Trintellix (vortioxetine)

FDA warning: Risk of suicidal thoughts in children

This medication has a boxed warning from the Food and Drug Administration (FDA). This is the strongest warning that the FDA requires. A boxed warning alerts doctors and patients about drug effects that may be dangerous.

• Trintellix can increase the risk of suicidal thoughts and actions in children and young adults. This increased risk does not seem to apply to older adults taking this medication.
• Families and caregivers of children and young adults taking this medication or other antidepressants should watch for any symptoms of worsening depression or suicidal thoughts. If these occur, contact your doctor right away.

What is Trintellix?

Trintellix (vortioxetine) is a brand-name prescription antidepressant medication. It’s used to treat a serious form of depression called major depressive disorder.

Trintellix comes only as an oral tablet. It’s available in 5-mg, 10-mg, and 20-mg tablets. It was formerly known as Brintellix.

Trintellix works in a unique way and doesn’t fit into other antidepressant classes. Because of this, it’s sometimes classified as an atypical antidepressant, a multimodal antidepressant, or a miscellaneous antidepressant.

An analysis of clinical research showed that Trintellix is effective for reducing symptoms of depression. In the studies covered in the analysis, about half of the people taking Trintellix had their symptoms reduced by 50 percent. About a third of people who took the medication had complete or near complete symptom relief.

Trintellix generic

Trintellix is a brand-name drug. It contains the drug vortioxetine. Trintellix isn’t currently available in a generic form.

Trintellix side effects

Trintellix can cause mild or serious side effects. The following list contains some of the key side effects that may occur while taking Trintellix. This list doesn’t include all possible side effects.

For more information on the possible side effects of Trintellix or for tips on how to deal with a troubling side effect, talk with your doctor or pharmacist.

More common side effects

The more common side effects of Trintellix include:

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

Serotonin syndrome

Trintellix and other antidepressants that increase serotonin in your body can increase your risk of developing serotonin syndrome, a drug reaction that can be dangerous.

This reaction can occur when Trintellix is taken alone, but is more likely to happen if it’s taken with other medications that affect serotonin levels. These include other antidepressants, stimulants used to treat attention deficit hyperactivity disorder (ADHD), St. John’s wort, and others.

Symptoms of serotonin syndrome can include:

Serious bleeding

Trintellix and other antidepressants can increase the risk of bleeding episodes, from mild nosebleeds to more serious bleeding in the stomach or brain.

Serious bleeding is more likely to occur when Trintellix is used with other medications that increase the risk of bleeding. These drugs include aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), warfarin, and others.

Symptoms of serious bleeding can include:

• bleeding that is severe or uncontrollable
• red-, pink-, or brown-colored urine
• red- or black-colored (tarry) stools
• coughing up blood or blood clots
• vomiting blood or vomit that looks like coffee grounds

Low sodium levels

Trintellix can cause low sodium levels in certain people. In some cases, this may be due to fluid retention caused by a condition called syndrome of inappropriate antidiuretic hormone. People over the age of 65 years, or those taking a diuretic medication, are more likely to have this side effect.

Symptoms of low sodium can include:

• headache
• confusion
• weakness or unsteadiness
• trouble concentrating

Worsening symptoms or suicidal thoughts

People with depression can have worsening symptoms and thoughts of suicide despite being treated with medication. The use of Trintellix can increase the risk of suicidal thoughts in children and young adults.

Weight gain

Some people who take Trintellix have gained weight while taking the medication. It’s not clear how often this happens or if Trintellix is the cause of the weight gain.

Sexual side effects

Sexual side effects are common in both men and women who take Trintellix or other antidepressants. These effects occur in 16 to 29 percent of men and 22 to 34 percent of women who take Trintellix. They’re more likely to happen when higher doses are taken.

Sexual side effects can include:

• decreased libido (sex drive, or interest in sex)
• erectile dysfunction (impotence)
• delayed ejaculation
• orgasm dysfunction
• vaginal dryness

Nausea

Nausea is one of the most common side effects of Trintellix. In studies, 21 to 32 percent of people taking the drug experienced nausea. This side effect may go away with continued use of the drug.

Headache

Headache isn’t a common side effect of Trintellix. However, some people report having headache after suddenly stopping Trintellix. If you take Trintellix, talk with your doctor before stopping the medication.

