Does Trintellix (vortioxetine) cause weight gain?

Trintellix and Weight Gain

Trintellix (vortioxetine) does not cause significant weight gain and is considered weight-neutral based on clinical evidence. 1

Evidence on Trintellix and Weight

The FDA drug label for Trintellix specifically addresses weight effects, stating that "TRINTELLIX had no significant effect on body weight as measured by the mean change from baseline in the 6 to 8 week placebo-controlled studies." Furthermore, in a six-month, double-blind, placebo-controlled phase of a long-term study, "there was no significant effect on body weight between TRINTELLIX and placebo-treated patients." 1

This weight-neutral profile distinguishes Trintellix from many other antidepressants that are known to cause weight gain.

Comparison with Other Antidepressants

When considering antidepressant options with respect to weight effects:

• Weight gain-promoting antidepressants:

  • Tricyclic antidepressants (TCAs), particularly amitriptyline 2, 3
  • Mirtazapine 2
  • Lithium 2
  • Monoamine oxidase inhibitors (MAOIs) 2
  • Paroxetine (among SSRIs) 2

• Weight-neutral or weight loss-promoting antidepressants:

  • Trintellix (vortioxetine) 1
  • Fluoxetine and sertraline (short-term weight loss, long-term weight neutrality) 2
  • Bupropion (consistently promotes weight loss) 2

Clinical Implications

Weight gain is a significant concern in antidepressant therapy because:

1. It can lead to treatment discontinuation, with weight gain being the most common reason patients stop taking certain antidepressants 4, 3
2. It may contribute to metabolic complications and reduced quality of life
3. Weight gained during therapy may be difficult to lose even after discontinuation 4

For patients with obesity or those concerned about weight gain:

• Trintellix represents a good option due to its weight-neutral profile
• Patients taking medications associated with weight gain are less likely to succeed in weight management programs 5

Special Considerations

For obese patients taking Trintellix, be aware that:

• The half-life of vortioxetine is significantly prolonged in obese individuals (3.26 days vs. 2.21 days in normal-weight controls) 6
• This may require extending the washout period when switching from Trintellix to a monoamine oxidase inhibitor (MAOI) beyond what is recommended in the product label to avoid serotonin syndrome 6

Monitoring Recommendations

While Trintellix is weight-neutral, individual responses can vary. Therefore:

• Monitor weight at baseline and periodically during treatment
• If unexpected weight changes occur, evaluate for other potential causes
• Document weight changes to help inform future medication choices

By selecting Trintellix for patients concerned about weight gain, clinicians can potentially improve medication adherence and long-term outcomes while effectively treating depression.