Trintellix interactions: Alcohol, medications, and other factors

Trintellix (vortioxetine) is a brand-name prescription drug used to treat major depressive disorder in adults. As with other medications, Trintellix can interact with certain other drugs. It can also interact with some supplements. An interaction occurs when one substance causes another substance to have a different effect than expected.

For details about Trintellix’s interactions, keep reading. For additional information about Trintellix, including details about its uses, see this article.

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)

If you’ve recently taken a monoamine oxidase inhibitor (MAOI), talk with your doctor or pharmacist before taking Trintellix. Similar to Trintellix, MAOIs are used to treat depression.

Taking a combination of Trintellix and an MAOI can increase your risk of a serious side effect called serotonin syndrome.* (With serotonin syndrome, high levels of a chemical called serotonin build up in your body. This can lead to seizures and other life threatening complications.)

Due to this risk, doctors usually won’t prescribe Trintellix if you’re taking an MAOI or have taken one in the past 14 days. Also, your doctor likely won’t recommend starting treatment with an MAOI within 21 days of stopping Trintellix treatment.

Examples of MAOIs include:

• methylene blue (Provayblue)
• tranylcypromine (Parnate)
• phenelzine (Nardil)
• linezolid (Zyvox)
• selegiline (Emsam)
• isocarboxazid (Marplan)

If you take an MAOI, talk with your doctor. They can help determine when it’s safe for you to start Trintellix treatment.

* To learn about this side effect of Trintellix, see this article.

Having had an allergic reaction to Trintellix or any of its ingredients

If you’ve had an allergic reaction to Trintellix or any of its ingredients, your doctor will likely not prescribe Trintellix. Taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.

Note: Before you start treatment with Trintellix, it’s important to tell your doctor if either of these contraindications applies to you. They can determine whether to prescribe Trintellix.

Trintellix is not known to interact with alcohol.

Your doctor may recommend avoiding alcohol when taking Trintellix. This is because alcohol may increase the risk of side effects* of Trintellix. For example, Trintellix may cause:

• nausea
• vomiting
• increased risk of bleeding

Since alcohol may also cause these side effects, the combination of alcohol and Trintellix may increase your risk even more.

If you’d like to drink alcohol while taking Trintellix, talk with your doctor about how much, if any, is safe for you.

* To learn about side effects of Trintellix, see this article.

Before you start treatment with Trintellix, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions.

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

Here’s a chart of drugs that can interact with Trintellix. Keep in mind that this chart doesn’t include all drugs that may interact with Trintellix. Some of these interactions are described in detail just below in “Drug interactions in depth.”

* To learn about side effects of Trintellix, see this article.
† For more details, see the “When to avoid Trintellix” section above.

Here’s a closer look at certain drug interactions of Trintellix.

Selective serotonin reuptake inhibitors (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) are drugs that can be used to treat depression, panic disorder, and obsessive-compulsive disorder.

Interaction result. Taking Trintellix and an SSRIcan increase the risk of serotonin syndrome* and other side effects. (With serotonin syndrome, high levels of a chemical called serotonin build up in your body. This can lead to seizures and other life threatening complications.)

Interaction explained. Trintellix and SSRIs may work in similar ways to treat your depression. Both drugs are thought to increase the level of serotonin in your body. And taking multiple drugs that affect serotonin can increase your risk of serious side effects, such as serotonin syndrome.

Examples of SSRI drugs. Here are some SSRIs that may interact with Trintellix:

• sertraline (Zoloft)
• escitalopram (Lexapro)
• fluoxetine (Prozac)
• paroxetine (Paxil)

Steps you or your doctor may take. Before starting Trintellix treatment, tell your doctor if you take any SSRIs. They may recommend that you avoid taking SSRIs along with Trintellix. Your doctor will recommend the best treatment plan for your depression.

However, if your doctor prescribes Trintellix with an SSRI, they may monitor you more often for symptoms of serotonin syndrome. You can also watch for these symptoms. They may include anxiety, hallucinations, sweating, and muscle spasms. If you have any of these symptoms, contact your doctor or seek emergency help right away.

* To learn about this side effect of Trintellix, see this article.

CYP2D6 inducers

CYP2D6 inducers are drugs that can be used for different conditions, including seizures and infections.

Interaction result. Taking Trintellix and a CYP2D6 inducer together can decrease the effectiveness of Trintellix.

Interaction explained. Trintellix is broken down in your body by an enzyme (a type of protein) called CYP2D6. Some drugs may cause CYP2D6 to work faster than usual. These are known as CYP2D6 inducers.

If you take Trintellix and a CYP2D6 inducer, the inducer may cause the CYP2D6 enzyme to break down Trintellix more quickly. This means you’ll have less Trintellix in your body than usual. So, the drug likely won’t be as effective as it should be.

