Key takeaways
- Trintellix has major interactions with certain antidepressants (MAOIs), requiring specific “washout” periods to avoid a dangerous condition called serotonin syndrome.
- Common medications like bupropion (Wellbutrin) or certain pain relievers can change how much Trintellix is in your system, often requiring a doctor to adjust your dosage.
- While Trintellix doesn’t interact with alcohol, doctors generally recommend limiting alcohol consumption to help manage depression symptoms.
Trintellix (vortioxetine) can be an effective partner to help manage major depressive disorder (MDD). However, like most medications, Trintellix can interact with other drugs, supplements, and even certain health conditions.
Understanding these interactions is a key part of staying safe and getting the most out of your treatment. Think of this guide as a starting point for a conversation with your healthcare professional.
In some cases, factors or conditions could prevent your doctor from prescribing Trintellix due to the risk of harm. These are known as contraindications. The contraindications of Trintellix include:
Taking a monoamine oxidase inhibitor (MAOI)
Doctors typically won’t prescribe Trintellix if you are currently taking a monoamine oxidase inhibitor (MAOI) or have taken one in the last 14 days. This includes medications such as methylene blue (ProvayBlue), linezolid (Zyvox), and phenelzine (Nardil).
Typical recommended washout period:
- Starting Trintellix: Wait at least 14 days after stopping an MAOI.
- Starting an MAOI: Wait at least 21 days after stopping Trintellix.
Mixing Trintellix with an MAOI can lead to serotonin syndrome, a serious condition caused by too much serotonin in the body. Serotonin syndrome can lead to seizures and other life threatening complications.
What is a “washout period”?
A washout period is a specific amount of time you must wait between stopping one medication and starting another. This allows the first drug to completely leave your system so it doesn’t interact with the new one.
» More on this: What to expect when switching antidepressants
Allergic reaction
If you have had a previous allergic reaction to Trintellix or any ingredients in the medication, be sure to let your doctor know. They’ll find a different treatment option for you.
Allergic reaction symptoms may range from mild to serious, and they can include:
- hives
- swelling
- trouble breathing
Many medications can be taken with Trintellix, but some require your doctor to adjust your dose or monitor you more closely.
Serotonin-affecting drugs
Trintellix works by increasing serotonin levels. If you take other serotonergic drugs, the risk of serotonin syndrome increases.
- selective serotonin reuptake inhibitors (SSRIs), such as sertraline (Zoloft) and escitalopram (Lexapro)
- serotonin-norepinephrine reuptake inhibitors (SNRIs), such as duloxetine (Cymbalta) and venlafaxine (Effexor XR)
- triptans (which are used for migraines), such as rizatriptan (Maxalt) and sumatriptan (Imitrex)
- tricyclic antidepressants (TCAs), including amitriptyline (Elavil)
- pain medications, such as fentanyl (Duragesic) and tramadol (Ultram)
- other substances that increase serotonin, such as lithium (Lithobid) and buspirone (Buspar)
Metabolism and dosing adjustments
Your body uses specific enzymes to break down Trintellix. Other drugs can speed up or slow down this process.
- Strong CYP2D6 inhibitors: Drugs such as bupropion (Wellbutrin), fluoxetine (Prozac), or quinidine can increase the levels of Trintellix in your system. Your doctor will likely reduce your Trintellix dose by half if you take these together.
- Strong CYP inducers: Drugs such as rifampin (Rifadin), carbamazepine (Tegretol), or phenytoin (Dilantin) can cause your body to process Trintellix too quickly. Your doctor may need to increase your dose of Trintellix if you’re taking one of these medications.
Bleeding risks
Trintellix can increase your risk of bleeding. Be sure to talk with your doctor before taking other drugs that similarly increase the risk of bleeding, including:
- nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil), naproxen (Aleve), or aspirin
- blood thinners, such as warfarin (Jantoven)
Taking Trintellix with any of these drugs may increase your risk of bruising, nosebleeds, or gastrointestinal bleeding.
Quick tip: Checking interactions before starting a new medication or supplement can help prevent surprises.
Trintellix and alcohol
Clinical studies show that Trintellix doesn’t necessarily interact with alcohol.
