What to Know About Trintellix (Vortioxetine)

In this article, you will learn:

  1. What is Trintellix?
  2. Trintellix Generic
  3. Trintellix Dosage
  4. What is Trintellix Used For?
  5. Trintellix Side Effects
  6. Trintellix Reviews
  7. Trintellix for Anxiety
  8. Trintellix vs Lexapro
  9. Trintellix vs Zoloft
  10. Trintellix vs Viibryd
  11. Trintellix Mechanism of Action

What is Trintellix?

Trintellix drug belongs to a group of medicines called antidepressants. It is indicated to treat major depressive disorders in adults by increasing the levels of serotonin.

Serotonin is an important hormone that stabilizes your mood, enhances feelings of wellbeing, and of happiness.  

Is Trintellix an SSRI?

Trintellix is categorized as Serotonin Modulator and Stimulator (SMS). SMS is a type of drug that performs different modes of activity. 

Such activity is specific to the Serotonin Neutransmitter System. In other words, SMSs modulate one or more serotonin receptors and thus inhibit the reuptake of serotonin. 

You must understand that there are different subtypes of serotonin receptors. Further, not all of these receptors are apparently involved in the anti-depressant effects of SSRIs. 

Certain serotonin receptors play an insignificant role in regulating mood. Whereas the other serotonin receptors play an important role in treating mood disorders like depression. 

To be more specific, Vortioxetine works through a set of certain biological mechanisms. One of such mechanisms is that it acts as an SSRI. 

Accordingly, it inhibits the transportation of serotonin to the other neurons, thus increasing the level of serotonin in the pre-synaptic cell. 

Thus, Trintellix is a Selective Serotonin Reuptake Inhibitor (SSRI) apart from other biological mechanisms under SMS.

Selective Serotonin Reuptake Inhibitors (SSRIs) are a class of drugs typically used as antidepressants in treating Major Depressive Disorder (MDD), anxiety disorders, and other psychological conditions. 

These are the first-line medications for treating depression and various other psychotic disorders. 

How Do SSRIs Work?

SSRIs improve the functioning of neurons regulating emotions inside our brains. The communication between two neurons happens due to the chemical messengers that carry signals from one neuron to the other. 

These chemical messengers are called neurotransmitters. Accordingly, serotonin is one of the types of neurotransmitters that regulates your behavior, mood, and memory. 

Like other neurotransmitters, serotonin gets released in an area between two neurons whenever a neuron is activated. 

Serotonin is then absorbed by the specific receptors on the neighboring cells.  Such reabsorption is called reuptake and is important for a neuron releasing the neurotransmitter to send the next message. 

Such activity leads to an increase or decrease in the transmission of signals along a particular circuit. 

Now, people suffering from mental disorders like depression have reduced levels of serotonin available to pass messages between two nerve cells. 

SSRIs like Trintillex increase the level of serotonin by blocking the reuptake process.

This allows the serotonin to build up between the two neurons so that messages can be passed on correctly. 

They are called Selective Serotonin Reuptake Inhibitors (SSRIs) as these antidepressant drugs target only serotonin. 

Trintellix Generic

The Trintellix drug contains an active substance called Vortioxetine. It is a novel multi-channel compound that the FDA has recently approved for the treatment of Major Depressive Disorder (MDD).

The Tritellix generic name is vortioxetine hydrobromide. That is, vortioxetine is sold under the brand name Trintellix. However, previously, Tritellix was sold under the brand name Brintellix.

Currently, there are no Tritellix generic alternatives.

As per research, vortioxetine showcased its increased efficacy in treating patients with MDD. This study was conducted for a duration of six weeks and proved significantly superior to the placebo trial.

Likewise, another study indicated a significant reduction in depression symptoms. This study included three randomized controlled trials over the duration of 8 weeks. 

In other words, vortioxetine therapy proved successful in reducing the symptoms of depression in a significant number of patients.

Also, there was a reduction of 50% in the depression symptoms from the baseline in patients with MDD who were on vortioxetine.

Also, the study showcased that the decrease in depression symptoms intensified with an increase in the vortioxetine dosage.

In addition to this, no reduction in the efficiency levels of vortioxetine with long-term use of the compound was observed.

