Trintellix (Vortioxetine) - Treatment Overview
What Trintellix Is and What It Treats
Trintellix (vortioxetine) is an antidepressant medication approved for the treatment of major depressive disorder (MDD) in adults. 1 The drug has a unique pharmacological profile that combines serotonin transporter inhibition with modulation of multiple serotonin receptors (5-HT1A, 5-HT1B, 5-HT3, and 5-HT7). 1, 2
Clinical Efficacy
Depression Treatment
- Vortioxetine demonstrates efficacy as an antidepressant agent with generally good tolerability in adults with MDD. 1
- The drug's therapeutic effects may be independent of serotonin transporter (SERT) blockade, as demonstrated in animal models where antidepressant actions persisted despite reduced SERT interaction. 2
Cognitive Function Benefits
- Vortioxetine produces statistically significant and clinically meaningful improvements in cognitive performance across multiple domains, including executive function, attention, processing speed, learning, and memory. 1
- Improvements were demonstrated on objective measures (Digit Symbol Substitution Test and Rey Auditory Verbal Learning Test) across three large placebo-controlled studies. 1
- Cognitive benefits appear largely independent of improvements in depressive symptoms, making this particularly valuable for MDD patients with prominent cognitive dysfunction. 1
- Functional capacity also improved as measured by the University of San Diego performance-based skills assessment. 1
Important Safety Considerations
Brand Name Confusion
- The medication was originally marketed as Brintellix but was renamed to Trintellix in June 2016 due to prescribing and dispensing errors with the antiplatelet drug Brilinta (ticagrelor). 3, 4
- Clinicians should verify they are prescribing the correct medication, as confusion between these drugs poses serious safety risks—one treats depression while the other prevents cardiovascular events. 3, 4
- The formulation, indication, and dosage information remained unchanged with the name change. 4
Use in Breastfeeding
- Vortioxetine transfers into breast milk at low levels with a relative infant dose of 1.1% at 10 mg daily and 1.7% at 20 mg daily—both well below the 10% theoretical level of concern. 5
- No adverse effects were reported in breastfed infants in limited case series, though caution is warranted given the small sample size. 5
- Maximum milk concentrations were 13.89 ng/mL at 10 mg daily and 52.32 ng/mL at 20 mg daily, showing dose-proportional transfer. 5
Clinical Positioning
Vortioxetine represents a useful treatment option specifically for patients with MDD where cognitive impairment is a prominent feature. 1 Its dual benefit on both mood and cognitive function distinguishes it from traditional selective serotonin reuptake inhibitors (SSRIs), which primarily target depressive symptoms without the same degree of cognitive enhancement. 1