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Antidepressants may increase the risk of suicidal thinking and behavior (suicidality). If you’re considering using Trintellix or any other antidepressant, it’s important to balance this possible risk with your current medical needs. When on antidepressant therapy, your healthcare provider will work with you to help look for any symptoms over time that may mean that your condition is worsening (e.g., suicidality, unusual behavior). It’s important that the individual on the medication, family members, and/or caregivers thoughtfully and carefully observe any changes, and keep communication open with each other and the prescriber.

Trintellix (vortioxetine) is an antidepressant used to treat major depressive disorder (MDD), also known as clinical depression.

As a potent selective serotonin reuptake inhibitor (SSRI), Trintellix helps improve mood by reducing feelings of depression and anxiety while increasing the feelings of joy and happiness. It corrects an imbalance of chemicals in the brain. This medication helps balance a neurotransmitter called serotonin. Serotonin sends signals throughout the brain to stabilize your mood. It also plays a crucial role in your digestive system and sleep cycles.

Trintellix is available in tablet form.

Therapeutic Classification: Antidepressant Available Generically: No

The Food and Drug Administration (FDA) approved Trintellix for MDD in adults.

MDD is a common but serious mood disorder that can affect how you feel, think, and act regularly. Depression is a persistent condition. People who are diagnosed with MDD typically have had symptoms for more than two weeks.

Take Trintellix exactly as advised by your healthcare provider.

Trintellix should be taken by mouth at around the same time each day. You can take it with or without food. It may take two weeks of using this medication before you notice its effects.

Your healthcare provider may change the dose according to the severity of your depression. Prescribed dosages can range from 5 milligrams to 20 milligrams each day.

This antidepressant should not be used with other antidepressants.

Keep Trintellix stored in a tightly closed container away from light, heat, and moisture. An optimal temperature for storing this medication is between 68 degrees and 77 degrees Fahrenheit. However, while traveling with this medication, you can store it in temperatures of 59–86 degrees.

Do not keep this medication in the refrigerator, your car, or in an area with a lot of moisture, such as a restroom cabinet. Keep the tablets in a high or safe place, away from children and pets.

Trintellix has been studied as a medication with multiple uses. Based on this research, healthcare providers may prescribe it to treat conditions not listed on the product label. This is called off-label use.

Trintellix is sometimes prescribed off-label for people with more than one mental disorder or comorbidities (coexisting conditions).

One study showed that Trintellix was tolerated by those with generalized anxiety disorder (GAD) and had a relatively small potential for adverse reactions. Although not the most effective for treating anxiety disorder alone, it is sometimes used to treat people with anxiety disorder and MDD. Research is underway and in the final stages of clinical trials to determine if this medication can be used for other conditions.

Another study showed that vortioxetine might benefit people who have both MDD and social anxiety disorder (SAD). People in the study who took vortioxetine had improved MDD compared to the controlled placebo, but only a slight improvement in their SAD. However, it can be beneficial in treating various mental health disorders, as depression could be the underlying cause of some of them.

Further research is underway in the use of the generic, vortioxetine, in other disorders, including:

It may take six to eight weeks before you see the full benefits of this medication. It is essential to take this medication as directed, ask questions, and communicate with your healthcare provider to track the progression of your treatment.

All drugs have side effects associated with their use. However, you may not experience any side effects at all.

This is not a complete list of side effects, and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at www.fda.gov/medwatch or 800-FDA-1088.

Common side effects of Trintellix can include:

Although these side effects may not seem severe, they may become serious if they do not go away. It is best to contact your healthcare provider if any of these symptoms persist or worsen.

Severe side effects of Trintellix include:  

Serotonin syndrome could be a life-threatening condition if medicines such as Trintellix are taken with other medications of the same class (SSRIs).

Symptoms of serotonin syndrome include:

Suicidal thoughts are a severe and potential risk associated with taking SSRIs. Look for the emergence of suicidal thoughts and behavior, especially early on during your use of this medication. This is very important when your healthcare provider increases your dose or if you are taking the maximum dose.

Symptoms associated with hypomania or manic episodes include:

Visual problems that may occur when taking this medication include:

Not everyone will experience these problems, and only some people are at risk. You may want to undergo an eye exam and receive preventative treatment before beginning this medication.