This was revealed in two multi-center, open-label, flexible-dose extension studies treating MDD patients. 

At present, one of the common limitations of the available antidepressants is the delay to either induce a response. Or slow the onset of action. 

Such a lag in the onset of action by an antidepressant is linked with negative outcomes of having such an antidepressant. 

These include intentional self-harm and increased risk of suicide.

However, this was not the case with MDD patients who were treated with vortioxetine.

In fact, a large number of patients with MDD achieved antidepressant-induced response within 6-8 weeks. 

Trintellix Dosage


The starting Trintellix dosage recommended is Tritellix 10 mg per day in adults less than 65 years of age.

The patient needs to consume a Tritellix 10 mg dose once daily as per the professional’s recommendation.

However, the Trintellix dosage may increase to Trintellix 20 mg per day depending upon the response or tolerance of individual patients.

Again, the patient needs to consume a 20 mg dose once daily on the doctor’s recommendation.

Further, the Trintellix dosage may be reduced to a minimum of 5mg vortioxetine for those who cannot tolerate high doses.

The patient needs to consume a 5mg dose on the doctor’s recommendation. 

It is important to know that severe depressive disorders require several months of pharmacological treatment. 

Therefore, during the long-term therapy, the Trintellix dosage must be maintained at the lowest effective level.

Further, the professionals undertaking such a therapy need to reassess the patients periodically. 

This is to determine if the treatment needs to be continued. 

Geriatric (Greater than or Equal to 65 years of age)

The starting Trintellix dosage for patients 65 years of age or older must be at the lowest effective level.

That is, such patients need to be given 5mg vortioxetine per day as a beginner.

Furthermore, professionals must exercise immense caution when treating elderly patients with a Trintellix dosage higher than Trintellix 10mg per day.

This is because the data regarding the efficacy and safety of high Trintellix dosage given to patients 65 years of age and older is limited.

Patients With Renal Impairment

There is no Trintellix dosage adjustment recommended for patients suffering from severe kidney failure or renal impairment.

Further, no Trintellix dosage adjustment is also recommended for those who are experiencing the end stage of renal disease.

Although it is advised that a great amount of caution needs to be exercised when treating patients with severe renal insufficiency. 

Patients With Hepatic Impairment

The liver is majorly responsible for maintaining a human body’s metabolism. 

Further, it also helps in clearing drugs and their metabolites. 

Therefore, diseases or injures that harm liver functioning may have a great impact on the manner in which certain drugs interact with the human body. 

Since the liver plays an important role in removing drugs from the human body, no Trintellix dosage is recommended for patients having impaired liver function. (Hepatic Impairment)

However, it is advised to exercise great caution while prescribing Trintellix to patients with moderate or severe Hepatic Impairment.

Effect on Enzymes Released or Inhibited

Cytochrome P450 (CYP450)

CYP450 are the enzymes that play an important role in generating cholesterol and steroids. 

Furthermore, they are also essential for metabolizing various drugs and detoxifying foreign chemicals. 

The genetic variability of these enzymes may have an impact on the manner in which a patient’s body responds to the commonly prescribed drugs. 

It is important to note that Cytochrome P450 enzymes can be either induced or inhibited by drugs. 

This may lead to causing unexpected adverse effects due to the interaction of the prescribed drugs with such enzymes. 

Therefore, it is advised to reduce the Trintellix dosage by half in case CYP2D6 inhibitors are added to the Trintellix treatment.

Drugs like Bupropion, Quinidine Fluoxetine Paroxetine, etc have CYP2D6 inhibitor enzymes. 

It is important to note that CYP2D6 is a member of the Cytochrome P450. Further, CYP2D6 is responsible for the metabolism and elimination of a portion of the clinically used drugs. 

Cytochrome P450 Inducers

As mentioned above, CYP450 enzymes metabolize drugs in your body. It interacts in several ways with different drugs. 

Thus, drugs that lead to CYP450 metabolic drug interactions are of two types. These include inhibitors or inducers. 

Cytochrome P450 inducers increase the activity of Cytochrome P450 enzymes by increasing enzyme synthesis. 

Furthermore, before the enzyme activity increases, there is typically a delay. This depends on the half-life of the drug. 

