approved for major depressive disorder, but it may also help relieve anxiety symptoms in some patients. However, it is not specifically indicated for generalized anxiety disorder (GAD).

Comprehensive Drug Guide

How Does Trintellix Work?

Trintellix works by modulating the activity of serotonin, a neurotransmitter that plays a key role in mood regulation. It acts as a serotonin reuptake inhibitor (SRI) and also affects several serotonin receptors, including 5-HT1A, 5-HT3, 5-HT1B, and 5-HT7. By increasing the availability of serotonin and modulating its receptor activity, Trintellix helps improve mood, cognitive function, and overall emotional balance.

Common Dosages

  • 5 mg tablets
  • 10 mg tablets
  • 20 mg tablets

Typical Dosing

  • The typical starting dose for Trintellix is 10 mg once daily, which may be increased to 20 mg once daily depending on the patient's response to the medication.
  • For patients who experience side effects, the dose may be reduced to 5 mg once daily.
  • Trintellix can be taken with or without food.

Typical Dosing

FDA Approved Indications

  • Major depressive disorder (MDD) in adults

Who Shouldn't Take Trintellix?

  • Known hypersensitivity to vortioxetine or any component of the formulation.
  • Concurrent use of monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuing an MAOI, due to the risk of serotonin syndrome.

Advice From The Pharmacist

  • Take Trintellix once daily, with or without food, at the same time each day.
  • It may take several weeks for the full therapeutic effects of Trintellix to be felt, so continue taking the medication as prescribed, even if you do not notice an immediate improvement in symptoms.
  • Do not stop taking Trintellix suddenly, as this may lead to withdrawal symptoms or a relapse of depression. Talk to your healthcare provider about tapering the dose if discontinuation is needed.
  • Avoid drinking alcohol while taking Trintellix, as it may increase the risk of side effects such as dizziness and drowsiness.
  • Grapefruit or grapefruit juice should not interact with Trintellix, but it’s always a good idea to check with your healthcare provider if you’re concerned about food interactions.

Side Effects of Trintellix

Common Side Effects

  • Nausea (most common)
  • Diarrhea or constipation
  • Dizziness
  • Dry mouth
  • Increased sweating
  • Fatigue or drowsiness

Uncommon/Severe Side Effects

  • Serotonin syndrome: Symptoms include agitation, hallucinations, rapid heartbeat, and severe nausea or vomiting.
  • Suicidal thoughts: Like other antidepressants, Trintellix may increase the risk of suicidal thoughts in young adults (under age 24), especially during the initial treatment period.

Risks and Warnings of Trintellix

  • Suicidal thoughts and behaviors: Antidepressants, including Trintellix, may increase the risk of suicidal thoughts and behaviors, particularly in young adults, adolescents, and children. Close monitoring is necessary during the first few months of treatment or when adjusting doses.
  • Serotonin syndrome: Trintellix can increase the risk of serotonin syndrome, especially when used with other serotonergic drugs, such as SSRIs, SNRIs, triptans, or tramadol. Symptoms include agitation, confusion, rapid heart rate, and muscle rigidity.
  • Bleeding risk: The use of Trintellix may increase the risk of bleeding, especially when used with NSAIDs, aspirin, or anticoagulants.
  • Withdrawal symptoms: Stopping Trintellix suddenly may lead to withdrawal symptoms such as dizziness, irritability, and flu-like symptoms. Gradual dose reduction is recommended.

Interactions with Trintellix

Common Drug Interactions

  • MAOIs: Trintellix should not be used with MAOIs (such as phenelzine or tranylcypromine) due to the risk of serotonin syndrome. There should be at least a 14-day washout period between discontinuing an MAOI and starting Trintellix.
  • Serotonergic drugs: Combining Trintellix with other serotonergic drugs (such as SSRIs, SNRIs, or triptans) increases the risk of serotonin syndrome.
  • NSAIDs and anticoagulants: The use of Trintellix with blood thinners or NSAIDs may increase the risk of bleeding.
  • CYP2D6 inhibitors: Medications that inhibit CYP2D6 (such as fluoxetine or paroxetine) may increase the concentration of Trintellix in the blood, requiring dose adjustments.

Alternatives to Trintellix

  • SSRIs (selective serotonin reuptake inhibitors): Such as sertraline (Zoloft) or escitalopram (Lexapro), commonly used for major depressive disorder.
  • SNRIs (serotonin-norepinephrine reuptake inhibitors): Such as venlafaxine (Effexor XR) or duloxetine (Cymbalta), used for depression and anxiety.
  • Bupropion (Wellbutrin): An antidepressant that works differently from serotonin modulators, often used for those who do not tolerate SSRIs or SNRIs.
  • Mirtazapine (Remeron): An antidepressant that works on serotonin and norepinephrine, often used for patients with depression and insomnia.