Medications for treating depression are of different types, from SSRIs, SNRIs, tricyclic antidepressants, atypical depressants, MAOIs, NMDA agonist and GABA-A receptor positive modulator. Trintellix is one among the different types of medication used in treating MDD, acronym for major depressive disorder. Following subsections offer detailed information about the medication, its mechanism of action, and possible side effects of Trintellix to help users exercise the required level of caution when using the medication. As the drug is intended to be taken on a long-term basis, it is essential to be on guard to prevent or mitigate any possible adverse effects.
Overview of the antidepressant
Belonging to the category of SMS (serotonin modulator and stimulator), the medication is also used for treating other conditions, listed below. The drug is known to be effective for treating this category of depression mainly due to its multimodal mechanism of action. It modulates receptors, while at the same time inhibiting the reuptake of serotonin. The main reason behind the development of SMS is the different subtypes of serotonin receptors, wherein some receptors do not have a role in antidepressant effects. MDD is known as a severe form of depression, and the drug is FDA approved for treating this condition; however, the drug is also used off label for other conditions, including:
- Generalized anxiety disorder
- ADHD (attention deficit hyperactivity disorder)
- OCD (obsessive-compulsive disorder)
Incorrect dosage and schedule are identified as some of the main reasons for undesirable outcomes in medications. Patients are often known to increase dosage or frequency of intake in an effort to quicken the pace of treatment. This does not have any positive impact on the patient, whereas, it ends up causing undesirable outcomes. The right dosage is determined by various factors, including the severity of the condition being treated, existence of other conditions, intake of other medications, age and gender. Trintellix is often started with a small dose, that is incrementally increased to reach the recommended dosage. When prescribed for depression, the maximum dosage is 20 mg, with a starting dose of 10 mg. In the event of any side effects being experienced, the dosage is reduced accordingly. Patients are advised not to take double doses to make up for missed doses.
Warnings about its use
While the drug as mentioned above is used off label for certain other conditions, it is warned against use in specific cases. For instance, the medication is not be used as treatment for children; and this includes youngsters. The drug is known to induce suicidal tendencies, and it is therefore strictly warned against use in youngsters. As patients belonging to the vulnerable categories, the possibility of committing suicide is higher in youngsters.
Effectiveness of the antidepressant when treating major depressive disorder
The medication is known to be effective in treating the symptoms linked to major depressive disorder. Patients have recorded a clear reduction in symptoms, and the drug is known to be similar in effectiveness to SNRIs (serotonin-norepinephrine reuptake inhibitors). By virtue of its mechanism of action and the unique manner in which it works, it is also known by as atypical/multimodal/ miscellaneous. Available as a tablet, it is available in strengths of 5 mg, 10 mg and 20 mg, and contains vortioxetine.
Commonly reported side effects of Trintellix
All medications come with the possibility of undesirable effects and Trintellix is no exception. Unwanted outcomes are primarily attributed to the mechanism of action of the drugs, or the properties of active ingredients. These effects are broadly classified in to mild/moderate or serious/adverse. The former category of effects is known to be relatively frequently occurring and may not require any medical intervention in most cases. The effects generally resolve or wear off after a days or weeks, without any intervention. However, the serious or adverse effects require medical attention; in some instances, this may also require emergency medical attention at a healthcare facility. However, the rate of occurrence of such effects is rare.
The actual effects depend on a variety of reasons. This includes, the dosage, the schedule of intake, the condition being treated, the duration of treatment, overall health of the patient, age, gender, existing health issues, and medications in use. Here is a compilation of some of the known effects experienced by patients. This is intended to serve as a reference of the type of effects and is not claimed to be exhaustive in nature.
Frequently occurring effects of Trintellix
Effects that may frequently occur include the possibility of feelings of nausea, that may or may not be accompanied by diarrhea. Patients may at times experience vomiting sensations, while some may end up with a dry mouth. Bouts of constipation is also a possibility, while some are known to have dizzy feelings. Build-up of gas/flatulence is another effect that patients may have to contend with frequently. There is also the likelihood of individuals experiencing abnormal dreams as a result of the drug’s properties. Itching sensations may increase, and the individual may require some symptomatic treatment to handle increased pruritus.