The half-life of a drug means the time taken to reduce the concentration of a drug in the human body by 50%. 

It is important to note that a drug inducer with a short half-life can decrease the concentration of a drug metabolized in the human body within 24 hours. Whereas, the drug inducer with a very long half-life can reduce the concentration of a drug metabolized up to one week after its initiation. 

Discontinuation of Trintellix

It is important to note that Trintellix has a relatively long elimination half-life. However, it was observed in the Placebo-controlled trials that discontinuation of Trintellix abruptly showcased discontinuation symptoms.

Thus, it is important that a patient is monitored for discontinuation symptoms. This is in case treatment with Trintellix is to be discontinued.

Further, it is recommended that the Trintellix dosage must be reduced gradually rather than abruptly, whenever possible.

In addition to this, there is one more thing that you should consider when discontinuing Trintellix.

It is the impact of the elimination half-life of Trintellix in case the prescribed drugs are the ones that may interact with Trintellix.

The elimination half-life of Trintellix means an elimination half-life of 66 hours.

What is Trintellix Used For?

Trintellix is used for treating Major Depressive Disorder in adults (individuals 18 years and above). 

Accordingly, Trintellix uses to provide you relief from the symptoms of depression. These include:

  • Feelings of sadness, depression, or hopelessness
  • Restlessness
  • Irritability
  • Change in weight or appetite
  • Difficulty in sleeping or concentrating
  • Feeling tired, agitated, or angry
  • Having headaches
  • Unusual changes in behavior or mood
  • Unexplained pains and aches
  • Developing thoughts or feelings of suicide
  • Panic attacks
  • Acting on dangerous impulses
  • New or worse anxiety
  • Loss of interest or pleasure in doing things

There was a long-term study conducted over a period of six to eight weeks. As per this, it was observed that Trintellix uses included reducing multiple symptoms of MDD. This was on the basis of the overall score.

Furthermore, such a score was calculated using a standardized depression rating scale. 

Besides the long-term studies, the short-term studies also indicated the therapeutic effects of Trintellix.

However, such an effect was generally observed to start at week 2. Whereas, the full effect of Trintellix was not seen until week 4 or later.

Again, the overall score in short-term studies was based on a standardized depression rating scale. 

Trintellix Side Effects

The following section lays out both the common as well as adverse side effects of Trintellix. It is important to note that the following is an exhaustive list and does not include all the possible Trintellix side effects you may experience while consuming Trintellix.

Accordingly, you must consult your health care professional in case you experience any of the Trintellix side effects not mentioned in the list.

Common Trintellix Side Effects

1. Gastrointestinal Disorders

  • Nausea 
  • Diarrhea 
  • Dry mouth 
  • Constipation 
  • Vomiting 
  • Dyspepsia 
  • Flatulence 
  • Abdominal discomfort

2. General Disorders and Administration Site Conditions

  • Fatigue

3. Infections and Infestations

  • Nasopharyngitis

4. Metabolism and Nutrition Disorders

  • Decreased appetite

5. Musculoskeletal and Connective Tissue Disorders

  • Arthralgia

6. Nervous System

  • Dizziness 
  • Somnolence 
  • Sedation

7. Psychiatric Disorders

  • Insomnia 
  • Abnormal dreams

8. Skin and Subcutaneous Tissue Disorders

  • Hyperhidrosis 
  • Pruritus generalized

9. Male and Female Sexual Dysfunction

  • Decrease in libido
  • Normal orgasm 
  • Decrease in sexual arousal
  • Decrease in orgasmic sensation 
  • Delayed ejaculation in males
  • Erectile dysfunction
  • Vulvovaginal dryness

* Events included are those occurring in 1% or more of patients treated with TRINTELLIX. Further, the incidence in patients treated with TRINTELLIX was greater than the incidence in placebo-treated patients.

Adverse Trintellix Side Effects

Discontinuation Symptoms

  • Headache
  • Mood swings
  • Increased dreaming or nightmares
  • Sudden outbursts of anger
  • Muscle tension or stiffness
  • Dizziness or vertigo
  • Running nose

Changes in Weight

No significant change in body weight was observed with patients consuming Trintellix.