Itching

Itchy skin happens in about 1 to 3 percent of people who take Trintellix. This side effect may go away with continued use of the drug.

Insomnia

Some people who take Trintellix or other antidepressants can have insomnia (trouble sleeping). For some, this may go away with continued use of the drug.

If this side effect continues or occurs along with certain other symptoms, it could mean that the depression is worsening or that suicidal thoughts may occur.

If you or a loved one has insomnia along with symptoms such as anxiety, irritability, restlessness, or agitation, call your doctor. The doctor may want to change the treatment.

Diarrhea

Diarrhea is a common side effect of Trintellix. In studies, 7 to 10 percent of people had diarrhea. This side effect may go away with continued use of the drug.

Constipation

Constipation happens in about 3 to 6 percent of people who take Trintellix. This side effect may go away with continued use of the drug.

Vomiting

Vomiting happens in about 3 to 6 percent of people who take Trintellix. This side effect may go away with continued use of the drug.

Hair loss

Hair loss isn’t a side effect that has happened in studies of Trintellix. However, some people who take Trintellix have reported hair loss. It’s not known if Trintellix was the cause.

Rash

Some people who have taken Trintellix have had a mild rash. How often this happens isn’t known.

Side effects in children

Trintellix isn’t FDA-approved for use by children. However, it may be used off-label for children. In one study of children ages 7 to 17 years, the most common side effects included:

• headache
• nausea
• painful menstruation in girls
• vomiting
• weight gain

This drug also has a boxed warning about the use of Trintellix in children and young adults with depression. Trintellix can increase the risk of suicidal thoughts and actions in this age group.

Families and caregivers of children and young adults taking this medication should watch for any symptoms of worsening depression or suicidal thoughts. If these occur, call their doctor right away.

Trintellix dosage

The Trintellix dosage your doctor prescribes will depend on several factors. These include:

• the type and severity of the condition you’re using Trintellix to treat
• your age
• other medical conditions you may have
• other medications you may take

Typically, your doctor will start you on a low dosage and adjust it over time to reach the dosage that’s right for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Dosage for depression

For treating major depressive disorder, the typical starting dosage is 10 mg once daily. This dosage may then be increased up to 20 mg once daily.

If side effects are a problem, your doctor may decrease your dosage.

What if I miss a dose?

If you miss a dose, take it as soon as you remember. If it’s almost time for your next dose, just take that one dose. Don’t try to catch up by taking two doses at once.

Will I need to use this drug long term?

Yes, this medication is usually taken long term.

Trintellix withdrawal

Some people who stop taking Trintellix abruptly may experience withdrawal symptoms. These can include:

• headache
• muscle tension
• moodiness
• dizziness
• anger
• runny nose

To avoid these symptoms, your doctor may recommend that your dosage be decreased for a week before fully stopping Trintellix. For instance, if you’re taking 20 mg once daily, your doctor may decrease it to 10 mg once daily for a week before you stop taking it.

Trintellix uses

The Food and Drug Administration (FDA) approves prescription drugs such as Trintellix to treat certain conditions.

Approved uses for Trintellix

Trintellix is FDA-approved only for treating major depressive disorder (MDD). This is a severe form of depression.

Trintellix for MDD

Clinical research shows that Trintellix is effective for reducing symptoms of MDD compared to taking a placebo. In an analysis of clinical research, about half of the people who took Trintellix had a 50 percent reduction in symptoms. And about a third of people who took it had complete or near complete symptom relief.

According to another analysis, Trintellix may work about as well as antidepressants in another class of drugs called serotonin-norepinephrine reuptake inhibitors (SNRIs).

Trintellix hasn’t been directly compared to the most commonly used antidepressants, which are called selective serotonin reuptake inhibitors (SSRIs).

Uses that aren’t approved

Trintellix is only approved for treating depression, but it may be used off-label for other conditions. Off-label use is when a drug is approved for one purpose but is used for a different purpose.

Trintellix for anxiety

Trintellix is sometimes used off-label for treating anxiety conditions such as generalized anxiety disorder. An analysis of clinical research shows that it improves symptoms of generalized anxiety more than a placebo pill.

