From the FDA Drug Label
The dose should then be increased to 20 mg/day, as tolerated (2. 1). Consider 5 mg/day for patients who do not tolerate higher doses (2.1).
The recommended dose increase for vortioxetine (Brintellix) at a time is 10 mg, as the initial dose is 10 mg and it should be increased to 20 mg/day as tolerated. However, for patients who do not tolerate higher doses, a dose of 5 mg/day should be considered. 1
From the Research
The recommended dose increase for vortioxetine (Brintellix) is 5 mg at a time, allowing at least one week between dose increases, as supported by the most recent and highest quality study 2. When adjusting the dosage of vortioxetine, clinicians should increase the dose in 5 mg increments. This gradual titration approach helps minimize side effects while allowing the body to adjust to the medication.
- Vortioxetine is typically initiated at 10 mg once daily for most adults with major depressive disorder, with a target dose range of 5-20 mg daily depending on individual response and tolerability.
- The maximum recommended daily dose is 20 mg.
- Patients who are known CYP2D6 poor metabolizers should start at 5 mg daily with a maximum of 10 mg daily, as they process the medication more slowly.
- Common side effects during dose increases include nausea, vomiting, and diarrhea, which often improve with continued treatment.
- If side effects are problematic during titration, maintaining the current dose for an additional week before attempting another increase may improve tolerability, as suggested by 3, 4, 5, 6. However, the most recent study 2 provides the strongest evidence for the recommended dose increase, and its findings should be prioritized in clinical practice.