Cardiovascular Parameters

No clinically important changes in blood pressure or heart rate were observed with Trintellix treatment.


Trintellix has not been associated with any clinically significant effect on ECG parameters. These parameters include QT, QTc, PR, QRS intervals.

Adverse Events In Case of MDD Patients

Patients experiencing less severe symptoms were observed to experience relapse of the past condition with Trintellix treatment.

Adverse Events in Pediatric Patients With Depressive or Anxiety Disorder 

  • Nausea
  • Vomiting
  • Headache
  • Suicidal thoughts
  • Upper Abdominal pain
  • Fatigue
  • Sedation
  • Dysbysmenorrhoea

Post Market Adverse Reactions

  • Acute Pancreatitis
  • Serotonin Syndrome
  • Agitation or aggression
  • Hemorrhage
  • Anaphylactic reaction
  • Angioedema

Serious Drug Interactions

  • Combined Use of Trintellix and Monoamine Oxidase Inhibitors (MAOIs) may lead to hyperthermia, rigidity, myoclonus, changes in vital signs, extreme agitation, etc. 
  • Coadministration of Trintellix  with drugs affecting serotonergic neurotransmitter systems like SRIs, Triptans, Lithium, St. John’s Wort, Fentanyl Dextromethorphan, etc
  • Combined use of Trintellix  with psychotropic drugs like NSAIDs, ASA, or other anticoagulants may lead to the risk of bleeding
  • Coadministration of Trintellix with antidepressants with serotonergic effect can lower the seizure threshold. 
  • The combined use of Vortioxetine with medicinal products like lithium and tryptophan should be taken with caution.
  • Alcohol intake is not advised during antidepressant treatment

Less Common Adverse Reactions 

I. Blood and Lymphatic System Disorders

  • Leukopenia (rare)

II. Cardiac Disorders

  • Sinus Bradycardia, Angina Pectoris (infrequent)
  • Ventricular Extrasystoles (rare)

III. Ear and Labyrinth Disorders

  • Vertigo (infrequent)

IV. Eye Disorders

  • Dry eye
  • Visual impairment
  • Visual acuity reduced
  • Vitreous Floaters
  • Eye pain
  • Mydriasis

V. Gastrointestinal Disorders

  •  Abdominal distension, 
  • Gastritis
  • Epigastric discomfort
  • Salivary hypersecretion
  •  Aphthous stomatitis
  • Eructation
  • Glossitis
  • Bowel movement irregularity
  • Cheilitis
  • Colitis
  • Haematochezia

VI. General Disorders and Administration Site Conditions

  • Chest discomfort
  • Malaise
  • Non-cardiac chest pain

VII. Hepatobiliary Disorders 

  • Hepatic function abnormal 

VIII. Immune System Disorders 

  • Hypersensitivity

IX. Investigations

  • Weight increased
  • Electrocardiogram QT prolonged
  • Heart rate increased
  • Low-density lipoprotein increased
  • Blood cholesterol increased
  • Blood triglycerides increased
  • Blood creatine phosphokinase increased
  • Blood gamma-glutamyltransferase increased 
  • Blood alkaline phosphatase increased
  • Hepatic enzyme increased
  • Transaminases Increased

X. Metabolism and Nutrition Disorders

  • Dehydration
  • Hyperglycaemia
  • Dyslipidaemia
  • Glucose tolerance impaired
  • Hypoglycemia 

XI. Nervous System

  • Dysgeusia
  • Lethargy
  • Tremor
  • Myoclonus
  • Hypersomnia
  • Restless legs syndrome
  • Memory impairment
  • Ageusia
  • Psychomotor hyperactivity
  • Convulsion
  • Hyperreflexia 
  • Muscle contractions involuntary
  • Sensory disturbance
  • Formication

XII. Psychiatric Disorders

  • Tension
  • Bruxism
  • Restlessness
  • Derealisation
  • Depersonalization 
  • Suicide attempt
  • Terminal insomnia
  • Euphoric mood