Trintellix for ADHD

Trintellix has been studied for treating symptoms of attention deficit hyperactivity disorder (ADHD) in adults. However, it didn’t improve ADHD symptoms more than a placebo pill.

Your doctor may prescribe Trintellix or other antidepressants if you have ADHD as well as symptoms of depression.

Trintellix for OCD

Trintellix is sometimes used off-label to treat obsessive-compulsive disorder (OCD). However, clinical studies haven’t evaluated Trintellix for this use.

Trintellix for children

Trintellix isn’t FDA-approved for treating children. However, some doctors may prescribe Trintellix off-label to treat depression in children.

Trintellix and alcohol

You shouldn’t drink alcohol while taking Trintellix. Consuming alcohol with Trintellix might worsen some side effects of the drug, such as:

• dizziness
• confusion
• vomiting

Trintellix interactions

Trintellix can interact with several other medications. It can also interact with certain supplements.

Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.

Trintellix and other medications

Below are some examples of medications that can interact with Trintellix. These aren’t all the drugs that may interact with Trintellix.

Before taking Trintellix, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Monoamine oxidase inhibitors (MAOIs)

Taking Trintellix with MAOIs can lead to dangerous side effects such as very high blood pressure, chest pain, severe headache, and increased body temperature. Trintellix shouldn’t be taken within 14 days of using an MAOI. An MAOI shouldn’t be taken within 21 days of taking Trintellix.

Examples of MAOIs include:

• isocarboxazid (Marplan)
• linezolid (Zyvox)
• phenelzine (Nardil)
• selegiline (Eldepryl)
• tranylcypromine (Parnate)

Serotonergic drugs

Taking Trintellix with medications that increase serotonin levels in your body can increase your risk of developing serotonin syndrome, a drug reaction that can be dangerous.

Examples of medications that increase serotonin include:

• antidepressants, including:
• selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac), paroxetine (Paxil, Pexeva, Brisdelle), and sertraline (Zoloft)
• serotonin-norepinephrine reuptake inhibitors (SNRIs) such as duloxetine (Cymbalta), venlafaxine (Effexor XR)
• tricyclic antidepressants such as amitriptyline, desipramine (Norpramin), and imipramine (Tofranil)
• monoamine oxidase inhibitors (MAOIs) such as phenelzine (Nardil) and selegiline (Emsam, Eldepryl, Zelapar)
• certain opioids such as fentanyl (Fentora, Abstral, others) and tramadol (Ultram, Conzip)
• the anxiety medication buspirone

Drugs that reduce blood clotting

Taking Trintellix with drugs that reduce blood clotting might increase the risk of stomach bleeding. In some cases, this could be serious.

Examples of medications that reduce blood clotting include:

• apixaban (Eliquis)
• aspirin
• dabigatran (Pradaxa)
• fondaparinux (Arixtra)
• nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin) or naproxen (Aleve)
• warfarin (Coumadin)

Drug metabolism inhibitors

Certain medications that block an enzyme called cytochrome P450 2D6 (CYP2D6) can decrease how the body breaks down Trintellix. This can increase the risk of serious side effects from the drug, including serotonin syndrome.

If you take these medications, your doctor may prescribe a lower dosage of Trintellix. Examples of these medications include:

• bupropion (Aplenzin, Fortivo XL, Wellbutrin SR, Zyban)
• fluoxetine (Prozac, Sarafem)
• paroxetine (Paxil, Pexeva)
• quinidine

Drug metabolism inducers

Certain medications that make an enzyme called cytochrome P450 3A4 (CYP3A4) more active can increase how fast the body breaks down Trintellix. This can make Trintellix less effective. If you take these medications, your doctor may prescribe a higher dosage of Trintellix.

Examples of these medications include:

• carbamazepine (Carbatrol, Epitol, Equetro, Tegretol)
• phenobarbital
• phenytoin (Dilantin, Phenytek)
• primidone (Mysoline)
• rifampin (Rifadin)

Trintellix and Vyvanse

Trintellix and Vyvanse (lisdexamfetamine) are sometimes prescribed together, especially for people who have both attention deficit hyperactivity disorder (ADHD) and depression.

These medications should only be taken together if your doctor prescribes them. Combining Trintellix and Vyvanse can increase your risk of developing serotonin syndrome, a drug reaction that can be dangerous.

