Vortioxetine

Trintellix

Trintellix is an antidepressant medication containing the active ingredient Vortioxetine. It is approved by the FDA to treat adults with major depressive disorder (MDD), also known as depression, which is a serious mental health condition. Trintellix increases serotonin activity in the brain and has unique effects on specific serotonin receptors. It comes as immediate-release tablets with strengths of 5mg, 10mg, and 20mg. Common side effects include nausea, constipation, and vomiting. It’s essential to consult a doctor for personalized dosage and to monitor for any serious side effects or interactions with other medications.

Product Overview

Trintellix (vortioxetine) is a prescription medication primarily used to treat major depressive disorder (MDD). It works by enhancing serotonin activity in the brain, which is thought to have a positive effect on mood and emotional well-being. It is unique among antidepressants because it not only inhibits the reuptake of serotonin but also directly affects certain serotonin receptors in the brain. It is available in the form of immediate-release tablets in three strengths: 5mg, 10mg, and 20mg. The usual starting dose for adults with depression or MDD is 10mg once daily, which can be adjusted based on individual response and tolerability, with a maintenance dose ranging from 5mg to 20mg once daily. 

There can be some common side effects of Trintellix, including vomiting, nausea, and constipation which typically improve as the body adjusts to the medication. However, it can also cause more serious side effects such as increased risk of bleeding, discontinuation syndrome, serotonin syndrome, manic episodes, and low sodium levels in the blood. Therefore, it is crucial to follow the doctor’s instructions and report any adverse reactions.

Before starting Trintellix, patients should be screened for bipolar disorder, mania, and hypomania. It is also essential to discuss any other medications being taken to avoid potential interactions. Trintellix should not be abruptly discontinued without consulting a healthcare provider to prevent withdrawal symptoms. It is an effective treatment for depression and MDD, but it requires careful monitoring and adherence to the prescribed regimen to ensure safety and efficacy.

Uses of Trintellix 

Trintellix is used to treat:

• Major depressive disorder (MDD)
• Depression

How to Use Trintellix?

Dosage

It comes in the form of immediate-release tablets and has three following strengths:

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

Recommended Dosage for Trintellix 

Adults with Depression & Major Depressive Disorder (MDD)

• Starting Dose: 10 mg once daily
• Maintenance Dose: 5 to 20 mg once daily
• Maximum Dose: 20 mg daily

[Note: Remember these recommendations may vary depending on person to person. Discuss it with your doctor, and they’ll customize your Trintellix dosage accordingly.]

How to Take It?

• Always use Trintellix exactly as your doctor has prescribed. Pay attention to your prescription label and any additional guides or sheets provided. 
• You can take Trintellix either on an empty stomach or with food. 
• Before beginning treatment, patients should be checked for bipolar disorder, mania, and hypomania. Those who cannot handle higher doses may continue on a daily oral dose of 5 mg.
• It’s important to check patients for bipolar disorder, mania, and hypomania before starting treatment.
• Patients who find higher doses difficult to handle may continue on a daily oral dose of 5 mg.
• Stopping Trintellix abruptly can lead to withdrawal symptoms. Consult your doctor before discontinuing.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Trintellix Work?

Trintellix is a type of antidepressant medication known for its unique way of working. It works by increasing the activity of serotonin in the brain. It does this by stopping the reabsorption of serotonin, which can help balance the levels of brain chemicals and improve symptoms of depression. Trintellix is different from other antidepressants as it targets and blocks specific serotonin receptors in the brain. These receptors are like docking stations for serotonin. By blocking these receptors, serotonin cannot attach to them. Although it’s not entirely clear how this action contributes to relieving depression, it is an important aspect of how Trintellix works.

Important Safety Information

Side Effects

Common side effects of Trintellix may include:

• Constipation
• Nausea 
• Vomiting 

These Trintellix side effects are common and may go away as your body adjusts to the medication. However, if they worsen, inform your doctor or healthcare provider.

Serious side effects of Trintellix include:

Serotonin Syndrome: It is a serious health condition that can be life-threatening when Trintellix is combined with certain other medications. Signs and symptoms of this syndrome:

• Nausea, vomiting
• Confusion
• Seizures
• Fast heartbeat
• Sweating
• Loss of coordination
• Dizziness
• Flushing
• High body temperature (Hyperthermia)
• Stiff muscles or muscle twitching
• Changes in blood pressure
• Agitation
• Shaking (Tremors)
• Seeing or hearing things that are not real (Hallucinations)
• Coma

Increased Risk of Bleeding: Combining Trintellix with non-steroidal anti-inflammatory drugs (NSAIDs), aspirin, warfarin, or blood thinners can increase the risk of bleeding. Inform your healthcare provider immediately if you notice any unusual bleeding or bruising.

