Generic name: Vortioxetine (vor tye OX e teen)
Medication class: Selective serotonin reuptake inhibitor/5HT1A agonist/5HT1B partial agonist/5HT3, 5HT1D, 5HT 7 antagonist
Vortioxetine is an antidepressant medication that works in the brain. It is approved for the treatment of major depressive disorder (MDD).
Symptoms of depression include:
Do not stop taking vortioxetine, even when you feel better. Only your healthcare provider can determine the length of treatment that is right for you.
Missing doses of vortioxetine may increase your risk for relapse in your symptoms.
Stopping vortioxetine abruptly may result in one or more of the following withdrawal symptoms: headache, muscle tension, mood swings, sudden outbursts of anger, dizziness, and/or runny nose.
Depression is also a part of bipolar illness. People with bipolar disorder who take antidepressants may be at risk for "switching" from depression into mania. Symptoms of mania include "high" or irritable mood, very high self esteem, decreased need for sleep, pressure to keep talking, racing thoughts, being easily distracted, frequently involved in activities with a large risk for bad consequences (for example, excessive buying sprees).
Medical attention should be sought if serotonin syndrome is suspected. Please refer to serious side effects for signs/symptoms.
If you are planning on becoming pregnant, notify your healthcare provider to best manage your medications. People living with MDD who wish to become pregnant face important decisions. Untreated MDD has risks to the fetus, as well as the mother. It is important to discuss the risks and benefits of treatment with your doctor and caregivers.
For mothers who have taken SSRIs during their pregnancy, there appears to be less than a 1% chance of infants developing persistent pulmonary hypertension. This is a potentially fatal condition that is associated with use of the antidepressant in the second half of pregnancy. However, women who discontinued antidepressant therapy were five times more likely to have a depression relapse than those who continued their antidepressant. If you are pregnant, please discuss the risks and benefits of antidepressant use with your healthcare provider.
Regarding breast-feeding, caution is advised since it is not known if vortioxetine passes into breast milk.
Vortioxetine is usually taken one time per day without regard to meals.
Typically patients begin at a low dose of medicine and the dose is increased slowly over several weeks.
The dose usually ranges from 5 mg to 20 mg. Only your healthcare provider can determine the correct dose for you.
Consider using a calendar, pillbox, alarm clock, or cell to help you remember to take your medication. You may also ask a family member or friend to remind you or check in with you to be sure you are taking your medication.
If you miss a dose of vortioxetine, take it as soon as you remember, unless it is closer to the time of your next dose. Discuss this with your healthcare provider. Do not double your next dose or take more than what is prescribed.
Avoid drinking alcohol or using illegal drugs while you are taking antidepressant medications. They may decrease the benefits (e.g., worsen your condition) and increase adverse effects (e.g., sedation) of the medication.
If an overdose occurs, call your doctor or 911. You may need urgent medical care. You may also contact the poison control center at 1-800-222-1222.
A specific treatment to reverse the effects of vortioxetine does not exist.
Common Side Effects
Nausea, constipation, vomiting, sexual dysfunction, dizziness, diarrhea.
Rare/Serious Side Effects
Serotonin syndrome (symptoms may include shivering, diarrhea, confusion, severe muscle tightness, fever, seizures, and death), increased bleeding (e.g., gums may bleed more easily), low sodium blood levels (symptoms of low sodium levels may include headache, weakness, difficulty concentrating and remembering)
To date, there are no known problems associated with long term use of vortioxetine. It is a safe and effective medication when used as directed.
Vortioxetine should not be taken with or within 2 weeks of taking monoamine oxidase inhibitors (MAOIs). These include phenelzine (Nardil®), tranylcypromine (Parnate®), isocarboxazid (Marplan®), and selegeline (Emsam®).
Although rare, there is an increased risk of serotonin syndrome when vortioxetine is used with other medications that increase serotonin, such as other antidepressants, migraine medications called "triptans" (e.g., Imitrex®), some pain medications (e.g., tramadol (Ultram®), and the antibiotic linezolid (Zyvox®).
Vortioxetine may increase the effects of other medications that can cause bleeding (e.g., ibuprofen (Advil®, Motrin®), warfarin (Coumadin®) and aspirin)
The following medications may increase the levels and effects of vortioxetine: bupropion (Wellbutrin®), fluoxetine (Prozac ®), paroxetine (Paxil®), quinidine.
The following medications may decrease the levels and effects of vortioxetine: rifampin (Rifadin®), carbamazepine (Tegretol®), phenytoin (Dilantin®).
Sleep, energy, or appetite may show some improvement within the first 1-2 weeks. Improvement in these physical symptoms can be an important early signal that the medication is working. Depressed mood and lack of interest in activities may need up to 6-8 weeks to fully improve.
Provided by the College of Psychiatric and Neurologic Pharmacists
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