Generic Name: Vortioxetine
Brand Names: Trintellix, Brintellix
Drug Class: Serotonin modulator and stimulator (SMS) or Serotonin partial agonist and reuptake inhibitor (SPARI), Antidepressant, Anxiolytic
Similar Class Drug: Velozodone
Available Dosage form: Film-coated immediate-release oral tablet
What is Vortioxetine?
Vortioxetine is used as an alternative to first-line drugs (SNRIs and SSRIs) to treat major depression and generalized anxiety disorder in adults. It is a potent modulator of serotonergic neurotransmission. Remission in depressive symptoms with Vortioxetine is caused by the inhibition of serotonin transporter and agonism of 5HT receptors. The resultant rise in the concentration of Serotonin significantly enhances mood. It also improves metabolism and functional impairment.
In addition, Vortioxetine alters the activity of a multitude of neurotransmitters which include dopamine, cholines, adrenaline, etc.1
The efficacy of Vortioxetine is much lower when compared to Duloxetine. However, adverse events experienced with Vortioxetine were markedly fewer than with Duloxetine.2
How to use Vortioxetine?
Oral immediate-release tablets with varying dosages are available. The tablet has to be swallowed whole with water. It can be taken with or without food. People with frequent stomach issues should take it with food. Keep a reminder to help you follow your dosage schedule.
Overdose may cause a marked increase in the risk of adverse events and even death. Improvement in symptoms will take a few weeks. Do not stop treatment even if you see an improvement in your symptoms. Your doctor is going to taper your dosages gradually to prevent harmful side effects. Always share a detailed history of your conditions, medications, and allergens.
What are the side effects of Vortioxetine?
The medication does not cause symptoms classic for most antidepressants, like weight gain, metabolic disturbances, cardiovascular events, and sexual dysfunctions. The incidence of sexual dysfunctions was markedly lower with Vortioxetine compared to other serotonergic agonists.1 However, there is not enough evidence to support the use of Vortioxetine over SNRIs.2
The most common side effects of Vortioxetine include:
– Nausea
– Vomiting
– Constipation
– Headache
Potential adverse effects with the use of Vortioxetine:
– Anaphylaxis
– Serotonin syndrome
– Impaired clotting factors
– Withdrawal symptoms 1
– Suicidal inclination (in children, adolescents, and young adults)
– Hyponatremia
Who should not use Vortioxetine?
– Hypersensitive patients
– Concomitant use of MAOI’s, linezolid, and methylene blue therapy
It must be used with caution in:
– Pregnant and breastfeeding women
– Patients with a medication history
– Children and adolescents
– Elderly
– Kidney impairment
– Immunocompromised
References
- Koesters M, Ostuzzi G, Guiana G, Breilmann J, Barbui C. Vortioxetine for depression in adults. Cochrane Database Syst Rev. 2017 Jul 5;7(7):CD011520. doi: 10.1002/14651858.CD011520.pub2. PMID: 28677828; PMCID: PMC6483322.
- Alvarez E, Perez V, Artigas F. Pharmacology and clinical potential of vortioxetine in the treatment of major depressive disorder. Neuropsy Dis Treat. 2014;10:1297-1307. Published 2014 Jul 15. doi:10.2147/NDT.S41387