Manic Episodes: Symptoms may include:

• Feeling too much happiness or irritability
• Talking faster or more than usual
• Excessive energy
• Severe problems sleeping
• Reckless behavior
• Racing thoughts
• Unusually grand ideas

Discontinuation Syndrome: Abruptly stopping Trintellix can cause serious side effects. Your healthcare provider may decrease the amount of your dose slowly. Symptoms may include:

• Dizziness
• Anxiety
• Confusion
• Headache
• Tiredness
• Problems sleeping
• Hypomania
• Ringing in your ears (Tinnitus)
• Seizures
• Nausea
• Changes in your mood
• Sweating
• Irritability and agitation
• Electric shock feeling (Paresthesia)
• Tremor

Eye Problems (Angle-closure Glaucoma): Trintellix can lead to angle-closure glaucoma (an eye problem) in individuals with specific pre-existing eye conditions. If you experience any changes in your vision, eye pain, redness, or swelling in or around the eye, contact your doctor promptly for evaluation and guidance.

Low Levels of Sodium in Your Blood (Hyponatremia). Low levels of sodium in the blood can occur during treatment with Trintellix, and this can be severe and potentially fatal. Older adults and individuals taking certain medications may be at higher risk for developing this condition. Signs and symptoms may include:

• Headache
• Confusion
• Difficulty concentrating
• Memory changes
• Weakness and unsteadiness on your feet

Sexual Problems (Dysfunction): Symptoms in males and females may include:

• Decreased sex drive
• Delayed ejaculation or inability to have an ejaculation
• Problems getting or keeping an erection

If you experience severe side effects, immediately contact your doctor. In cases where the side effects appear life-threatening, or you believe you are facing a medical emergency, call 911 or your local emergency services without delay.

[Note: Remember, this list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

Warnings

Avoid it with Recent MAO Inhibitor Use: Do not take Trintellix if you have taken an MAO inhibitor in the last 14 days. Examples of MAO inhibitors include isocarboxazid, methylene blue injection, phenelzine, and tranylcypromine. Also, wait for at least 21 days after stopping Trintellix before you start an MAO inhibitor.

Monitoring Mood and Symptoms: Some young adults may experience suicidal thoughts when they begin taking an antidepressant-like Trintellix. It’s crucial to watch for any changes in your mood or symptoms. Inform your doctor immediately if you notice changes such as:

• Mood swings
• Depression intensifying
• Panic attacks
• Anxiety
• Sleep difficulties
• Irritability
• Agitation 
• Impulsiveness
• Aggression
• Increased hyperactivity 
• Restlessness
• Thoughts of suicide or self-harm

Age Restrictions: Trintellix should not be given to anyone under the age of 18 without a doctor’s recommendation. This medication is not approved for children’s use.

Boxed Warning 

Trintellix comes with a special warning, known as a “boxed warning,” the most serious type of warning issued by the Food and Drug Administration (FDA). This warning is to let doctors and patients know that this drug can be associated with severe risks.

One of the risks of Trintellix is that it can increase the chances of having suicidal thoughts and behaviors in children and young adults. However, this increased risk does not seem to affect older adults. Because of this, Trintellix is not recommended for use in children. If you are a family member or caregiver of a child or young adult who is taking Trintellix, it’s essential to keep an eye out for any signs that their depression is getting worse or if they are having suicidal thoughts. You should contact a doctor immediately if you notice any of these signs.

Precautions

Here are some precautions you need to be aware of when using Trintellix:

• If you are allergic to Vortioxetine, do not take Trintellix.
• Avoid starting an MAO inhibitor until at least 21 days after stopping Trintellix.
• Talk to your doctor if you have a history of suicidal thoughts, bipolar disorder, seizures or epilepsy, glaucoma, bleeding issues, drug abuse, or low sodium levels in your blood.
• Young individuals starting antidepressants should be monitored closely as they may experience suicidal thoughts. Regular doctor visits and attentive family or caregivers are important to notice any mood or symptom changes.
• Trintellix is not recommended for anyone under 18 years old.
• Using Trintellix in the last 3 months of pregnancy can lead to withdrawal symptoms, serious lung problems, or other complications in the newborn. However, stopping the medicine might also be risky. Always consult your primary health care giver before starting or stopping Trintellix during pregnancy.
• If you are breastfeeding or planning to breastfeed, ask your doctor if Trintellix is safe for you.

