From the Guidelines
Yes, reflux can appear as a side effect of Trintellix (vortioxetine) later in treatment, even if you didn't experience it initially. Gastrointestinal side effects, including acid reflux, nausea, and constipation, are among the most common side effects of Trintellix, affecting approximately 20-30% of patients. These side effects can emerge at any point during treatment, though they often appear within the first few weeks. According to a recent clinical practice update on the personalized approach to the evaluation and management of GERD, patients with typical reflux symptoms and no alarm symptoms can be managed with a stepwise diagnostic approach, including lifestyle modifications and a trial of single-dose PPI therapy 1. If you develop reflux while taking Trintellix, try taking the medication with food, avoiding lying down for 30 minutes after taking it, and limiting spicy foods, caffeine, and alcohol. Over-the-counter antacids may help manage symptoms, but consult your healthcare provider before adding any medications. This delayed onset of side effects can occur because your body's response to the medication may change over time as it fully adjusts to the serotonergic effects of the drug.
Management of Reflux Symptoms
- Take Trintellix with food to reduce gastrointestinal side effects
- Avoid lying down for 30 minutes after taking the medication
- Limit spicy foods, caffeine, and alcohol
- Consider over-the-counter antacids, but consult your healthcare provider before adding any medications If reflux symptoms become severe or persistent, contact your healthcare provider, as they may recommend dosage adjustments or alternative treatments, and may consider objective reflux testing, such as upper GI endoscopy or prolonged wireless pH monitoring, to establish a diagnosis of GERD and guide long-term management 1.
From the Research
Side Effects of Trintellix
- Trintellix, also known as vortioxetine, is a novel antidepressant that has been associated with various side effects, including nausea, vomiting, and unexpected adverse events such as vision blurred, bruxism, and disturbance in attention 2
- The median onset time of adverse events associated with vortioxetine was 7 days, and most adverse events (75.10%) occurred within the first month after initiation of the medication 2
Gastroesophageal Reflux Disease (GERD) and Trintellix
- There is no direct evidence in the provided studies that links Trintellix to an increased risk of GERD or reflux symptoms
- However, studies have shown that proton-pump inhibitors (PPIs), which are commonly used to treat GERD, may have varying effects on the healing of erosive esophagitis and the relief of heartburn symptoms 3, 4
- Vonoprazan, a potassium-competitive acid blocker, has been shown to be effective in healing and maintaining the healing of erosive esophagitis, and relieving heartburn symptoms in patients with non-erosive GERD 3, 4
Reflux Symptoms and Antidepressant Use
- A study on the association between GERD symptoms, PPI use, and esophageal carcinogenesis found that patients with severe GERD symptoms were less likely to have adenocarcinogenesis, and that PPI use was associated with a higher risk of adenocarcinogenesis in patients with mild or absent GERD symptoms 5
- Another study found that a significant proportion of patients with esophageal adenocarcinoma had preoperative GERD symptoms, PPI use, or a diagnosis of Barrett's esophagus, and that these factors were associated with a survival advantage 6