To prevent this reaction, your doctor may need to decrease your dosage of Trintellix or Vyvanse.

Trintellix and Xanax

There are no known interactions between Trintellix and Xanax (alprazolam).

Trintellix and herbs and supplements

Trintellix can interact with certain supplements or herbs you may be taking. Supplements that affect serotonin levels can increase your risk of developing serotonin syndrome.

Examples of these supplements include:

• 5-HTP
• garcinia
• L-tryptophan
• St. John’s wort

How to take Trintellix

You should take Trintellix according to your doctor’s instructions.

Timing

Trintellix is taken just once daily. You should take it at about the same time each day.

Taking Trintellix with food

Trintellix can be taken with or without food. Taking it with food might help decrease stomach upset caused by the medication.

Can Trintellix be crushed?

The manufacturer hasn’t stated whether it’s safe to crush Trintellix tablets. Therefore, it might be safer to avoid crushing them.

Should Trintellix be taken in the morning or at night?

Trintellix can be taken either in the morning or at night. Some people who take Trintellix can feel restless, energized, or have trouble sleeping soon after they take the medication. If this happens to you, try taking Trintellix in the morning.

How Trintellix works

Trintellix is a unique antidepressant medication because of the way it works. It’s sometimes called an atypical antidepressant or a multimodal antidepressant.

Depression may be partly caused by decreased levels of brain chemicals such as serotonin.

Like many antidepressants, Trintellix increases serotonin activity by blocking the reabsorption (reuptake) of serotonin in the brain. This increase in serotonin might help balance out levels of brain chemicals to help improve symptoms of depression.

But unlike other antidepressants, Trintellix also binds to and blocks certain types of serotonin receptors in the brain. Receptors are like docking stations on cells, and serotonin attaches to them.

But when Trintellix blocks these receptors, serotonin can’t attach to them. It’s not clear how this action helps relieve depression.

How long does it take to work?

Most antidepressants, including Trintellix, don’t work quickly. Although you may feel some effects sooner, the maximum effect on depression symptoms usually doesn’t happen for six to eight weeks after you start taking the medication.

If you don’t have improved symptoms after this time period, talk to your doctor.

Alternatives to Trintellix

There are many different antidepressant medications that are effective for treating major depressive disorder, the condition that Trintellix is approved to treat.

If the first antidepressant tried doesn’t help or only partially helps, the next step is often trying an antidepressant from a different drug class. A drug class is a group of medications that work in a similar way.

Options from other antidepressant drug classes can be alternatives to Trintellix. The different drug classes of antidepressants include:

• Selective serotonin reuptake inhibitors (SSRIs). These include:
• citalopram (Celexa)
• escitalopram (Lexapro)
• fluoxetine (Prozac, Sarafem)
• paroxetine (Paxil)
• sertraline (Zoloft)
• Serotonin-norepinephrine reuptake inhibitors (SNRIs). These include:
• desvenlafaxine (Khedezla, Pristiq)
• duloxetine (Cymbalta)
• levomilnacipran (Fetzima)
• milnacipran (Savella)
• venlafaxine (Effexor XR)
• Norepinephrine and dopamine reuptake inhibitors (NDRIs). These include:
• bupropion (Aplenzin, Forfivo, Wellbutrin SR, Zyban)
• Tetracyclic antidepressants. These include:
• maprotiline
• mirtazapine (Remeron)
• Tricyclic antidepressants (TCAs). These include:
• amitriptyline (Elavil)
• desipramine (Norpramin)
• doxepin
• imipramine (Tofranil)
• nortriptyline (Pamelor)
• Monoamine oxidase inhibitors (MAOIs). These include:
• phenelzine (Nardil)
• selegiline (Eldepryl, Emsam)
• tranylcypromine (Parnate)
• Miscellaneous. These include:
• nefazodone
• St. John’s wort
• trazodone
• vilazodone (Viibryd)

Trintellix vs. other drugs

You may wonder how certain drugs compare to Trintellix. Below are comparisons between Trintellix and several other medications.

Trintellix vs. Viibryd

Trintellix and Viibryd (vilazodone) are both brand-name prescription antidepressant medications. They each affect serotonin, a chemical messenger in the brain, but they work slightly differently.