Trintellix has also been reported to lower sodium concentration in the blood. 

People with low levels of salt in their blood may experience:

More severe cases of sudden low salt levels in the blood may include:

If not treated, severely low sodium levels can cause death.

It is important to measure any electrolyte imbalances in your body through at-home tests or by visiting clinics with laboratory tests. This can help monitor potassium, sodium, or calcium levels in the body.

Long-term side effects of SSRIs include:

Trintellix may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

There are several factors that your healthcare provider may consider when prescribing you this medication.

Generally, antidepressant use during pregnancy is only recommended if the benefits outweigh the risk to the fetus. Using Trintellix during the third trimester of pregnancy can increase the risk for persistent pulmonary hypertension (high blood pressure in the pulmonary artery) and withdrawal in the newborn.

If you are pregnant or plan on becoming pregnant, it is best to speak with your healthcare provider before starting a medication.

Talk to your provider if you are breastfeeding or planning to breastfeed. They may weigh the risks vs. benefits when prescribing Trintellix.

Older adults aged 65 years and older tend to have lower sodium levels in the blood. Trintellix can also lower sodium levels, leading to dangerous side effects. Low sodium levels can cause confusion and instability, heightening the risk of falls.

If you miss a dose, take the next dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue your medication as scheduled. Do not take an extra dose or multiple doses at the same time.

There is limited clinical data regarding Trillentix overdoses in people. In clinical studies, doses from 40 milligrams to 75 milligrams were associated with the following symptoms:

If you think you or someone else may have overdosed on Trintellix, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Trintellix, call 911 immediately.

It is important that your doctor check your progress at regular visits to allow changes in your dose and help reduce any side effects. Blood and urine tests may be needed to check for unwanted effects.

Do not take vortioxetine if you have taken a monoamine oxidase (MAO) inhibitor (eg, Eldepryl®, Marplan®, Nardil®, Parnate®), methylene blue injection, or linezolid in the past 14 days. Do not start taking a MAO inhibitor within 21 days of stopping vortioxetine. If you do, you may develop confusion, agitation, restlessness, sudden high body temperature, extremely high blood pressure, or severe convulsions.

Vortioxetine may cause some teenagers and young adults to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. Some people may have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. If you or your caregiver notice any of these unwanted effects, tell your doctor right away. Let the doctor know if you or anyone in your family has bipolar disorder (manic-depressive) or has tried to commit suicide.

Vortioxetine may cause a serious condition called serotonin syndrome if taken together with some medicines, including buspirone (Buspar®), fentanyl (Abstral®, Duragesic®), lithium (Eskalith®, Lithobid®), tryptophan, St. John's wort, other medicines for depression (eg, ,SNRIs, SSRIs, TCAs), or some pain or migraine medicines (eg, rizatriptan, sumatriptan, tramadol, Frova®, Imitrex®, Maxalt®, Relpax®, Ultram®, Zomig®). Check with your doctor first before taking any other medicines with vortioxetine.

This medicine may increase your risk for bleeding problems. Make sure your doctor knows if you are also taking other medicines that thin the blood, including aspirin, nonsteroidal antiinflammatory agents, also called NSAIDs (eg, diclofenac, ibuprofen, naproxen, Advil®, Aleve®, Celebrex®, Voltaren®), or warfarin (Coumadin®, Jantoven®).

Hyponatremia (low sodium in the blood) may occur with this medicine. This is more common in elderly patients, those who are taking diuretic medicines for high blood pressure, or those who have decreased amounts of fluid in the body due to severe diarrhea or vomiting. Check with your doctor right away if you have confusion, difficulty concentrating, headaches, memory problems, weakness, and unsteadiness.

Do not suddenly stop taking this medicine without checking first with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This will decrease the chance of having withdrawal symptoms, including agitation, dizziness, headache, irritability, muscle tension, mood swings, nausea, runny nose, sudden outbursts of anger, or sweating.

