Trintellix

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Jul 20, 2022

Warnings

Trintellix Risks, Warnings, and Complications

Trintellix can cause serious health problems, especially in certain high-risk patients. Some of the risks of Trintellix treatment include:

SUICIDAL THOUGHTS OR BEHAVIOR: Trintellix and other antidepressants can increase the risk of suicidal thoughts or behavior. Young adults (people under the age of 24) are at increased risk. The risk is especially high in the first few months of initiating treatment. You should be vigilant for worsening depression or any unusual changes in mood or behavior. Family members should watch out for any new or worsening symptoms. Contact your healthcare provider if you experience clinical worsening and seek urgent care if needed.
SEROTONIN SYNDROME: Trintellix is a serotonin modulator that works by increasing serotonin levels. Rarely, taking antidepressant medications like Trintellix can lead to too much serotonin in the body, and a potentially life-threatening condition called serotonin syndrome. The risk of serotonin syndrome is higher if you take other serotonergic drugs. Serotonin syndrome symptoms include fever, confusion, sweating, fast heart rate, and muscle stiffness. Contact your healthcare provider immediately or seek emergency medical help if you experience these symptoms.
ABNORMAL BLEEDING: Taking Trintellix with certain medications like warfarin, aspirin, and nonsteroidal anti-inflammatory drugs like ibuprofen and naproxen can affect blood clotting and increase the risk of bleeding. Tell your healthcare provider if you take any of these medications before starting Trintellix.
HYPONATREMIA: Trintellix can put you at risk of developing a condition called “syndrome of inappropriate antidiuretic hormone secretion” (SIADH), which can cause hyponatremia (low sodium levels in the blood). Tell your healthcare provider if you experience symptoms such as headache, problems focusing, memory difficulties, confusion, unsteadiness, and weakness. The risk of this occurring is higher in elderly patients and patients taking diuretics (water pills).
EYE PROBLEMS: In people who have an underlying eye condition called angle-closure glaucoma, Trintellix can cause symptoms such as eye pain, swelling, redness, and vision changes. Tell your healthcare provider if you have any eye problems before starting Trintellix. Your doctor may order an eye exam before starting you on Trintellix drug therapy.
TRIGGERING OF MANIA: In a small number of patients treated with antidepressant drugs like Trintellix, it can trigger a manic episode with symptoms like racing thoughts, increased energy, trouble sleeping, extreme happiness, fast-talking, reckless behavior, and grand ideas. The risk is higher in people with a history of bipolar disorder or prior manic episodes. Tell your healthcare provider if you have a personal or family history of bipolar disorder before starting Trintellix.

Talk to your doctor or pharmacist about alternative treatments if you are at a high risk of complications from Trintellix use.

Precautions Before Starting Trintellix

Tell your healthcare provider if you have ever had an allergic reaction to Trintellix, any ingredients in Trintellix tablets, or any other medications. Your pharmacy can give you a list of ingredients.

Give your healthcare provider a complete medical history. Trintellix may not be suitable for people with certain medical conditions such as low sodium levels, heavy alcohol use, seizures, glaucoma, bleeding problems, or bipolar disorder.

Give your doctor a complete list of all your medications, including prescription medicines, over-the-counter medications, vitamins, dietary supplements, and herbal products. This can help avoid serious drug interactions between Trintellix and your other medicines.

Specifically, tell your doctor if you are taking supplements such as St. John’s Wort and tryptophan or prescription medications called monoamine oxidase inhibitors (MAOIs). MAOIs include medications such as linezolid (Zyvox), isocarboxazid (Marplan), phenelzine (Nardil), methylene blue, tranylcypromine (Parnate), and selegiline (Emsam, Zelapar). Also, tell your doctor if you have stopped monoamine oxidase inhibitors within the past 2 weeks. Your doctor may want to delay treatment initiation with Trintellix if you have taken an MAOI in the past 21 days.

Tell your doctor if you are pregnant, could be pregnant, plan to get pregnant, or are breastfeeding. Trintellix can cause neonatal complications, specifically persistent pulmonary hypertension in the newborn, if the mother takes Trintellix during the last few months of pregnancy.

Precautions During Use of Trintellix

Keep all your medical and lab appointments while on Trintellix. Doctors like to monitor patients and adjust the dose of Trintellix based on how well the medication is working and side effects if any.

Trintellix can affect your thinking, judgment, and movements. Do not drive or do anything that requires focus until you know how this medication affects you.

Tell your healthcare professionals you are on Trintellix before undergoing any surgery, including dental procedures.

Call your doctor if you become pregnant while on Trintellix.

Trintellix Drug Interactions

Taking Trintellix together with some other drugs can affect how the medications work. Drug interactions between medications can also increase the risk of serious adverse reactions. Your physician may choose different medications for you, change the dose or frequency of one or both medicines, and/or closely monitor you for side effects if there are known drug interactions between Trintellix and your other medications.

There can be potential interactions between Trintellix and the following medications:

Anticoagulants or blood thinners like warfarin (Coumadin, Jantoven) and heparin
Antiplatelet medications like clopidogrel (Plavix)
Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Motrin, Advil) and naproxen (Naprosyn, Aleve)
Medications used to treat ADHD, such as dextroamphetamine (Dexedrine, in Adderall), amphetamine (in Adderall, in Mydayis), and methamphetamine (Desoxyn)
Tricyclic antidepressants such as amitriptyline, nortriptyline (Pamelor), imipramine (Tofranil), desipramine (Norpramin), clomipramine (Anafranil), doxepin (Silenor), and amoxapine
Antidepressant drugs like bupropion (Wellbutrin, Zyban, Forfivo, Aplenzin, Contrave)
Anxiety medications like buspirone
Anti-seizure medications like carbamazepine (Tegretol, Carbatrol, Equetro) and phenytoin (Dilantin, Phenytek)
Diuretics or water pills
Opioid pain medications like fentanyl (Actiq, Duragesic, Fentora, Subsys) and tramadol (Ultram, Conzip, Qdola, in Ultracet)
Medications such as lithium that are used to treat psychiatric disorders
Medications for migraine headaches such as eletriptan (Relpax), almotriptan, frovatriptan (Frova), rizatriptan (Maxalt), naratriptan (Amerge), zolmitriptan (Zomig), and sumatriptan (Imitrex)
Heart medications like quinidine (in Nuedexta)
Antibiotics used to treat tuberculosis, such as rifampin (Rifadin, Rimactane)
Other antidepressant drugs (selective serotonin-reuptake inhibitors or SSRIs) such as fluoxetine (Prozac, in Symbyax), citalopram (Celexa), escitalopram (Lexapro), paroxetine (Brisdelle, Paxil, Pexeva), fluvoxamine (Luvox), and sertraline (Zoloft)
Antidepressant medications called serotonin and norepinephrine reuptake inhibitors (SNRIs), such as desvenlafaxine (Pristiq), venlafaxine (Effexor), and duloxetine (Cymbalta)

This list does not describe all possible Trintellix drug interactions. Give your healthcare professionals a complete list of your medications, including prescription drugs, over-the-counter medicines, vitamins, dietary supplements, and herbal products. Also, tell your health care provider if you smoke, drink alcohol, or use illegal drugs because some of these substances can cause serious health complications when used with prescription medicines.

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