Uses

Trintellix and Viibryd are both FDA-approved for treating major depressive disorder (MDD) in adults.

Dosage and forms

Trintellix and Viibryd both come only as oral tablets. They’re both taken once daily.

Side effects and risks

Trintellix and Viibryd share many common and serious side effects.

More common side effects

More common side effects shared by Trintellix and Viibryd include:

• nausea
• diarrhea
• dry mouth
• dizziness
• trouble sleeping
• flatulence (gas)
• vomiting
• sexual side effects such as erectile dysfunction
• abnormal dreams

Serious side effects

Serious side effects shared by Trintellix and Viibryd include:

• worsening symptoms or suicidal thoughts
• serotonin syndrome
• serious bleeding
• low sodium levels

In an indirect comparison of antidepressants, users were less likely to stop taking Trintellix because of side effects than they were Viibryd.

Effectiveness

The effectiveness of Trintellix and Viibryd in treating MDD hasn’t been directly compared in clinical studies. However, an indirect comparison of antidepressants showed that Trintellix and Viibryd work about equally well.

Cost

Trintellix and Viibryd are both available only as brand-name drugs. They don’t have generic forms, which are typically less expensive than brand-name versions.

Trintellix usually costs more than Viibryd. The actual amount you pay will depend on your insurance plan.

Trintellix vs. Effexor XR

Trintellix and Effexor XR (venlafaxine) are both prescription antidepressant medications. They both affect serotonin, a chemical messenger in the brain, but Effexor XR also affects norepinephrine.

Uses

Trintellix and Effexor XR are both FDA-approved for treating major depressive disorder (MDD) in adults. Effexor XR is also approved for other uses, including:

Dosage and forms

Trintellix comes only as an oral tablet that’s taken once daily.

Effexor XR comes as an extended-release capsule that’s taken once daily. A generic immediate-release tablet is also available that’s taken two to three times daily.

Side effects and risks

Trintellix and Effexor XR (and generic Effexor) have some similar side effects, and some that differ. Below are examples of these side effects.

	Both Trintellix and Effexor	Trintellix	Effexor
More common side effects	diarrhea vomiting dry mouth dizziness trouble sleeping sexual side effects constipation abnormal dreams	flatulence (gas) itchy skin	weakness loss of appetite nervousness sleepiness sweating
Serious side effects	worsening symptoms or suicidal thoughts serotonin syndrome bleeding low sodium levels	(few unique serious side effects)

In an indirect comparison of antidepressants, users were less likely to stop taking Trintellix because of side effects than Effexor.

Effectiveness

The only condition both Trintellix and Effexor XR are used to treat is MDD. The effectiveness of these drugs in treating MDD hasn’t been directly compared in clinical studies. However, an indirect comparison of antidepressants showed that Effexor may be slightly more effective than Trintellix.

Cost

Trintellix is only available as a brand-name drug. Effexor XR capsules are available as a brand-name drug and in a generic form called venlafaxine. (Effexor oral tablets are only available in generic form.)

Effexor XR is similar in price to Trintellix. Generic Effexor XR is typically less expensive than both brand-name products. In any case, the actual amount you pay will depend on your insurance plan.

Trintellix vs. Wellbutrin

Trintellix and Wellbutrin (bupropion) are both prescription antidepressant medications. Trintellix mainly affects serotonin, a chemical messenger in the brain. Wellbutrin affects different chemical messengers called norepinephrine and dopamine.

Uses

Wellbutrin comes as extended-release tablets called Wellbutrin SR and Wellbutrin XL. Wellbutrin XL is FDA-approved for treating major depressive disorder (MDD) and seasonal affective disorder. Wellbutrin SR is approved only for treating MDD.

Trintellix is approved only for treating MDD.

Dosage and forms

Trintellix comes only as an oral tablet that’s taken once daily. Wellbutrin XL and Wellbutrin SR both come as extended-release tablets that are taken once daily in the morning.

Side effects and risks

Trintellix and Wellbutrin XR and Wellbutrin SR have some similar side effects, and some that differ. Below are examples of these side effects.