This medicine may cause some people to become dizzy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

Check with your doctor right away if you have decreased interest in sexual intercourse, delayed or inability to have an orgasm in women, inability to have or keep an erection in men, or loss in sexual ability, desire, drive, or performance. These could be symptoms of sexual dysfunction.

Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of some tests may be affected by this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.

You should not take Trintellix if you are allergic to the medication or its ingredients. 

If you experience swelling of the face or signs of hives anywhere near the face or neck, stop taking this medication as you may be allergic or highly sensitive to this medication.

Taking monoamine oxidase inhibitors (MAOIs), another type of antidepressant, with Trintellix can increase the risk of serotonin syndrome. Serotonin syndrome is a rare but potentially fatal disease caused by the buildup of the chemical serotonin in the body. It is usually caused when different medications that increase serotonin are used together.

MAOIs and Trintellix should not be taken together. Your healthcare provider will have you wait at least 14 days between stopping an MAOI and starting Trintellix. If you are obese, your provider may extend this period to 32 days.

Other drugs can also affect how Trintellix works. If you take any of the following medications (strong CYP2D6 inhibitors), you may need a reduced dose of Trintellix:

If you are also taking strong CYP inducers, such as the following, your healthcare provider may increase your dose of Trintellix:

Tell your healthcare provider of all the medications you take. Your provider will help you determine how to take Trintellix safely or determine whether you need an alternative medication. 

There are many classes of medications used for depression.

Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

The SNRIs work similarly to SSRIs. Both types of medications block the reuptake of another neurotransmitter, norepinephrine. SNRIs include:

TCAs can block the reuptake of norepinephrine and serotonin. They also block acetylcholine (neurotransmitter that plays a vital role in the central nervous system and peripheral nervous system). TCAs include:

These medications are different from other antidepressants because they can treat various forms of depression and other nervous system disorders such as panic disorder, social phobias, and depression with features such as hypersomnia. 

MAOIs are no longer considered the first treatment choice due to dietary restrictions, side effects, and safety concerns. 

It may take six to eight weeks before you see the full benefits of this medication. It is essential to take this medication as directed, ask questions, and communicate with your healthcare provider to track the progression of your treatment.

Do not stop the medication abruptly, as you may experience withdrawal symptoms. You should only discontinue this medication under the direction of your provider. If you are currently on the highest dose, your provider can guide you to lower your dose before completely stopping this medication gradually. Weaning off Trintellix can take weeks to months, depending on your dose and symptoms.

Take Trintellix once daily, around the same time each day without regard to meals. You can take your dose in the morning or afternoon.

There is limited data on whether Trintellix increased the effects of alcohol on mental or motor skills. Generally, it’s not recommended to drink alcohol while taking Trintellix.

The list price of Trintellix is $423 for a 30-day prescription. The cost might be lower depending on your health insurance coverage. If you are commercially insured, you can qualify for the manufacturer’s Trintellix Savings Card.

It is important to prioritize your health and self-care routine while taking antidepressants. Although taking your medication is an effective therapy, managing depression in other ways is just as important.

Some people also benefit from talk therapy (psychotherapy) such as cognitive behavioral therapy (CBT), interpersonal therapy, and psychodynamic therapy.

In addition to taking medication, you can work to improve your mood by:

Verywell Health's drug information is meant for educational purposes only and is not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare professional. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

Hormone Health Network. What is Serotonin?

Food and Drug Administration. Trintellix label.

Chen G, Højer AM, Areberg J, Nomikos G. Vortioxetine: Clinical pharmacokinetics and drug interactions. Clin Pharmacokinet. 2018;57(6):673-686. doi:10.1007/s40262-017-0612-7

Orsolini L, Tomasetti C, et al. New advances in the treatment of generalized anxiety disorder: the multimodal antidepressant vortioxetine. Expert Review of Neurotherapeutics. 2016; 16:5, 483-495. doi: 10.1586/14737175.2016.1173545

Liebowitz MR, Careri J, Blatt K, et al. Vortioxetine versus placebo in major depressive disorder comorbid with social anxiety disorder. Depress Anxiety. 2017;34(12):1164-1172. doi:10.1002/da.22702.

Centers for Disease Control and Prevention. Key findings––A Closer Look at the Link Between Specific SSRIs and Birth Defects.

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