Brand Name:

Trintellix (formerly Brintellix)

Drug Class: 

It doesn’t really have a class name, maybe multimodal antidepressant is best.

How it works: 

It increases the release of Serotonin, Norepinephrine, Dopamine, Glutamate, Acetylcholine, and Histamine.

What makes it unique:

Vortioxetine has a unique multimodal mechanism. This medication may have pro-cognitive effects as well, which could be useful in an elderly population.

Side effects:

Nausea, vomiting, constipation, sexual dysfunction.

Rare side effects include abnormal bleeding, hyponatremia, seizures, induction of mania, angle-closure glaucoma, and activation of suicidal ideation.

How effective is it:

(1) A study reviewed 602 patients taking Vortioxetine or placebo. The study measured both depression and cognitive function. Vortioxetine significantly improved depression symptoms and interestingly, also improved objective and subjective measures of cognitive function in adults with depression. The cognitive improvements were largely independent of the effect on improving depressive symptoms.

(2) A study evaluated Vortioxetine against placebo and even had an active comparator using the antidepressant Duloxetine. Vortioxetine 15 and 20mg was found to be safe and effective. The Duloxetine decreased depression and anxiety scores slightly more than Vortioxetine.

Clinical experience: 

This is rarely seen due to being newer and more expensive. It is causing some excitement due to the differences it has from other antidepressants. The potential pro-cognitive effects are interesting. More time is needed to find this medication’s place in treatment. Pharmaceuticals should never be used as the sole treatment for mental illnesses. Therapy, exercise, meditation or other treatments should always accompany prescriptions.

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1. McIntyre R, Lophaven S, Olsen C.  A randomized, double-blind, placebo-controlled study of vortioxetine on cognitive function in depressed adults.  International Journal of Neuropsychopharmacology, Volume 17, Issue 10, 1 October 2014, Pages 1557–1567.

2. Boulenger JP, Loft H, Olsen CK. Efficacy and safety of vortioxetine (Lu AA21004), 15 and 20 mg/day: a randomized, double-blind, placebo-controlled, duloxetine-referenced study in the acute treatment of adult patients with major depressive disorder. Int Clin Psychopharmacol. 2014 May;29(3):138-49.

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