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A pill bottle with pills coming out: Does Trintellix cause sexual side effects?
Drug Info

Does Trintellix cause sexual side effects?

Trintellix is less likely to cause sexual side effects than other popular antidepressants
Sarah Bradley writer headshot
By | Aug. 19, 2024 Medically reviewed by Leslie Greenberg, MD

Key takeaways

  • As an antidepressant, Trintellix can cause negative sexual side effects like lower libido and difficulty with arousal or orgasm.

  • Trintellix is a serotonin modulator, which means it works like an SSRI but has an added mechanism of action that may reduce its overall effects on sex drive.

  • In studies and clinical trials, Trintellix has been shown to have fewer side effects than popular SSRIs like Zoloft and Lexapro. 

  • There are ways to manage the sexual side effects of any antidepressant, including Trintellix, aside from discontinuing or changing your medication. 

In this article:

For some people with major depressive disorder (MDD), the antidepressant medication Trintellix (vortioxetine) plays an important role in treatment. Trintellix was approved by the Food and Drug Administration (FDA) in 2013 to treat adults with MDD and is in the family of antidepressants called a serotonin modulator. It works in multiple ways to treat depression symptoms, including functioning as a selective serotonin reuptake inhibitor (SSRI).

A common concern people have when considering taking an antidepressant is whether it will affect their sexual performance since side effects like low libido and difficulty with arousal are often reported with antidepressant use. While Trintellix can cause sexual side effects for some people, studies suggest its classification as a serotonin modulator makes it less likely to affect sexual performance than other similar antidepressants, such as Zoloft (sertraline) and Paxil (paroxetine). 

Here’s what to know about the potential for sexual side effects on Trintellix, including what to do if you think Trintellix is affecting your sexual performance.  

The connection between antidepressants and sex drive

According to Alex Dimitriu, MD, psychiatrist, sleep medicine specialist, and founder of Menlo Park Psychiatry & Sleep Medicine, certain antidepressants—particularly SSRIs, which affect your serotonin levels—can cause a decrease in sex drive because they block specific receptors in the brain that contribute to sexual arousal.

Additionally, increasing serotonin levels with SSRIs can lower the amount of dopamine in your brain, the “feel-good” hormone tied to desire.

“Very generally speaking, there is a balance in the brain between serotonin and dopamine, and for some people, increasing serotonin can lower dopamine,” Dr. Dimitriu says. “I often tell my patients that SSRIs dull the passions, bad and good.” 

Trintellix sexual side effects

The manufacturer of Trintellix, Takeda Pharmaceuticals USA, does report sexual side effects as a possibility when taking the drug. In its own clinical trials, Takeda found that up to 5% of people with MDD taking Trintellix reported sexual side effects after six and eight weeks of treatment. More side effects were reported in people taking higher doses, and side effects were more common in females than males. These side effects included lower sex drive, difficulty becoming aroused, and delay or failure to have an orgasm or ejaculation.

In studies, though, Trintellix is associated less with sexual side effects than other types of antidepressants. Arpit Aggarwal, MD, University of Missouri Health Care psychiatrist, points to an eight-week study of participants who switched from Zoloft, Celexa (citalopram), or Paxil to either Trintellix or Lexapro (escitalopram) after reporting sexual side effects. In the study, participants who switched to Trintellix showed more improvement in sexual performance than participants who switched to Lexapro.

“One possible reason for this,” explains Dr. Aggarwal, “is that in addition to acting as an SSRI, Trintellix binds to certain receptors in the brain called 5-HT1A receptors, possibly helping mitigate the sexual dysfunction that typically happens with SSRIs.”  

This is also true for another serotonin modulator called Viibryd (vilazodone): “Antidepressants like vortioxetine or vilazodone have built-in mechanisms in addition to the SSRI effect, to reverse some of the unwanted side effects,” Dr. Dimitriu says.

Other antidepressants with a low risk of sexual side effects

“There are many types of antidepressants, and different types work in different ways,” Dr. Dimitriu says. Some of them don’t affect serotonin levels at all, making them less likely to cause sexual side effects. In addition to Trintellix and Viibryd, Wellbutrin (bupropion) and Remeron (mirtazapine) have been shown to be the least likely antidepressants to cause sexual side effects.

In contrast, Dr. Dimitriu says monoamine oxidase inhibitor (MAOI) antidepressants and Paxil have historically been associated with the most severe sexual side effects.

How to manage sexual side effects of antidepressants

Dr. Dimitriu says it’s important to note that while some antidepressants are known to cause a decline in libido and ability to climax, these effects are also often experienced with untreated anxiety or depression. In other words, concerns about a lower sex drive shouldn’t keep you from properly treating and managing your symptoms with medication if your healthcare provider thinks it will help you.

It also shouldn’t cause you to suddenly stop Trintellix, especially not without talking to your provider first. 

“Stopping abruptly can result in many unwanted symptoms, including severe mood swings, depression, and irritability, which would be avoided with a more gradual discontinuation,” Dr. Dimitriu says. 

RELATED: What happens if I suddenly stop taking Trintellix?

As far as switching to another antidepressant to avoid sexual side effects, remember that Trintellix is actually associated with fewer sexual side effects than many other antidepressants, including SSRIs, because of its unique method of action. Although you and your provider may ultimately decide to switch to a Trintellix alternative like Wellbutrin or Remeron, keep in mind that there are ways to manage the side effects of antidepressants that don’t include changing your medication. 

Dr. Dimitriu says prioritizing healthy behavioral habits—like sleeping well, exercising, eating a nutritious diet, and spending time outdoors or in social situations—can help reduce antidepressant adverse side effects, and so can lowering your dose to an amount that still provides mental health benefits but doesn’t affect your sex drive. 

There may also be other medications you can take to offset the sexual side effects of Trintellix. However, Dr. Dimitriu advises trying lifestyle and dose changes first before introducing new medications. 

“Some people benefit from the addition of medications like buspirone or Wellbutrin,” he explains, “and other people benefit from the use of [erectile dysfunction] medications like Viagra (sildenafil).”