However, as a general rule, your doctor may suggest avoiding or limiting alcohol consumption. Both substances can cause nausea and dizziness, and alcohol can often worsen the symptoms of depression.
Supplements and herbs
- St. John’s wort and tryptophan: These supplements can increase the levels of serotonin in your body. Taking them with Trintellix increases your risk of serotonin syndrome, so they should generally be avoided. Your doctor or pharmacist can let you know what supplements are safe to take with Trintellix.
- Cannabidiol (CBD) and cannabis: Specific interactions with CBD or cannabis products were not reported in Trintellix’s studies. However, these products may affect your mood and how well your treatment plan works. If you use any CBD products, it’s important to tell your doctor before starting treatment.
CBD resources
Visit our dedicated hub for more research-backed information and in-depth resources on CBD.
Before starting Trintellix, make sure your doctor knows your full health history, especially regarding:
- Glaucoma: Trintellix can cause your pupils to dilate, which may cause acute (sudden) angle-closure glaucoma in people with narrow eye angles.
- Bleeding disorders: Tell your doctor if you bruise easily or have a history of bleeding problems.
- Seizures: Trintellix can cause seizures as a side effect. If you have a seizure disorder, such as epilepsy, Trintellix may not be safe for you to take.
- Low sodium (hyponatremia): Doctors typically monitor older adults or those taking diuretics for low sodium levels, which can cause confusion and headaches.
- Bipolar disorder: Let your doctor know if you have a personal or family history of bipolar disorder. Antidepressants, including Trintellex, can sometimes trigger a manic episode in people with this condition.
Here are some frequently asked questions about Trintellix and possible interactions.
No, Trintellix shouldn’t interfere with sleep medications. In fact, common sleep aids such as zolpidem (Ambien) or eszopiclone (Lunesta) are generally safe to take with Trintellix when prescribed by a doctor.
If you find you are having new trouble sleeping, talk with your doctor about whether a sleep aid is right for you.
» FIND CARE: Find a sleep medicine specialist in your area today.
Yes, Trintellix is generally safe to take with medications such as sildenafil (Viagra).
While Trintellix may have a lower risk of sexual side effects than other antidepressants, they can still occur. If you experience changes in libido or performance, your doctor may suggest taking a medication like Viagra to help manage those effects.
» Further reading: What are the sexual side effects of antidepressants?
Taking an antidepressant during the third trimester may increase the risk of withdrawal-like symptoms or breathing problems in newborns. And it’s not clear whether Trintellix passes into breast milk or how it may affect a child who’s breastfed.
However, untreated depression also carries risks during pregnancy. Your doctor can help you weigh the risks and benefits of taking Trintellix while pregnant or breastfeeding.
You can take certain steps alongside your doctor or pharmacist to help prevent interactions with Trintellix. For example:
- Keep a list: Write down every medication, vitamin, and herb you take. Similarly, let your doctor know if you drink alcohol or use cannabis, and how often. This printable
medication record from the FDA is a great way to keep your information in one place. - Try to fill your medications at the same pharmacy: This allows your pharmacist’s system to automatically flag potential interactions.
- Do not stop suddenly: If you’re concerned about an interaction, talk with your doctor or pharmacist before stopping the medication. Stopping suddenly can lead to discontinuation symptoms.
Besides learning about interactions, you may want to find out more about Trintellix. These resources might help:
- Overview of Trintellix. For a general overview of Trintellix, see this Trintellix overview article.
- Side effects. If you’re interested in the side effects of Trintellix, see this article on Trintellix side effects. Another option is to refer to the Trintellix prescribing information.
- Dosage specifics. To learn about the dosage of Trintellix, see this article on Trintellix’s dosage.
Disclaimer: While Medical News Today strives for factual, comprehensive, and current information, this article is not a substitute for a licensed healthcare professional’s expertise. Always consult a doctor before taking or discontinuing any medication. Drug information is subject to change and may not cover all uses, directions, precautions, warnings, interactions, reactions, or adverse effects. The lack of a warning does not guarantee a drug’s safety, effectiveness, or appropriateness for all patients or specific uses. Learn more about our approach to content integrity.