An antidepressant
Vortioxetine
An antidepressant used for major depression, sometimes chosen when other antidepressants have not suited.
What is Vortioxetine?
Vortioxetine is an antidepressant used to treat major depression. It works on serotonin in several ways and is sometimes tried when other antidepressants have not worked well or have caused troublesome side effects. Like all antidepressants, it usually takes a few weeks to help.
Education and reference only. This is a plain-language guide to Vortioxetine — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Vortioxetine is a relatively newer antidepressant used in adults for major depression. It is often considered when an earlier antidepressant has not worked well enough or has caused side effects that are hard to live with. It is taken as a long-term, once-daily tablet rather than something used only when you feel low.
How it works
Vortioxetine acts mainly on serotonin, a brain chemical involved in mood. As well as blocking the reuptake of serotonin (the way most SSRIs work), it also acts directly on several serotonin receptors, which is why it is described as "multimodal". The overall effect is to gradually lift low mood and related symptoms over a few weeks.
Company & origin
Originated / developed by: Lundbeck and Takeda (originators).
A multimodal antidepressant introduced in the 2010s for major depression.
What it treats
Conditions Vortioxetine is used for
Practical use
How to take Vortioxetine
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is usually taken once a day, with or without food, at a time you can keep to consistently.
- Give it time — mood often takes a few weeks to lift, so don't expect an instant change.
- Don't stop suddenly, even if you feel better or feel no benefit; stopping abruptly can cause withdrawal-type effects.
- Tell your prescriber promptly if your mood worsens or you have thoughts of self-harm, especially early on.
- If you miss a dose, take it when you remember unless it is nearly time for the next one, in which case skip the missed dose — never double up.
Weighing it up
Advantages & disadvantages of Vortioxetine
Advantages
- May suit people who have not done well on, or could not tolerate, an earlier antidepressant.
- Tends to cause less weight gain and fewer sexual side effects than some other antidepressants.
- Taken just once a day, which makes it easy to fit into a routine.
Disadvantages
- Nausea is fairly common, particularly when first starting.
- Like other antidepressants, it takes weeks rather than days to help.
- It is a newer, often more expensive option, so is usually not the first antidepressant tried.
Practical use
Good to know
It usually takes a couple of weeks before any benefit is noticed and several weeks for the full effect, so it is worth persevering unless side effects are a problem. Nausea is the most common nuisance effect and often settles. Like all antidepressants it should not be stopped suddenly, as this can cause discontinuation symptoms; any plan to stop is normally done by tapering with your prescriber. Anyone starting an antidepressant should be watched for worsening mood or thoughts of self-harm, particularly in the first weeks and in people under 25.
Who should not take it / use with caution
- People taking, or who have recently taken, an MAOI antidepressant — combining them risks dangerous serotonin syndrome.
- Used with caution in people with a history of mania or bipolar disorder, or with a bleeding tendency.
- Care is needed in pregnancy and breastfeeding, and the benefits and risks should be discussed with your prescriber.
Monitoring
- Mood and any thoughts of self-harm, especially in the first weeks and in people under 25.
- Response to treatment and any side effects at review appointments.
- Signs of serotonin syndrome if combined with other serotonin-acting medicines.
Side effects
- Nausea is the most common effect, especially at first, and often settles with time.
- Headache, dizziness, dry mouth, constipation or diarrhoea, and unusual dreams can occur.
- Rarely, signs of serotonin syndrome (agitation, sweating, shivering, fast heartbeat) or worsening mood and thoughts of self-harm — seek prompt help.
Key interactions
- Must not be combined with MAOI antidepressants, and other serotonin-raising medicines (such as triptans, tramadol or other antidepressants) raise the risk of serotonin syndrome.
- Caution with medicines that increase bleeding risk, such as anti-inflammatory painkillers, aspirin and anticoagulants.
- Some medicines and St John's wort can affect vortioxetine levels — tell your pharmacist about everything you take.
Available as: Tablets.
Answers
Vortioxetine: frequently asked questions
How long does vortioxetine take to work?
Some improvement is often seen within a couple of weeks, but the full effect can take several weeks. It is worth continuing unless side effects are troublesome.
Will it cause weight gain or sexual problems?
It tends to cause less weight gain and fewer sexual side effects than some other antidepressants, though everyone responds differently. Tell your prescriber if these are a problem.
Can I stop taking it once I feel better?
Don't stop suddenly. Antidepressants are usually continued for several months after you feel well, and stopping is done gradually to avoid discontinuation symptoms.
Is vortioxetine the same as Brintellix?
Yes. Vortioxetine is the active-ingredient name and Brintellix is a brand name for the same medicine.
Can I drink alcohol with it?
Alcohol can worsen low mood and may add to drowsiness. It is best kept to a minimum, particularly while you are settling on treatment.
Authoritative sources
- BNF: Vortioxetine.
- NICE CKS: Antidepressants.
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