Can you take Trintellix for anxiety? Here’s what our research shows

Trintellix is a prescription antidepressant that’s FDA approved to treat major depressive disorder (MDD). It works by balancing levels of the neurotransmitter serotonin, which plays an important role in mood, emotions, and appetite. Because serotonin is believed to help regulate anxiety, Trintellix is also sometimes used off-label to treat anxiety. Let’s take a more in-depth look at taking Trintellix for anxiety. 

Does Trintellix work for anxiety?

Trintellix is one of the brand-names of the generic medication vortioxetine, which belongs to a group of medications called selective serotonin reuptake inhibitors (SSRIs). Trintellix used to be called Brintellix, but it was renamed in 2016 because it was frequently getting confused with an antiplatelet medication called Brilinta. Renaming the medication to Trintellix has helped minimize confusion in doctors and patients. 

Trintellix is an SSRI that can help improve a person’s mood, emotions, and sleep patterns. The Food and Drug Administration (FDA) has only approved Trintellix to treat major depressive disorder, but it can be prescribed off-label to treat anxiety.

Off-label prescribing happens when a doctor prescribes a patient a medication that’s FDA approved to treat a condition that’s different from what the patient has. This is a common occurrence that’s completely legal to do, and it’s estimated that about 1 in 5 prescriptions are actually off-label prescriptions. 

So a doctor can write someone with anxiety a prescription for Trintellix, but why might they do this when there are so many other anti-anxiety medications on the market? Trintellix blocks serotonin reuptake like other SSRIs, but unlike other antidepressants, it also has agonist and antagonistic effects on the 5-HT1A and 5-HT3 serotonin receptors in the brain. Researchers aren’t exactly sure how this works, but they believe it contributes to the antidepressant effects of Trintellix.        

Studies have shown that Trintellix improves symptoms of generalized anxiety disorder more than a placebo and that it is effective and tolerable in patients with severe anxiety. A meta-analysis study published in the Current Drug Targets journal found that Trintellix is effective for people with anxiety disorder with only mild to moderate side effects. Overall, it has proven to be effective at reducing anxiety and depression symptoms for people with major depressive disorder or high levels of anxiety.      

Starting Trintellix for anxiety

Starting any new medication can be stressful, and if you already have anxiety, then knowing what to expect when you start taking Trintellix can help make the process easier. One of the most important things to be aware of when you first start taking Trintellix is that it isn’t a fast-acting medication. It may take some time before you start to see your anxiety symptoms get better. It can take two to four weeks (or longer) to feel the full effects of Trintellix.

Dosage

Trintellix is available as an immediate-release tablet in three dosage strengths: 5 mg, 10 mg, and 20 mg. The usual starting dose of Trintellix is 10 mg taken once per day with or without food. This dosage may be increased to 20 mg per day or decreased to 5 mg per day depending on how the drug is working or any side effects experienced. 

The exact amount of Trintellix that you’ll need to take and how long you’ll need to take it will vary based on your individual symptoms and medical history. Taking higher doses or more than one dose of Trintellix in an attempt to make it work faster isn’t safe and may cause side effects. This is why it’s important to talk with your healthcare provider about the appropriate dosage for managing your anxiety. If you’ve taken too much Trintellix you should call your doctor or the Poison Control Center at 1-800-222-1222. They will be able to advise you on whether or not you should visit an emergency room or urgent care center.     

Interactions

Trintellix shouldn’t be taken at the same time as certain medications because of potential drug-drug interactions. It shouldn’t be taken within two weeks of taking: 

• Monoamine Oxidase Inhibitors (MAOIs)
• Methylene blue
• Linezolid 

Trintellix shouldn’t be taken within two weeks of taking a monoamine oxidase inhibitor (MAOI), and an MAOI shouldn’t be taken within 21 days of stopping Trintellix because of a heightened risk of experiencing serotonin syndrome. Serotonin syndrome is a potentially life-threatening condition that happens when too much serotonin builds up in the body. Symptoms of serotonin syndrome include shivering, tremors, high blood pressure, rapid heart rate, confusion, muscle rigidity, and seizures.  

