On September 2013, Brintellix (Vortioxetine) a new medication was approved by the FDA. It is indicated for the treatment of Major Depressive Disorder (MDD) in adults. The mechanism of its antidepressant effect is not completely known but it seems to have multiple mechanisms of actions unlike current antidepressant agents. It seems to inhibit the reuptake of serotonin but also seems to bind to some serotonin receptors. For example, it appears to have serotonin-3 and serotonin-7 receptor antagonism, serotonin-1A receptor agonism and partial serotonin-1B receptor agonism. It may offer relief to patients who have had poor or minimal efficacy with current antidepressant medications. Also, antidepressant efficacy was demonstrated in the elderly population.
The recommended starting dose is 5-10mg once daily, with an eventual increase to 20mg a day as tolerated. It can be taken with or without food.
- Nausea was the most common side effect reported. It mostly occurred within the first week of therapy but seemed to decrease for some people after 6-8 weeks of therapy. The nausea was considered to be mild or moderate in intensity.
- Dry Mouth
As with any antidepressant, there is a risk of causing increase suicidal ideas or increase in mania in patients with bipolar disease.
Also there can be a risk of abnormal bleeding as with any serotonergic antidepressant.
Serotonin Syndrome can be a life-threatening problem that can happen when serotonergic medications are mixed with other medications.
Suddenly stopping Brintellix without talking to your doctor can cause serious side effects.
This medication has not been tested in children so it is not recommended in the pediatric population.
As with any medication, only your prescriber can determine what medication is best for your specific situation and condition.
Baldwin DS, Hansen T, Florea I. Vortioxetine in the long-term open-label treatment of major depressive disorder. Curr Med Res Opin. 2012;28:1717-1724
Brintellix (Vortioxetine) [package insert] Deerfield, IL: Takeda Pharmaceuticals, Lundbeck; 2013.
Jain R, Mahableshwarkar AR, Jacobsen PL, Chen Y, Thase ME. A randomized, double-blind, placebo-controlled 6-wk trial of the efficacy and tolerability of 5 mg vortioxetine in adults with major depressive disorder. Int J Neuropsychopharmacol. 2013;16:313-321