	Both Trintellix and Wellbutrin (XL and SR)	Trintellix	Wellbutrin (XL and SR)
More common side effects	nausea diarrhea vomiting dry mouth dizziness trouble sleeping constipation itchy skin	flatulence (gas) sexual side effects abnormal dreams	headache infection stomach pain weakness chest pain ringing in ears (tinnitus) muscle and joint pain loss of appetite tremor sleepiness sweating sore throat nervousness or anxiety urge to urinate often
Serious side effects	worsening symptoms or suicidal thoughts	serotonin syndrome serious bleeding low sodium levels	increased blood pressure seizures symptoms of psychosis, such as hallucinations, confusion, and paranoia

Effectiveness

The only condition both Trintellix and Wellbutrin are used to treat is MDD. The effectiveness of these drugs in treating MDD hasn’t been directly compared in clinical studies. However, an indirect comparison of antidepressants showed that Trintellix may be more effective than Wellbutrin.

Cost

Trintellix is only available as a brand-name drug. Wellbutrin XL and Wellbutrin SR are available as brand-name drugs as well as in generic forms. Their generic names are bupropion XL and bupropion SR.

The generic forms of Wellbutrin XL and Wellbutrin SR are much less expensive than Trintellix. But Trintellix is usually less expensive than the brand-name forms of Wellbutrin XL and Wellbutrin SR. In any case, the actual amount you pay will depend on your insurance plan.

Trintellix vs. Celexa

Trintellix and Celexa (citalopram) are both prescription antidepressant medications. They both affect serotonin, a chemical messenger in the brain, but they work slightly differently.

Uses

Trintellix and Celexa are both FDA-approved for treating major depressive disorder (MDD) in adults.

Dosage and forms

Trintellix and Celexa both come only as oral tablets. They’re both taken once daily.

Side effects and risks

Trintellix and Celexa have some similar side effects, and some that differ. Below are examples of these side effects.

	Both Trintellix and Celexa	Trintellix	Celexa
More common side effects	nausea diarrhea vomiting dry mouth trouble sleeping sexual side effects	flatulence (gas) abnormal dreams dizziness constipation itchy skin	sweating tremor fatigue muscle or joint pain sleepiness loss of appetite anxiety respiratory infection runny nose
Serious side effects	worsening symptoms or suicidal thoughts serotonin syndrome bleeding low sodium levels	(few unique serious side effects)	abnormal heartbeat

Effectiveness

The effectiveness of Trintellix and Celexa in treating MDD hasn’t been directly compared in clinical studies. However, an indirect comparison of antidepressants showed that Trintellix may be slightly more effective than Celexa.

Cost

Trintellix comes only as a brand-name drug. Celexa comes as a brand-name drug and in a generic form called citalopram.

The generic form of Celexa is much less expensive than Trintellix. Also, brand-name Celexa is usually less expensive than Trintellix. In any case, the actual amount you pay will depend on your insurance plan.

Trintellix vs. Lexapro

Trintellix and Lexapro (escitalopram) are both prescription antidepressant medications. They both affect serotonin, a chemical messenger in the brain, but they work slightly differently.

Uses

Trintellix and Lexapro are both FDA-approved for treating major depressive disorder (MDD) in adults. Lexapro is also approved for treating generalized anxiety disorder.

Dosage and forms

Trintellix and Lexapro both come as oral tablets that are taken once daily.

Side effects and risks

Trintellix and Lexapro have some similar side effects, and some that differ. Below are examples of these side effects.

	Both Trintellix and Lexapro	Trintellix	Lexapro
More common side effects	• nausea • diarrhea • dry mouth • trouble sleeping • sexual side effects • dizziness • constipation	vomiting flatulence (gas) abnormal dreams itchy skin	sweating flu-like symptoms runny nose fatigue sleepiness loss of appetite
Serious side effects	worsening symptoms or suicidal thoughts serotonin syndrome bleeding low sodium levels	(few unique serious side effects)

Effectiveness

The effectiveness of Trintellix and Lexapro in treating MDD hasn’t been directly compared in clinical studies. However, an indirect comparison of antidepressants showed that Trintellix and Lexapro work about equally well.

Cost

Trintellix is only available as a brand-name drug. Lexapro is available as a brand-name drug and in a generic form called escitalopram.