XIII. Renal and Urinary Disorders

  • Micturition urgency
  • Nocturia
  • Urine odor abnormal 

XIV. Reproductive System and Breast Disorders

  • Menstruation delayed
  • Polymenorrhoea
  • Breast tenderness

XV. Respiratory, Thoracic and Mediastinal Disorders

  • Yawning
  • Respiratory tract congestion
  • Dry throat

XVI. Skin and Subcutaneous Tissue Disorders

  • Pruritus
  • Night sweats
  • Rash
  • Urticaria
  • Dermatitis allergic,
  • Psoriasis
  • Rash erythematous
  • Skin irritation

XVII. Vascular Disorders

  • Hypertension
  • Flushing
  • Hypotension

Trintellix Reviews

The following are the Trintellix Reviews provided on WebMD and amazon. As far as WebMD is concerned, people have provided ratings on the basis of ease of use, effectiveness, and satisfaction derived after consuming Trintellix.

You can see the Trintellix Reviews posted on WebMD here.

Trintellix for Anxiety

Trintellix is only approved for treating Major Depressive Disorder (MDD). However, it is prescribed off-late to treat Generalized Anxiety Disorder (GAD).

As per studies, patients suffering from severe GAD showcased greater effects from Trintellix than those without.

Although there was an increased probability of the patients experiencing response and remission when treated with Trintellix for anxiety.

Furthermore, it was also observed that patients taking Trintellix for anxiety were more likely to discontinue it due to adverse effects.

Thus, such studies concluded that the use of Trintellix for anxiety was supported.

However, further long-term placebo-controlled observational studies or post-market surveys were required.

This is because there is limited evidence for Trintellix for anxiety.

Trintellix vs Lexapro

Used ForMay be used to treat depression in adults. Is prescribed to relieve depression and anxiety disorders. These may include GAD and MDD. Lexapro is also prescribed for treating BPD, OCD, Social Anxiety Disorder, and Panic Disorder off-late. 
Generic AvailabilityIt is not a generally available drugIt is a generally available drug
Half-lifeIt has a half-life of 66 hoursLexapro has a half-life of 32 hours
Side-effectsCommon side effects include headache, delayed ejaculation, diarrhea,  nausea, insomniaCommon side effects include nausea, fatigue, increased sweating, insomnia, sleepiness
Dosage FormIt comes only in the form of oral tabletsLexapro, on the other hand, comes both in tablet and oral solution form. 
Comorbid Interactions Bleeding, Hyponatremia, ManiaRenal dysfunction, Liver disease, Hyponatremia, SIADH, Haemorrhage
Downsides It may take a number of weeks before the patient experiences the full effects of Trintellix. Also, Trintellix is more likely to interact with other drugs relative to other antidepressants. Furthermore, stopping the intake of Trintellix may lead to a greater likelihood of side effects. It may lead to an increase in weight. Patients with heart or liver diseases are advised not to take Lexapro. It does not work for every individual as a first antidepressant. One may have to try different antidepressants before Lexapro.
Dosage5 mg, 10 mg, 15 mg, or 20 mg. The usual dose is once a day for adults. The doctor may increase the dose to 20 mg per day or decrease it to 5 mg per day, depending on how your body responds. Also, the starting dose for those 65 years or older is 5 mg per day. 5 mg, 10 mg, or 20 mg, once daily as per the disorder or condition
Generic Name VortioxetineEscitalopram

As per a study, both Trintellix and Lexapro were found to be effective drugs for treating depression. This is in comparison to other antidepressants. Furthermore, both the drugs were more tolerable than other antidepressants. 

Also, the brand Trintellix conducted a study. It concluded that both Lexapro and Trintellix were effective for treating depressive disorders. 

So, the answer to the question ‘Is Trintellix better than Lexapro’ is that there is very little study on the effectiveness of  Trintellix over Lexapro

However, Trintellix showcased a greater likelihood of certain side effects. These included itching and nausea relative to Lexapro. 

It is important to note that you need to consult a medical practitioner as he can suggest the most appropriate drug for you. 

Further, the healthcare professional may also have to look into your present health condition, history, as well as the type of drugs you already take.  

This is because the interactions of certain drugs with Trintellix and Lexapro may lead to serious side effects. 

Another study indicated that Trintellix was superior to the commonly used SSRI Lexapro in enhancing sexual dysfunction. His study was conducted on patients who were suffering from Treatment-emergent Sexual Dysfunction (TESD).