Examples of CYP2D6 inducers. Here are some CYP2D6 inducers that may interact with Trintellix:

• rifampin (Rifadin, Rimactane)
• carbamazepine (Carbatrol, Tegretol, others)
• phenytoin (Dilantin, Phenytek)

Steps you or your doctor may take. Before starting treatment with Trintellix, tell your doctor about any medications that you take. Your doctor or pharmacist can look through your current medications to see if you take any CYP2D6 inducers. In some cases, if you’re taking a CYP2D6 inducer, your doctor may prescribe a higher dose of Trintellix. (To learn about the dosages of Trintellix, see this article.)

Tricyclic antidepressants (TCAs)

Tricyclic antidepressants (TCAs) are often used to treat depression.

Interaction result. Taking Trintellix with TCAscan increase the risk of serotonin syndrome.

Interaction explained. Trintellix can increase the levels of a chemical in your body called serotonin. TCAs can also increase your serotonin levels. So, taking this combination of medications may increase the risk further. When serotonin levels become too high, a serious side effect called serotonin syndrome can occur.

Examples of TCA drugs. Here are some TCAs that may interact with Trintellix:

• amitriptyline
• nortriptyline (Pamelor)
• doxepin (Silenor)

Steps you or your doctor may take. Before starting Trintellix treatment, tell your doctor if you take any TCAs. Your doctor can look through your current medications and help identify if any are TCAs.They’ll likely recommend that you avoid these medications during Trintellix treatment. Your doctor will recommend the best treatment plan for your condition.

If your doctor prescribes Trintellix with a TCA, they may monitor you more often for symptoms of serotonin syndrome. You can also watch for these symptoms, which may include anxiety, hallucinations, sweating, and muscle spasms. If you have any of these symptoms, contact your doctor or seek emergency help right away.

Trintellix may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Trintellix.

Trintellix interactions with supplements

Before you start treatment with Trintellix, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

It’s possible for certain supplements to increase your serotonin levels. (Serotonin is a chemical in your body.) Trintellix can also raise serotonin levels. So, taking certain supplements with Trintellix may increase serotonin levels further.

If serotonin levels become too high, serotonin syndrome could occur. This can lead to seizures and other life threatening complications.

Examples of these supplements may include:

• tryptophan
• 5-hydroxytryptophan

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

Trintellix interactions with herbs

Certain herbs, such as St. John’s wort, can increase your serotonin levels. Similar to Trintellix, St. John’s wort can increase serotonin levels. So, taking certain this herb with Trintellix may increase serotonin levels even more. This could lead to serotonin syndrome, which could cause seizures and other life threatening complications.

If you have questions about what herbs you can take with Trintellix, talk with your doctor or pharmacist.

Trintellix and vitamins

There are no specific reports of vitamins interacting with Trintellix. However, it’s possible that interactions with vitamins could be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Trintellix.

Trintellix and food

There were no reports of food interactions with Trintellix. The drug isn’t known to interact with any foods. And Trintellix shouldn’t affect your appetite. If you’d like to learn more about eating certain foods during treatment with Trintellix, talk with your doctor.

Trintellix and vaccines

There aren’t any known interactions between Trintellix and vaccines. However, if you need to get any vaccines during your treatment with Trintellix, talk with your doctor or pharmacist. They can help make sure that none of your other medications interact with the vaccines.

Trintellix and lab tests

There aren’t any known interactions between Trintellix and lab tests. However, if you need to have any lab tests done, talk with your doctor about any medications that you take. They can help make sure that none of your other medications will interact with your lab tests.

TRINTELLIX INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Trintellix. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Trintellix. The impact of cannabis may affect how well you stick to your Trintellix treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many U.S. states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Trintellix. Before you take this drug, be sure to talk with your doctor about your health history. Trintellix may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Trintellix include:

Suicidal thoughts and behaviors. Before taking Trintellix, tell your doctor if you’ve ever had mood problems, such as suicidal thoughts or behaviors. The drug has a boxed warning about the risk of suicidal thoughts and behaviors in certain people. A boxed warning is a serious warning from the Food and Drug Administration (FDA). For details, refer to “Boxed warning” at the top of this article.

Seizures or seizure disorders. Tell your doctor if you’ve ever had any seizures or if you currently have a seizure disorder. In rare cases, it’s possible for Trintellix to increase your risk of seizures. So if you’ve ever had these conditions, you may have an increased risk of this side effect with the drug.

You may also have an increased risk of seizures if you stop taking Trintellix suddenly. Talk with your doctor to see whether Trintellix may be a safe treatment option for you.

Personal or family history of mood problems. If you have or have had any mood problems other than depression, tell your doctor before starting Trintellix treatment. Also tell them if anyone in your family has or has had a mood problem, including bipolar disorder. Trintellix can increase your risk of mood problems. Your doctor can help determine whether this medication is safe for you.