Generic Lexapro is much less expensive than Trintellix. Brand-name Lexapro is also usually slightly less expensive than Trintellix. In any case, the actual amount you pay will depend on your insurance plan.

Trintellix vs. Prozac

Trintellix and Prozac (fluoxetine) are both prescription antidepressant medications. They both affect serotonin, a chemical messenger in the brain, but they work slightly differently.

Uses

Trintellix and Prozac are both FDA-approved for treating major depressive disorder (MDD) in adults. Prozac is also approved for treating other conditions, including:

• obsessive-compulsive disorder (OCD)
• bulimia (an eating disorder)
• panic disorder

Dosage and forms

Trintellix comes as an oral tablet that’s taken once daily. Prozac comes as an oral pulvule, which is a type of capsule. It’s usually taken once daily in the morning. Prozac also comes as a delayed-release capsule that’s taken once weekly.

Side effects and risks

Trintellix and Prozac have some similar side effects, and some that differ. Below are examples of these side effects.

	Both Trintellix and Prozac	Trintellix	Prozac
More common side effects	diarrhea vomiting dry mouth trouble sleeping sexual side effects dizziness constipation abnormal dreams flatulence (gas) itchy skin	(few unique common side effects)	weakness flu-like symptoms loss of appetite sleepiness tremor sweating rash anxiety nervousness
Serious side effects	worsening symptoms or suicidal thoughts serotonin syndrome bleeding low sodium levels	(few unique serious side effects)	severe rash seizures weight loss abnormal heartbeat

Effectiveness

The only condition both Trintellix and Prozac are approved to treat is MDD. The effectiveness of these drugs in treating MDD hasn’t been directly compared in clinical studies. However, an indirect comparison of antidepressants showed that Trintellix may be more effective than Prozac.

Cost

Trintellix is only available as a brand-name drug. Prozac is available as a brand-name drug and in a generic form called fluoxetine.

Generic Prozac is much less expensive than Trintellix. But Trintellix is usually less expensive than Prozac. In any case, the actual amount you pay will depend on your insurance plan.

Trintellix vs. Zoloft

Trintellix and Zoloft (sertraline) are both prescription antidepressant medications. They both affect serotonin, a chemical messenger in the brain, but they work slightly differently.

Uses

Trintellix and Zoloft are both FDA-approved for treating major depressive disorder (MDD) in adults. Zoloft is also approved for treating other conditions, including:

Dosage and forms

Trintellix comes as an oral tablet that’s taken once daily. Zoloft comes as an oral tablet and an oral solution. Each form of Zoloft is usually taken once daily in the morning.

Side effects and risks

Trintellix and Zoloft have some similar side effects, and some that differ. Below are examples of these side effects.

	Both Trintellix and Zoloft	Trintellix	Zoloft
More common side effects	nausea diarrhea vomiting dry mouth dizziness trouble sleeping sexual side effects constipation	abnormal dreams flatulence (gas) itchy skin	blurred vision heart palpitations fatigue loss of appetite sleepiness tremor sweating
Serious side effects	worsening symptoms or suicidal thoughts serotonin syndrome serious bleeding low sodium levels	(few unique serious side effects)	seizures abnormal heartbeat

Effectiveness

The only condition both Trintellix and Prozac are approved to treat is MDD. The effectiveness of these drugs in treating MDD hasn’t been directly compared in clinical studies. However, an indirect comparison of antidepressants shows that Trintellix and Zoloft work about equally well.

Cost

Trintellix is only available as a brand-name drug. Zoloft is available as a brand-name drug and in a generic form called sertraline.

The generic form of Zoloft is much less expensive than Trintellix. Brand-name Zoloft is also typically less expensive than Trintellix. In any case, the actual amount you pay will depend on your insurance plan.

Trintellix and pregnancy

There haven’t been enough studies in humans to know if Trintellix is safe to use during pregnancy. Studies in animals have shown potential harm to the fetus when the mother is given the drug. However, animal studies don’t always predict the way humans would respond.

Studies using other antidepressants have found increased risks to newborns, especially when the drugs were used by the mother in the third trimester of pregnancy. Some complications that have occurred include trouble breathing, seizures, irritability, and trouble feeding.

It’s also important to keep in mind that stopping treatment with Trintellix in pregnant women with MDD can also have serious consequences. For instance, depression symptoms can return.