Trintellix Contraindications 

This medication is not recommended for individuals who are allergic to Trintellix or any of its ingredients. It should not be taken by individuals who are currently using monoamine oxidase inhibitors (MAOIs) or have used them in the last 14 days. Similarly, MAOIs should not be used within 21 days of stopping Trintellix. Also, Trintellix should not be taken by individuals who are receiving linezolid or intravenous methylene blue.

Missed Dose

In case of a missing dose of Trintellix. Take it as soon as you possibly can. If the next dose is almost due, skip the missed dose. Take your next dose at its usual time. Do not take two doses to make up for the one you missed.

[Note: If you have missed a dose of your medication and are unsure about when to take the next one, immediately consult your doctor or pharmacist.]

Overdose

Taking an overdose of Trintellix may increase your chances of getting serious side effects. Don’t use Trintellix more than your doctor prescribed.

[Note: If you consumed more than the recommended dose, get medical help right away, or call the Poison Help line at 1-800-222-1222.]

Storage

Keep Trintellix at room temperature and protect it from moisture and heat. Remember, this is a general guide. Always consult with your doctor or healthcare professional for personalized advice and adjustments to your treatment plan.

[Note: Discuss with your healthcare professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]

Trintellix Interactions

Always tell your doctor and pharmacist about all the medicines and supplements you’re taking. This includes everything from prescription drugs to over-the-counter items, vitamins, and even herbal supplements. Trintellix can react with some medications. These reactions might not be safe, so it’s crucial to be aware. 

Your doctor will decide the best course of action, which might mean not using Trintellix or adjusting other medications you’re taking. Here’s a list of specific drugs that can interact with Trintellix. Remember, this isn’t a complete list, but it covers some of the major ones:

• Iproniazid
• Metoclopramide
• Linezolid
• Isocarboxazid
• Furazolidone
• Moclobemide
• Methylene Blue
• Tranylcypromine
• Procarbazine
• Nialamide
• Pargyline
• Rasagiline
• Phenelzine
• Selegiline

[Note: This isn’t a complete list, and there could be other drugs that interact with Trintellix. Make sure to tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]

Trintellix Alternatives

• Zoloft (sertraline)
• Wellbutrin XL, Wellbutrin SR (bupropion)
• Effexor XR (venlafaxine)
• Celexa (citalopram)
• Marplan (isocarboxazid)
• Nardil (phenelzine)
• Norpramin (desipramine)
• Prozac (fluoxetine)
• Pamelor (nortriptyline)
• Pristiq (desvenlafaxine)
• Cymbalta (duloxetine)
• Paxil (paroxetine)
• Remeron (mirtazapine)
• Elavil (amitriptyline)
• Viibryd (vilazodone)
• Desyrel (trazodone)
• Tofranil (imipramine)
• Serzone (nefazodone)
• Lexapro (escitalopram)
• Parnate (tranylcypromine)
• Emsam (selegiline)

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.] 

Frequently Asked Questions

Is Trintellix better for depression or anxiety?

Trintellix is not used for treating anxiety, attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), or bipolar disorder. Currently, it is only prescribed for major depressive disorder, which is a type of depression. It is not practical for the conditions and disorders mentioned above.

Why is Trintellix better than other antidepressants?

It stands out among antidepressants because it directly affects serotonin receptors and inhibits serotonin reuptake. Compared to other antidepressants like tricyclics, MAOIs, or SSRIs, Trintellix is less likely to cause weight gain. Most people may notice some improvement in depression symptoms after two weeks of treatment, but the full effects may take four weeks or more to manifest.

What are the other conditions Trintellix used to treat?

Primarily, Trintellix is used to treat major depressive disorder (MDD) in adults. While it is not FDA-approved for anxiety, it has been used off-label to treat generalized anxiety disorder (GAD), especially in cases of severe GAD (HAMA of >25). 

How long does Trintellix (Vortioxetine) take to work?

It may take several weeks before you feel the full benefits of Trintellix. It’s common for some people to notice improvements in their mood within a couple of weeks of starting the medication. For others, it may take a month or longer to feel the full effects. If you don’t notice any changes after this time, it’s important to talk to your healthcare provider. They might suggest increasing the dose of Trintellix or talking to you about other options. It’s important to be patient and let the medication work appropriately.

Does Vortioxetine cause weight gain?

Vortioxetine, which is also known as Trintellix, usually doesn’t cause much change in weight. This was seen in studies that lasted for both short and long times. But, after the medicine was available for people to use, there were some cases where people noticed they gained weight. To avoid gaining weight while taking Trintellix, it’s a good idea to eat healthy foods and to do some exercise, like a 30-minute workout, every day.

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