Glaucoma. It’s possible for Trintellix to cause or worsen glaucoma. If you already have glaucoma, taking Trintellix may worsen your condition. In this case, your doctor can help determine whether Trintellix is right for you.

Low sodium levels in your blood. It’s possible for Trintellix to lower sodium levels in your blood. And, if you already have low blood sodium levels, taking Trintellix may worsen your condition.

If your blood sodium levels become too low, you may have increased risk of serious problems. These include memory problems, confusion, hallucinations, breathing problems, and seizures. Due to this risk, your doctor will likely treat your low sodium levels before you take Trintellix.

Bleeding problems. If you have any bleeding problems or bleeding disorders, such as hemophilia, tell your doctor before starting Trintellix treatment. This medication may increase your risk of bleeding, including serious bleeding in your digestive system. If you already have a bleeding disorder, you may have an increased risk of this side effect. Your doctor can help determine whether Trintellix is safe for you.

Pregnancy. It’s not known if it’s safe to take Trintellix during pregnancy. If you’re pregnant or planning to become pregnant, talk with your doctor to see whether it may be safe for you to take Trintellix.(For details about Trintellix and pregnancy, see this article.)

Breastfeeding. It’s unknown if it’s safe to take Trintellix while breastfeeding. Currently, it’s not known if the drug passes into breast milk or what effects it may have on a breastfed child. If you’re breastfeeding, talk with your doctor before taking Trintellix.

Allergic reaction. If you’ve had an allergic reaction to Trintellix or any of its ingredients, your doctor will likely not prescribe Trintellix. To learn more, see “When to avoid Trintellix” above.

Here are some frequently asked questions about Trintellix and possible interactions.

Does Trintellix interfere with sleep medications?

No, Trintellix shouldn’t interfere with sleep medications. So, if you take a sleep medication, it’s likely safe to continue taking it during Trintellix treatment.

Examples of sleep medications that are likely safe to take with Trintellix include:

• zolpidem (Ambien)
• eszopiclone (Lunesta)
• ramelteon (Rozerem)

It’s important to note that Trintellix may cause sleeping problems in rare cases. These problems may occur if you experience manic episodes (periods of high energy or excitement) or develop worsening depression or mood changes from Trintellix treatment.

If you notice changes in your sleep pattern when starting Trintellix treatment, talk with your doctor. They can help determine what may be causing them and suggest possible treatments.

Are there any interactions between Trintellix and Viagra?

No, there aren’t any known interactions between Trintellix and sildenafil (Viagra). However, Trintellix may affect you sexually and increase your risk of developing sexual side effects. These can include:

• delayed ejaculation
• decreased libido (sex drive)
• problems having or maintaining an erection

So, if you develop sexual side effects while taking Trintellix, your doctor may prescribe Viagra if you’re male.* Talk with your doctor if you have questions about sexual side effects from Trintellix or how to best treat them.

* Sex and gender exist on spectrums. Use of the term “male” in this article refers to sex assigned at birth.

What antidepressant works well with Trintellix?

Your doctor can help determine whether another antidepressant may work well with Trintellix.

However, other antidepressants aren’t typically prescribed with Trintellix due to possible interactions. These include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs). (To learn more, see the “Trintellix interactions with other medications” section above.)

Instead of antidepressants, your doctor may prescribe other drugs along with Trintellix to treat your depression. For example, your doctor may recommend taking Trintellix with antipsychotic drugs that are approved to treat depression. These include lurasidone (Latuda), brexpiprazole (Rexulti), and aripiprazole (Abilify). These drugs are not known to interact with Trintellix.

To learn about which drugs you can safely take with Trintellix, be sure to talk with your doctor or pharmacist.

Does Trintellix affect dopamine?

No, Trintellix shouldn’t affect dopamine levels in your body. Dopamine is a chemical messenger that helps regulate certain moods and emotions.

Instead, Trintellix works to treat depression by affecting the levels of another chemical called serotonin. Other antidepressants, such as bupropion (Wellbutrin SR, Wellbutrin XL), work by affecting the levels of dopamine and another chemical called norepinephrine.

If you have questions or concerns about how Trintellix works differently than other antidepressants, talk with your doctor or pharmacist.

You can take certain steps to help prevent interactions with Trintellix. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Trintellix label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions. (If Trintellix doesn’t come with paperwork, you can ask your pharmacist to print a copy.) If you have questions about this information, ask your doctor or pharmacist.

You can also help prevent interactions with Trintellix by taking it exactly as your doctor prescribes.

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 article.
• Side effects. If you’re interested in the side effects of Trintellix, see this article. Another option is to refer to the Trintellix prescribing information.
• Dosage specifics. To learn about the dosage of Trintellix, see this article.
• Drug comparison. For information about how Trintellix compares with Zoloft, Wellbutrin, Lexapro, and more, read this article.
• Facts about depression. To learn more about your condition, see our depression hub.

Disclaimer: Medical News Today 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 another 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.