If you’re taking Trintellix and are pregnant or planning to become pregnant, talk with your doctor. They can provide information about the risks and benefits of continuing or stopping antidepressant treatment.

Trintellix and breastfeeding

It isn’t known if Trintellix is present in the breast milk of women who take the medication. In an animal study, Trintellix was found in breast milk. However, animal studies don’t always reflect what occurs in humans.

If you’re breastfeeding your child and taking Trintellix, talk with your doctor about the potential risks and benefits.

Common questions

Here are answers to some frequently asked questions about Trintellix.

Is Trintellix an antidepressant?

Yes, Trintellix is an antidepressant medication.

Is Trintellix an SSRI?

No, Trintellix is not an SSRI (selective serotonin reuptake inhibitor). However, it does have some effects that are similar to those of SSRIs.

For instance, Trintellix increases serotonin activity in the brain. It does this by blocking reabsorption (reuptake) of serotonin.

Does Trintellix make you sleepy?

In most cases, people taking Trintellix haven’t reported feeling tired or sleepy. However, some people who’ve taken the drug have reported feeling sleepy. It’s not clear if Trintellix was the cause.

Trintellix overdose

Taking too much of this medication can increase your risk of serious side effects.

Overdose symptoms

Some symptoms of overdose of Trintellix may include:

• nausea
• diarrhea
• dizziness
• stomach upset
• itchiness
• sleepiness
• flushing

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor or seek guidance from the American Association of Poison Control Centers at 800-222-1222 or through their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

Trintellix warnings

FDA warning: Risk of suicidal thoughts in children

This drug has a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

• Trintellix can increase the risk of suicidal thoughts and actions in children and young adults. The increased risk of suicidal thoughts and actions does not seem to apply to older adults taking these medications.
• Families and caregivers of children and young adults taking this medication should watch for any symptoms of worsening depression or suicidal thoughts. If these occur, contact your doctor right away.

Other warnings

Before taking Trintellix, talk with your doctor about any medical conditions you have. Trintellix may not be right for you if you have certain medical conditions. Examples of these conditions include:

• Bipolar disorder: Trintellix can cause symptoms of mania, such as an unusually elevated, irritable, or energetic mood. This is more likely to happen if you have bipolar disorder.
• Bleeding disorders: Trintellix can increase the risk of bleeding episodes, such as nosebleeds and stomach bleeding. This is more likely to happen in people with bleeding disorders.
• Glaucoma: Trintellix can cause your pupils, the dark circle in the center of your eyes, to dilate (get bigger). This can worsen a type of glaucoma called closed-angle glaucoma.

Trintellix expiration

When Trintellix is dispensed from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically one year from the date the medication was dispensed.

The purpose of these expiration dates is to guarantee the effectiveness of the medication during this time.

The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. However, an FDA study showed that many medications may still be good beyond the expiration date listed on the bottle.

How long the medication remains good can depend on many factors, including how and where the medication is stored. Trintellix should be stored at room temperature, at about 77º F (25º C).

If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

Professional information for Trintellix

The following information is provided for clinicians and other healthcare professionals.

Mechanism of action

Trintellix has a unique mechanism of action. It’s sometimes classified as an atypical antidepressant or a multimodal antidepressant. Trintellix inhibits serotonin reuptake. It also has antagonistic effects at the 5-HT3 receptor and agonistic effects at the 5-HT1A receptor.

Pharmacokinetics and metabolism

The absolute bioavailability of Trintellix is 75 percent. The maximum plasma concentration occurs within 7 to 11 hours after an oral dose.

Trintellix is extensively metabolized through cytochrome P450 (CYP) isoenzymes, primarily CYP2D6.

The elimination half-life of Trintellix is about 66 hours.

Contraindications

Trintellix is contraindicated in people who have hypersensitivity to Trintellix or any of the product components. It’s also contraindicated in those who are taking monoamine oxidase inhibitors (MAOIs). Trintellix shouldn’t be used within 14 days of MAOI use. MAOIs shouldn’t be used within 21 days of Trintellix use.

Storage

Trintellix should be stored at room temperature, at about 77º F (25º C).

Disclaimer: MedicalNewsToday has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.