You should tell your doctor if you’re taking any of the following medications as well, because they may affect how Trintellix works or increase the risk of side effects: 

• Other depressants
• Antipsychotic medications 
• Over-the-counter pain medications like NSAIDs or aspirin 
• Blood thinners like Coumadin (warfarin)
• Triptan medicines or tryptophan supplements
• Diuretics
• St. John’s Wort
• Carbamazepine 
• Fentanyl 
• Lithium 
• Phenytoin 
• Quinidine
• Bupropion 
• Buspirone  
• Rifampin 
• Tramadol 

Side effects

When you first start taking Trintellix, you may experience some possible side effects. Some people may experience feeling restless or energized soon after taking a dose, which could lead to trouble sleeping. Here are some other common side effects that people experience when they start taking Trintellix:

• Nausea
• Vomiting
• Constipation
• Diarrhea
• Dry mouth
• Muscle stiffness 
• Gas 
• Weight gain 
• Abnormal dreams 
• Eye pain
• Vision changes
• Dizziness
• Sexual dysfunction   

It’s important that you avoid missing a dose of Trintellix to ensure treatment remains consistent and decreases the risk of relapse in depressive symptoms. If you do miss a dose it’s best to take your next dose as soon as you remember, unless it’s almost time to take your next dose. Doubling up on doses can cause side effects and, in rare cases, may cause serotonin syndrome. Many healthcare providers will recommend taking Trintellix at approximately the same time every day.   

Although it’s rare, Trintellix can cause more serious side effects that may require medical attention. The FDA label for Trintellix contains a boxed warning for potential suicidal thoughts and behaviors, especially in children, adolescents, and young adults. If you’re taking Trintellix and start to have any suicidal thoughts or behaviors, you should seek medical help right away.

Trintellix can also cause serious side effects like:  

• Unusual bleeding
• Unusual bruising
• Mania or hypomania in people with bipolar disorder
• Angle closure glaucoma
• Low sodium levels in the blood (hyponatremia)

If you experience any of these side effects while taking Trintellix you should talk with your healthcare provider as soon as you can. If you are allergic to vortioxetine or any of the other ingredients in Trintellix should avoid taking the medication because it may cause allergic reactions. 

Restrictions

People with bipolar disorder should take Trintellix only if approved by their doctor because it may cause manic episodes. People with glaucoma and bleeding disorders should only take Trintellix under the supervision of a doctor since it may increase the risk of bleeding episodes and worsen closed-angle glaucoma.  

Certain medications are unsafe for elderly patients, but Trintellix has been shown to be tolerable and safe for adults older than 65 years old. Clinical studies have shown no difference in safety or efficacy between older adults and younger adults, and there has been no noticeable difference in response to the medication between older and younger adults either. Trintellix is not approved for any patients under the age of 18. 

Trintellix may affect the fetus in pregnant women. Taking Trintellix in the third trimester of pregnancy may lead to an increased risk of a condition called persistent pulmonary hypertension in newborns. There’s no data on Trintellix and how it affects breast milk or breastfed infants, which is why it’s important to weigh the benefits and risks of using the medication while breastfeeding with a healthcare provider.      

What is the most effective antidepressant for anxiety?

There isn’t one medication that is most effective at treating anxiety. What works for one person may not work for another, but the good news is that there are many different types of antidepressants that can treat mental health conditions like anxiety. In addition to SSRIs, here are some other categories of antidepressants:  

• Serotonin and norepinephrine reuptake inhibitors (SNRIs): increase the availability of serotonin and norepinephrine in the brain.
• Tricyclic antidepressants: increase levels of serotonin and norepinephrine in the brain and block acetylcholine. 
• Monoamine oxidase inhibitors (MAOIs): prevent the enzyme monoamine oxidase from removing dopamine, serotonin, and norepinephrine from the brain.  

Here are some of the most effective antidepressants for anxiety.