Trintellix (vortioxetine) is an atypical antidepressant used to treat major depressive disorder (MDD). More specifically it is in the serotonin modulators and stimulators (SMS) class of medications, meaning that, like many antidepressants, it inhibits the reuptake of serotonin, but more significantly it stimulates transmission of serotonin at several receptor sites.

This product can be used in patients age 18 to 65. Younger and more elderly patients will require dosage adjustments and monitoring for developing side effects.

Treating Major Depressive Disorder

This medication is available in tablets, of which there are three strengths; 5 mg, 10 mg, and 20 mg. Using Trintellix to treat MDD is fairly straightforward:

• Most patients are started on 10 mg per day.
• After a couple weeks of 10 mg per day, dosage is increased to 20 mg per day.
• Most patients stay at 20 mg per day for up to 9 months.

Patients who are elderly, taking other medications, have other major medical conditions, and so forth may be kept at lower doses of 5 or 10 mg per day. Likewise, as side effects are largely dose-dependent, those who have severe side effects may be advised to take lower doses; however, it is more likely another medication will be tried.

Food is optional, though those who have stomach-related side effects may find them significantly alleviated if taking tablets with food. A missed dose should be skipped entirely; treatment can resume when it's time for the next dose. Do not take a double-dose to compensate for a mixed dose; 20 mg per day should not be exceeded.

Treating Other Conditions

SMS medications are relatively new; though created and approved for use in treating MDD, Trintellix may be effective in a wide variety of other mental conditions. It is already prescribed off-label for individuals with anxiety, chronic pain, sleeping issues, and so forth. However, it can be difficult to find information for treating such patients, as there were no trials performed and, again, the medication is fairly new.

A doctor should be consulted for the ideal Trintellix dosage in a particular condition. Off-label use is fully legal. As a rough general rule, if treatment extends beyond a year it should be done at lower, 5 or 10 mg doses. There may be exceptions, however.

Side Effects

Trintellix can produce side effects; as mentioned above, it appears to be largely dose-dependent---the more Trintellix taken, the greater the likelihood of side effects, and at greater severity. Patients concerned about side effects should speak with a doctor about adjusting dosage or alternative medications.

Most commonly experienced side effects are:

• Nausea
• Vomiting
• Constipation
• Minor vision changes
• Sleeping changes
• Dry mouth
• Flatulence

Like all antidepressants, Trintellix is associated with sexual side effects; loss of libido, erectile dysfunction, and so forth. In clinical trials Trintellix demonstrated less of such effects than most other antidepressants, though significantly more so than placebo. Sexual side effects are nearly always reversible when treatment ends, and can be addressed in the meantime, to some extent, with medications like Viagra or Cialis.

More serious side effects which call for medical attention include:

• Hallucinations
• Confusion
• Memory problems
• Major vision changes
• Rapid or pounding heartbeat
• Loss of coordination
• Fainting
• Risk-taking behavior

Trintellix can interact with a range of other medications. MAO inhibitors should be avoided completely; wait at least two weeks after taking an MAO inhibitor before taking Trintellix, or three weeks after taking Trintellix before taking an MAO inhibitor. Taking NSAIDs (ibuprofen, aspirin, etc) along with Trintellix can increase risk of unusual bleeding. Numerous other treatments can produce less alarming but still serious effects; speak with a doctor or pharmacist before taking other medications with Trintellix.