However, such patients were fully treated for depression. Further, these patients were switched from taking an SSRI (Citalopram), Sertralin, or Paroxetine.

It was observed that Trintellix had fewer sexual side effects relative to Lexapro. It demonstrated statistically significant improvement in sexual functioning as compared to Escitalopram. 

However, both the drugs maintained prior improvement in depression.  

Trintellix vs Zoloft

Trintellix and Zoloft are antidepressants effective in treating depressive disorders, especially MDD. 

Trintellix is categorized as Serotonin Modulator and Stimulator (SMS). SMS is a type of drug that performs different modes of activity. 

Such activity is specific to the Serotonin Neurotransmitter System. In other words, SMSs modulate one or more serotonin receptors and thus inhibit the reuptake of serotonin. 

You must understand that there are different subtypes of serotonin receptors. Further, not all of these receptors are apparently involved in the antidepressant effects of SSRIs. 

Certain serotonin receptors play an insignificant role in regulating mood. Whereas the other serotonin receptors play an important role in treating mood disorders like depression.

On the other hand, a Selective Serotonin Reuptake Inhibitor is a drug typically used as an antidepressant. However, it increases the level of serotonin by limiting its reuptake into the pr-synaptic cell. 

Zoloft is an SSRI and is similar to drugs like Citalopram and Fluoxetine. 

StructureIts an SMSIt an SSRI
Names and IdentifiersIt is called VortioxetineIt is called Sertraline 
Physical PropertyIt is slightly soluble in water, white to very slightly beige powder It is a solid 
MedicationVortioxetine is suggested for the treatment of MDD. It is a serotonergic antidepressant used for the treatment of MDDSertraline is indicative for the management of MDD, Post-traumatic Stress Disorder (PTSD), OCD, Panic Disorder (PD), Prementrualdysphoric Disorder (PMDD), and Social Anxiety Disorder (SAD). The off-label uses for Sertraline include prevention of GAD, Post Stroke Depression, Premature Ejaculation, Fibromyalgia, etc. 
Trade NameTrintellix and BrintellixZoloft
Side EffectsCommon side effects include suicidal thoughts and behavior
Major side effects include Serotonin Syndrome when used with other serotonergic drugs
Mild agitation, minimal sedation. Moderately severe sexual effects, and moderately severe gastrointestinal effects
Absorption, Distribution, and ExcretionIt takes 7-12 hours post dosage to reach its maximum absorption. Further, it gets eliminated in up to 48 hours. It takes between 4.5-8.4 hours after administration for Sertraline to reach its peak plasma concentrations. Further, it gets eliminated in up to 66 hours. 
Formulations or PreparationsOral tablets – 5 mg, 10 mg and 20 mg.Oral tablets – 25 mg, 50 mg and 100 mg. It also comes in oral solution – 25 mg per ml. 

As per a meta-analysis, many antidepressants were analyzed for their efficacy and tolerability. In this analysis, even the active components of Trintellix and Zoloft were included.

Accordingly, it was observed that all the antidepressants were more effective than the placebo pill. However, Trintellix was observed to be more effective than other antidepressants but Zoloft was not. 

But, both Zoloft and Trintellix were found more tolerable antidepressants. Therefore, these drugs had lower discontinuation rates. 

Another study was conducted to observe the efficacy and tolerability of Vortioxetine in MDD patients. These patients responded inadequately to SSRIs like Zoloft.

The study indicated that Vortioxetine had a statistically significantly higher remission rate than Sertraline. 

Furthermore, the withdrawal rates due to adverse events were statistically significantly lower for Vortioxetine than Sertraline. 

Therefore, the study indicated that Vortioxetine is well tolerated as it has lower withdrawal rates relative to other antidepressants. 

Further, switching to Vortioxetine leads to higher remission rates relative to Sertraline and other similar antidepressants. 

