What is Brintellix?

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 Brintellix (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 Brintellix (vortioxetine) tablets

• 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 Brintellix (vortioxetine) cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects, although not everyone experiences them. 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.

The most common side effects of Brintellix include:

• nausea,
• diarrhea,
• constipation,
• vomiting,
• sexual dysfunction,
• dry mouth,
• gas,
• dizziness,
• abnormal dreams, and
• itching

Brintellix may cause serious side effects including: 

Get medical help right away, if you have any of the symptoms listed below.

• suicide thoughts or attempts,
• acting on dangerous impulses,
• acting aggressive, angry or violent,
• new or worsening depression,
• new or worsening anxiety,
• restlessness,
• irritableness,
• trouble sleeping,
• manic behavior,
• unusual changes in behavior or mood,
• panic attack, and
• new or worsening irritability

References:

https://www.fda.gov/media/86743/download

https://www.webmd.com/drugs/2/drug-165188/brintellix-oral/details

https://www.rxlist.com/brintellix-drug.htm

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4296590/

https://www.medicines.org.uk/emc/product/7121/smpc#gref

https://www.psychdb.com/meds/antidepressants/serotonin-modulator/vortioxetine

https://patient.info/medicine/vortioxetine-for-depression-brintellix