Effects that are a cause for concern
As mentioned above, there is also the possibility of serous effects. This includes the likelihood of developing serotonin syndrome, which is regarded as a serious drug reaction. This is caused when medications end up spiking the levels of serotonin, a neurotransmitter. It is produced in the body naturally and is responsible for various functions in the brain and nerve cells. When the levels of serotonin are excessive (typically caused by external intake), various symptoms are known to manifest. This includes diarrhea and shivering that are classified as mild symptoms of excessive serotonin. When the levels are high, severe effects may be experienced, such as high fever, possible seizures and rigidity in the muscles. When left untreated, this may result in possible fatalities.
Options exist to stop the effects of serotonin syndrome, which includes discontinuation of the drug(s), and intake of medications that block serotonin. There are clear tell-tale symptoms of serotonin syndrome, that can be identified, and followed up with suitable action. This includes possible confusion and anxiety in the patients. The individual may also suffer muscle spasms when serotonin spikes. The possibility of diarrhea is also strong, while a relatively common symptom is a pacy heartbeat and possible increase in blood pressure levels.
Other effects that are concerning, include possible bleeding that is serious in nature. Bleeding could take the form of mild bleeding in the nose, that is relatively less concerning, while serious bleeding may also occur either in the brain or the stomach. The patient may also end up with lower levels of sodium in the body. This could pose complications and needs to be treated to restore the levels of sodium. Symptoms that indicate low sodium levels include, possible headache, and the individual may appear confused. The patient may appear weak/unsteady, and may also have difficulty in concentrating on simple tasks due to low sodium levels.
There is the possibility of impact on vision, with patients developing closed angle glaucoma. This occurs when the iris blocks the drainage angle in the eye. When the drainage angle gets blocked fully, it results in a condition known as acute attack. The impact on vision is serious and this requires to be treated at a specialist facility on observing symptoms.
Effects that are psychological, sexual in nature
The drug is also known to have a psychological impact. Patients may develop suicidal tendencies, and the symptoms of depression may also worsen. This needs to be treated at the earliest, as depression can result in a host of health and psychological problems. Effects that could manifest due to the drug includes sexual effects, wherein the individual ends up with lesser sexual drive. The patient may also have to contend with erectile dysfunction and this could pose relationship problems, in addition to causing severe mental anguish.
Other frequently recorded side effects of the antidepressant
There is a possibility of patients increasing weight as a result of the medication. The impact on sexual ability or functions is not limited to males, with females also experiencing the negative fallouts of the drug on sexual performance. For women, the impact on sexual performance includes dryness in the vagina, and possible dysfunction in orgasm. Men and women on the medications are to seek suitable medical advice regarding these effects. There is also the possibility of individuals finding it difficult to fall asleep. Such conditions, medically known as insomnia are usually known to resolve when the drug is discontinued.
Loss of hair is another possible negative fallout of the drug. This could pose additional problems to patients. As the drug is intended for MDD, the patient is likely to have been in some kind of depressive episode or feeling. When hair loss ends up as a new or additional effect, this could affect the individual at a psychological level.
Drug interactions of Trintellix
In addition to the side effects of Trintellix there is also the possibility of drug interactions. Such interactions are common to all medications and is attributed to the conflicting mechanisms of action and the properties of two or medications that are taken together for treating different conditions. The interaction is not limited to prescription medications alone, but may also be experienced with OTC formulations, herbal products, health supplements, food products, alcohol, intoxicants, and alternative medicines. The types of interaction include increased potency of either of the two products, decreased potency of either of the two products, or an aggravation of the side effects of one or both the products. Specialists typically discontinue or temporarily suspend either of the two medications, depending on their importance. However, in the event that the medications are equally important, then the dosage and schedule is altered to minimise the possible interactions.
Bleeding is a possible outcome of drug interaction when Trintellix is taken along with medications belonging to the nonsteroidal anti-inflammatory drugs category, blood thinners and aspirin. Symptoms of bleeding can be discerned easily; for instance, bleeding may turn abnormally uncontrollable, or there could be traces of blood in urine. This could appear as discolored urine, with a reddish, pinkish or brownish hue. Stools may also be discolored, indicating possible bleeding; such as reddish or black colored stools. The individual may also begin coughing up blood, or blood may be observed in vomit.