What to know about Trintellix
There are over 30 medications that aim to help with depression and improve a person's quality of life.
This article provides an overview of Trintellix, including its uses, side effects, warnings, and interactions with other drugs.
Doctors may prescribe Trintellix to treat MDD or depression.
Image credit: garzfoth 2016.
The Food and Drug Administration (FDA) have approved Trintellix to treat major depressive disorder (MDD), or depression.
Trintellix works differently to standard antidepressants. It belongs to a class that doctors call atypical, miscellaneous, or multimodal antidepressants. Whereas other antidepressants affect one mechanism within the brain, Trintellix works in several ways in the brain.
Researchers are not sure exactly how Trintellix works. They believe it may block the brain's reuptake of the neurotransmitter serotonin, which is a hormone involved in mood and motivation. However, it works differently to selective serotonin reuptake inhibitors (SSRIs).
There is currently no generic version of Trintellix available.
Like other antidepressants, Trintellix has some potential side effects and warnings.
Doctors prescribe Trintellix primarily to treat depression, a mental health condition that causes persistent feelings of sadness, feelings of hopelessness, and a loss of interest in usual activities.
Some doctors may prescribe Trintellix off label to treat other conditions. Off label use means that doctors prescribe a particular drug to treat a condition that was not the manufacturer's intended use for the drug. Some additional uses for Trintellix include:
How to take Trintellix
Trintellix is available in immediate-release tablet form in the following dosages:
- 5 milligrams (mg)
- 10 mg
- 15 mg
- 20 mg
The package insert for Trintellix recommends that a person starts treatment at 10 mg and moves up to 20 mg after a few weeks. A doctor may prescribe a 5 mg dose to people who cannot tolerate higher doses well.
A doctor will determine the appropriate dose based on:
- current medications
- medical conditions
- the severity of the condition
People should take Trintellix at the same time each day and avoid missing a dose. They can take the medication with or without food.
Like most antidepressants, it will take a few weeks before a person starts to notice any effects from taking Trintellix.
People can stop taking Trintellix abruptly, but a person should speak with their healthcare provider before stopping taking the drug. However, stopping abruptly when taking higher doses can cause:
Moderate side effects
Common side effects of Trintellix include nausea, constipation, and vomiting.
Like all drugs, Trintellix can cause side effects that range from mild to severe. Some people do not experience adverse side effects.
The most common side effects of Trintellix, which occur in at least 5% of people who take the drug, are:
Mild to moderate side effects of Trintellix include:
Severe side effects
Trintellix can also cause severe side effects. When deciding on the best treatments, a person can work with their healthcare provider to determine the risks of treating depression versus not treating it.
Severe side effects of Trintellix include the following:
Increased suicidal thoughts or actions
In the first few months of taking Trintellix, there are risks of increased suicidal thoughts or actions. The FDA advise people to pay close attention to how they are feeling and talk to their healthcare provider about any new or sudden changes in their mood, behavior, thoughts, or feelings.
- If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Call 911 or the local emergency number.
- Stay with the person until professional help arrives.
- Remove any weapons, medications, or other potentially harmful objects.
- Listen to the person without judgment.
- If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours a day at 1-800-273-8255.
Serotonin syndrome is a potentially life-threatening condition that can occur when a person takes Trintellix with other medication. The symptoms of serotonin syndrome include:
- poor muscle control or twitching
- a rapid heartbeat
- sweating or fever
- nausea and diarrhea
Bleeding or bruising
Trintellix can cause manic episodes. Symptoms include:
- greatly increased energy
- excessive happiness or irritability
- talking and thinking very fast
- risky behavior
Some people are at risk of eye problems linked with Trintellix. People may experience eye pain, changes in vision, and swelling or redness around the eye.
Low sodium levels
Trintellix can lead to low levels of salt (sodium) in the blood, which can cause the following symptoms:
- difficulty concentrating
- unsteadiness on the feet
In severe cases, it can cause hallucinations, fainting, coma, and can be fatal without treatment.
Trintellix may cause interactions with other medications that a person may be taking.
One of the most common drug interaction issues involves taking Trintellix while using monoamine oxidase inhibitors (MAOIs), which are another form of antidepressant. Using an MAOI medication with Trintellix may cause problems, such as:
- very high blood pressure
- severe headaches
- muscle rigidity
People should not take a MAOI within 21 days of stopping Trintellix, and wait for 14 days after taking an MAOI before starting Trintellix.
A person should avoid taking medications that increase serotonin levels in the body. Some examples to avoid include:
- tricyclic antidepressants (TCAs)
- St. John's wort
A person should also avoid taking blood thinners as they can increase the risk of stomach bleeding. Some examples include warfarin and Aspirin.
Some medications can increase the effectiveness of Trintellix, which means a person can take lower doses of Trintellix. Examples of these medicines include:
Other medications may cause Trintellix to become less effective. A doctor may need to prescribe higher doses of Trintellix if a person is taking one of the following drugs:
A person should also inform their doctor about any vitamins or supplements they are taking before they start taking Trintellix. Some vitamins or supplements may interact with Trintellix.
A person should discuss their medical history and medications, including supplements, with their doctor before starting Trintellix. They should also let their doctor know they are taking Trintellix to help avoid issues from drug interactions.
Trintellix is available only as a prescription. People with insurance will likely have to pay a slightly higher premium for brand name medications, such as Trintellix. Those without insurance may be able to find coupons or other price reductions to help cover the cost.
A healthcare provider may be able to suggest alternative treatments with the same levels of effectiveness and lower costs.
Trintellix vs. related drugs
A person should work with their doctor to find the drug treatment that best suits them.
Different antidepressants vary in levels of effectiveness and severities of side effects in different people.
People may find other drugs as effective as Trintellix. However, in many cases, alternatives also cause side effects. Individuals can work with their healthcare provider to find the best one for them.
Some comparable classes of medications that may work as well as Trintellix for treating major depressive disorder include:
- tetracyclic antidepressants
- serotonin-norepinephrine reuptake inhibitors (SNRIs)
- norepinephrine and dopamine reuptake inhibitors (NDRIs)
- miscellaneous drugs, such as trazodone, nefazodone, or St. John's wort
Pregnancy and breastfeeding
Based on animal studies, Trintellix may cause harm to the fetus if a woman takes it during pregnancy. Women should avoid Trintellix when pregnant or breastfeeding. Talk to a healthcare provider about alternative treatments for MDD during pregnancy.
Trintellix is one of many antidepressants that people can take to treat major depression. Some people find that taking Trintellix relieves their symptoms and helps them in their daily lives.
Some people experience severe side effects. If a person is concerned about the side effects they or a loved one is experiencing, they should speak to a doctor who can offer advice and discuss alternative treatments if needed.
Throughout treatment, people should let their doctor know about any changes in their mood, behavior, thoughts, and feelings.