Try to take vortioxetine at the same time each day.
It may take up to four weeks after starting this treatment before you feel the full benefit. Do not stop taking it, feeling it is not helping.
Tell your doctor if you feel that you are not getting any better, or if you experience any troublesome side-effects.
|Type of medicine||Antidepressant; serotonin re-uptake inhibitor and dual 5-HT agonist/antagonist|
Vortioxetine is prescribed for depression that has not been helped by treatment with other antidepressant medicines. Depression can develop for no apparent reason, or it can be triggered by a life event such as a relationship problem, bereavement, or an illness. Depression is caused by an imbalance of certain chemicals in the brain. Altering the levels of the chemicals in the brain can help ease symptoms of depression.
Brain cells, called neurons, release a number of chemicals which go on to stimulate other neurons. This leads to electrical impulses which control the functions of the brain and body. Serotonin is one such important chemical in the brain. It is also called 5-HT. Once released, serotonin stimulates other neurons before being taken back up and recycled. Vortioxetine stops serotonin being taken back up by the neurons and so increases the amount of circulating serotonin available in your brain.
Vortioxetine also works in other ways. Serotonin stimulates neurons by attaching to small 'receptors' on the surface of the cells. There are different types of serotonin, or 5-HT, receptor, leading to the release of chemicals with different effects in the brain. Vortioxetine blocks some 5-HT receptors and stimulates others in order to re-balance the brain's chemistry and ease symptoms.
Before taking vortioxetine for depression
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking vortioxetine it is important that your doctor knows:
- If you are pregnant, trying for a baby or breastfeeding.
- If you are under 18 or over 65 years of age.
- If you have any problems with the way your liver works or the way your kidneys work.
- If you have epilepsy or have had a fit (seizure) in the past.
- If you have ever had a bleeding disorder.
- If you have been told you have low levels of sodium in your blood.
- If you have ever had abnormally 'high' moods, called mania.
- If you are being treated with electroconvulsive therapy (ECT).
- If you have ever had an allergic reaction to a medicine.
- If you have taken an antidepressant known as a monoamine-oxidase inhibitor (MAOI) within the previous two weeks.
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
How to take vortioxetine tablets
- Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The manufacturer's leaflet will give you more information about vortioxetine and a full list of side-effects which you may experience from taking it.
- Take vortioxetine tablets exactly as your doctor tells you to - the directions will be printed on the label of the pack to remind you of what your doctor said. The usual starting dose is 10 mg taken once daily. Depending on how you respond to the medicine it may be increased to 20 mg or reduced to 5 mg once daily.
- You can generally take vortioxetine at a time to suit you, but try to take your dose at the same time of day, each day.
- You can take vortioxetine before or after food. Swallow the tablet with a glass of water.
- If you forget to take a dose, take it as soon as you remember. If you do not remember until the following day, skip the missed dose. Do not take two doses together to make up for a forgotten dose.
Getting the most from your treatment
- It is important to keep your regular appointments with your doctor. This is so your doctor can check on your progress and adjust your dose if necessary.
- You may feel that vortioxetine is not working for you straightaway. It may take a week or two after starting this treatment before the effect begins to build up, and 4-6 weeks before you feel the full benefit. Do not stop taking it after a week or two, feeling it is not helping.
- While you are taking vortioxetine you may have thoughts about harming yourself or ending your life. These thoughts may also be associated with your depression. It is very important that you tell your doctor about this if it happens.
- Do not stop taking vortioxetine unless your doctor tells you to do so. You should expect that a course of treatment will last for several months. This is normal and helps to prevent your symptoms from recurring. You should continue to take vortioxetine for at least six months after you feel well again.
- If you drink alcohol, ask your doctor for advice. Your doctor is likely to recommend that you do not drink alcohol while you are on vortioxetine.
- If you buy any medicines, check with a pharmacist that they are safe to take with vortioxetine. This is because several medicines which are available from general retail outlets can interfere with this treatment. In particular, do not take the herbal remedy St John's wort, and ask for advice before buying any anti-inflammatory painkillers.
- If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking vortioxetine for depression.
Can vortioxetine cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects, although not everyone experiences them. The table below contains some of the most common ones associated with vortioxetine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Common vortioxetine for depression side-effects||What can I do if I experience this?|
|Feeling sick (nausea) or being sick (vomiting)||Stick to simple foods|
|Constipation||Eat a well-balanced diet and drink plenty of water each day|
|Loose, watery stools (diarrhoea)||Drink plenty of water. If the diarrhoea is severe or continues for more than a week, let your doctor know|
|Itchy skin||Ask your pharmacist to recommend a suitable antihistamine|
|Feeling dizzy||If this happens, do not drive and do not use tools or machines until you feel better|
|Unusual dreams||Let your doctor know if this becomes troublesome|
On rare occasions, medicines that affect the level of serotonin in the brain can cause it to go too high and cause problems. The risk is higher if you are taking more than one medicine with this effect. Seek medical attention if you develop any combination of the following:
- Stiff muscles or 'jerky' movements.
- Unusually fast heartbeat.
- High temperature (fever), feeling or being sick, diarrhoea.
- Feeling delirious or seeing visions (hallucinating).
If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.
How to store vortioxetine tablets
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Brintellix® 5 mg, 10 mg, 15 mg, 20 mg tablets; Lundbeck Limited, The electronic Medicines Compendium. Dated June 2019.
British National Formulary, 77th Edition (Mar 2019); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.