Vortioxetine

Antidepressant Drug

Drug class: Selective Serotonin Reuptake Inhibitor

Vortioxetine (BRINTELLIX)（中文：沃替西汀）

Common Strengths of Vortioxetine

Vortioxetine are available in the following strengths:

• 5 mg, 10 mg, 20 mg tablets

Drug Trade Names of Vortioxetine

Brintellix

Drug Usage

Treatment of major depressive disorder in adults

Mechanism of Action

Vortioxetine has a miltimodal mechanism of action:

• Serotonin reuptake inhibitor
• 5-HT_1A receptor agonist
• 5-HT_1B receptor partial agonist
• 5-HT₃, 5-HT_1D and 5-HT₇ receptor antagonist

Route of Administration

Oral

Dosages

• Starting dose: 10 mg once daily
• Maintenance dose: 5 - 20 mg once daily
• Maximum dose: 20 mg/day

Side Effects

Frequency	Adverse reactions
Common	Nausea: This is the most frequently reported side effect, occurring in up to 42% of patients
	Constipation or diarrhoea: Reported in up to 15% of patients
	Vomiting
	Dry Mouth: Using sugar-free gum or candy can help alleviate dry mouth
	Dizziness: Moving slowly when changing positions can help reduce dizziness
	Headache: Drinking plenty of fluids and resting can help; avoid excessive alcohol consumption
	Sexual Dysfunction: This includes decreased libido and difficulty achieving orgasm
Serious	Serious side effects are less common but require immediate medical attention.
	Suicidal Thoughts or Actions: especially in the first few months of treatment or when the dose is changed. Symptoms include new or worsening depression, anxiety, or unusual changes in mood or behavior.
	Serotonin Syndrome: This potentially life-threatening condition can occur when there is too much serotonin in the body. Symptoms include agitation, hallucinations, rapid heart rate, fever, nausea, vomiting, diarrhea, and muscle twitching
	Severe Allergic Reactions: These include symptoms like difficulty breathing, swelling of the face, lips, tongue, or throat, and severe rash or hives
	Abnormal Bleeding: Can manifest as unusual bruising or bleeding
	Low Sodium Levels: Particularly in older adults, symptoms include headache, confusion, weakness, and difficulty concentrating
	Mania: Symptoms include excessively high energy, severe trouble sleeping, racing thoughts, reckless behavior, and unusually grand ideas
	Angle-closure glaucoma (eye pain, vision changes)
	Withdrawal Symptoms: If the medication is abruptly stopped, symptoms may include anxiety, irritability, mood swings, restlessness, changes in sleep habits, headache, sweating, shaking, nausea, dizziness, and electric shock-like sensations.

Pharmacokinetics

• Metabolism: Primarily via CYP2D6
• Elimination: Half-life approximately 66 hours
• Onset: 2 - 4 weeks for full antidepressant effect

Drug Precautions

Pregnancy

Use only if potential benefit outweighs risk. May cause withdrawal symptoms in newborns if used in third trimester.

Breastfeeding

Use caution

Children and Elderly

• Not approved for use in children <18 years
• No dosage adjustment required for elderly patients

Monitoring Requirements

• Monitor for clinical worsening and suicidal thoughts, especially early in treatment
• Monitor for signs of serotonin syndrome
• Monitor for signs of abnormal bleeding

Drug Interactions

• Strong CYP2D6 inhibitors: Reduce vortioxetine dose by half
• Strong CYP inducers: Consider dose increase
• Anticoagulants: Monitor for increased bleeding risk

FAQ

How Should I Take the Tablet?

Take once daily with or without food

What Should I Avoid While Taking?

Avoid alcohol. Use caution when driving or operating machinery until you know how it affects you.

What Happens if I Miss a Dose?

Take the missed dose as soon as you remember unless it is almost time for your next dose. Do not double doses.