Trintellix vs Viibryd

StructureIts an SMSIt an SSRI and Partial Serotonin Receptor Agonist 
Names and IdentifiersIt is called VortioxetineIt is called Vilazodone Hydrochloride
Drug InteractionsInteract with Monoamine Oxidase Inhibitors. Increases the risk of Serotonin Syndrome. A combination of Triptans with Trintellix should be avoided. Combined use of NSAIDs, alcohol, cough suppressant, dextromethorphan should be avoided.  Interact with Monoamine Oxidase Inhibitors. Increases the risk of Serotonin Syndrome. A combination of Triptans with Trintellix should be avoided. Combined use of NSAIDs, alcohol, cough suppressant, dextromethorphan should be avoided.  
MedicationVortioxetine is suggested for the treatment of MDD. It is a serotonergic antidepressant used for the treatment of MDDIt is a mood-stimulating drug that is used fundamentally in treating affective disorders and related conditions.
Trade NameTrintellix and BrintellixViibryd
Side EffectsCommon side effects include suicidal thoughts and behavior
Major side effects include Serotonin Syndrome when used with other serotonergic drugs
Common side effects include nausea, diarrhea, dizziness, dry mouth, and headaches. 
Other side effects include weight gain, insomnia, ejaculation disorder, or sexual dysfunction
Formulations or PreparationsOral tablets – 5 mg, 10 mg and 20 mg.Oral tablets – 20 mg and 40 mg.

As per a study, all antidepressants were more effective than placebo. However, Trintellix was found to be more effective than other antidepressants. 

Furthermore, Trintellix was found to be better tolerated relative to other antidepressants. 

Trintellix Mechanism of Action

Trintellix has a unique multimodal mode of action. Thus, it works through a combination of two mechanisms. One is Receptor Activity Modulation and the other is Reuptake Inhibition. 

In other words, Trinteliix is both an inhibitor of serotonin reuptake or blocks the receptor’s effect on serotonin. 

It is important to note that SMSs like Trintellix are the New-Generation Antidepressants (NGAs). After SSRIs were introduced, a host of other categories of antidepressants followed. 

These classes of antidepressants were identified by their main mechanisms of activity. 

Such classes of antidepressants include:

  • Serotonin and Norepinephrine
  • Serotonin Modulators and Stimulators (SMS); 
  • Serotonin Antagonists and Reuptake Inhibitors (SARI); 
  • Noradrenergic and Selective Serotonergic Antidepressants (NaSSA); 
  • Norepinephrine Reuptake Inhibitors (NeRI); 
  • Serotonin, Norepinephrine, and Dopamine Reuptake Inhibitors (SNDRI) or Triple Reuptake Inhibitors (TRI); and 
  • Melatonin and Serotonin Agonists (MaSA). 

Serotonin Modulator and Simulator (SMS) is a type of drug that changes the activity of various postsynaptic serotonin receptors. 

This is in addition to the function of inhibiting the reuptake of serotonin via the same mechanism as SSRI. 

The SMS antidepressants are alternative choices to SSRIs and SNRIs for treating MDD in adults. 

Traditionally, the research in the field of antidepressants considered developing drugs that bind to Serotonin Transporter (SERT). 

SERT transports serotonin from the synapse to the pre-synaptic neuron. However, when this transporter is inhibited, it causes an increase in the level of serotonin in the synapse. 

For your reference, the synapse is the neural junction between the two cells. Furthermore, the presynaptic cell is the one that releases neurotransmitters into the synapse. 

And the post-synaptic neuron is the nerve cell that receives the neurotransmitter after it passes through the synapse.

Now, it is important to note that many antidepressants also act on serotonin receptors known as 5-HT receptors. 

These receptors are a group of receptors that are found throughout your central and peripheral nervous system. 

You must note that the synaptic serotonin activates the serotonin receptors under normal conditions. 

Furthermore, the serotonin receptors are involved in both excitatory and inhibitory neurotransmission. 

Vortioxetine has a unique multimodal mechanism of action. One of the fundamental actions of Vortioxetine is that it blocks SERT as it has a great affinity for SERT. 

Thus, the natural reabsorption of serotonin gets reduced due to SERT blocked by Vortioxetine. 

Other functions of Vortioxetine include that it acts as:

  • 5 HT-1A agonist 
  • 5 HT-7 antagonism
  • 5 HT-1D antagonism
  • 5 HT-1B partial agonism 
  • 5 HT-3 antagonism