Side Effects of Trintellix: What to Know

Medically Reviewed By Melissa Badowski, PharmD, MPH, FCCP
Trintellix has a boxed warning for risk of suicidal thoughts and behaviors in children and young adults. This is a serious warning from the Food and Drug Administration (FDA). For details, see the “ Trintellix: Side effects explained” section below. Also, keep in mind that Trintellix is only approved for use in adults.

Trintellix: Introduction

Trintellix is a brand-name prescription drug. It’s a type of medication called an atypical antidepressant, and it contains the active drug vortioxetine. It comes as a tablet and is taken by mouth.

Trintellix is approved by the Food and Drug Administration (FDA) to treat major depressive disorder, which is also called depression, in adults. It’s typically used long term if you and your doctor agree the drug is working well.

Similar to other drugs, Trintellix may cause side effects. Read below for information about possible side effects, including common, mild, and serious ones.

For a general overview of Trintellix, including details about its uses, see this article.

If you’d like to take Trintellix, search here to find a healthcare professional who might prescribe it.

Trintellix: More common side effects

Some of Trintellix’s side effects may be more common than others. These side effects may last only a few days to weeks. However, some side effects may last longer or become severe or bothersome. Tell your doctor or pharmacist if you have concerns about any side effects with Trintellix.

In clinical studies of Trintellix, these were some side effects that occurred more often:

  • constipation
  • vomiting
  • nausea*

* For more information about this side effect, see “Trintellix: Side effects explained” below.

Trintellix: Mild side effects

Trintellix can cause mild side effects, which are listed below. However, this list doesn’t include all possible mild side effects. To learn more about Trintellix’s side effects, view the drug’s prescribing information.

Trintellix’s mild side effects include:

The side effects listed above may last only a few days to weeks. However, some side effects may last longer or become severe or bothersome. Tell your doctor or pharmacist if you have concerns about side effects with Trintellix.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you develop a side effect while taking Trintellix and want to tell the FDA about it, visit MedWatch.

* For more information about this side effect, see “Trintellix: Side effects explained” below.

Trintellix: Serious side effects

It’s possible to have serious side effects with Trintellix. Serious side effects are listed below, but this list may not include all possibilities. To learn more about Trintellix’s side effects, view the drug’s prescribing information.

Call your doctor right away if you have serious side effects with Trintellix. However, if you think you’re having a medical emergency or life threatening side effects, call 911 or your local emergency number.

Serious side effects of Trintellix and their possible symptoms include:

  • Serotonin syndrome (a condition in which there’s an increased amount of serotonin in the body). Symptoms can include:
    • agitation or confusion
    • flushing
    • hallucination (hearing or seeing things that aren’t real)
    • high body temperature
    • sweating
  • Hyponatremia (low sodium level). Symptoms can include:
    • balance and coordination problems, which may lead to falls
    • confusion
    • headache
    • memory problems
    • trouble concentrating
    • weakness
  • Sexual side effects, such as decreased libido.*
  • Withdrawal symptoms, especially if Trintellix is stopped suddenly.*
  • Risk of suicidal thoughts and behaviors in certain people.‡
  • Allergic reaction.†

* For more information about this side effect, see “Trintellix: Side effects explained” below.
† An allergic reaction is possible after taking Trintellix. However, this side effect wasn’t reported in clinical studies. To learn more, see “Trintellix: Side effects explained” below.
Trintellix has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Trintellix: Side effects explained” section below.

Trintellix: Side effects explained

Here’s detailed information about some of Trintellix’s side effects.

Risk of suicidal thoughts and behaviors in certain people

Trintellix has a boxed warning about the risk of suicidal thoughts and behaviors in certain people. A boxed warning is the strongest warning required by the Food and Drug Administration (FDA). These warnings alert doctors and patients about drug effects that may be dangerous.

Clinical studies have shown that antidepressants, including Trintellix, can increase the risk of suicidal thoughts and behaviors in children and young adults. (Keep in mind, though, that Trintellix is only approved for use in adults.) Specifically, this risk affects people ages 24 years and younger. The risk is highest when you begin treatment or any time your doctor changes your dosage.

However, there were no reports of suicidal thoughts or behaviors in clinical studies of Trintellix. Also, it’s important to note that depression and other mental health conditions are the most significant causes of suicidal thoughts and behaviors. And Trintellix is prescribed to treat depression.

In adults ages 24 and older, antidepressants such as Trintellix help decrease the risk of suicidal thoughts and behaviors.

What to do

Trintellix is only approved for treating depression in adults. It’s not approved for use in children.

While you’re taking Trintellix, your doctor will monitor you for changes, including suicidal thoughts or behavior. It’s important to keep all appointments with your doctor so they can check in with you regularly.

It’s also important to monitor yourself for these changes. It may be helpful to let a few loved ones or friends know that you’re taking Trintellix. They can also help watch for any changes in your mood or behavior.

Call your doctor right away if you have sudden or new changes in your mood, behavior, or feelings. Seek immediate medical help, such as by calling 911 or going to an emergency room, if you have any of the following:

  • thoughts about suicide or dying
  • feelings of aggression or violence
  • urges to act on dangerous impulses
  • new or worsening panic attacks or anxiety

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide

Prevention Lifeline is available 24 hours per day at 800-273-8255. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 800-273-8255.

Click here for more links and local resources.

Sexual side effects

Treatment with Trintellix can cause sexual side effects, including decreased libido. This isn’t unique to Trintellix because antidepressant medications are known to cause sexual side effects. (Trintellix is an atypical antidepressant.)

Sexual side effects with Trintellix have been reported in both males and females.* The side effects may include those shown below.

Sexual side effects in males Sexual side effects in females
erectile dysfunction decreased libido
delayed ejaculation • delayed orgasm
• inability to ejaculate inability to orgasm
• decreased libido  

* Sex and gender exist on spectrums. In this article, use of the terms “male” and “female” refers to sex assigned at birth.

It’s important to note that sexual dysfunction can be caused by other factors, including mental health conditions such as depression. And Trintellix is prescribed to treat depression in adults.

What to do

Talk with your doctor if you’re concerned about sexual side effects of Trintellix or you experience these side effects during treatment. They may suggest certain treatments depending on your symptoms, other medical conditions you may have, and other medications you may take.

Withdrawal symptoms

It’s possible to experience withdrawal symptoms after stopping treatment with Trintellix. This is especially the case if treatment is stopped suddenly. In clinical studies, withdrawal symptoms were rarely reported in people taking 15-milligram (mg) or 20-mg doses of Trintellix.

Withdrawal symptoms from Trintellix may include:

  • confusion
  • dizziness
  • irritation or agitation
  • headache
  • sudden shifts in mood
  • muscle tremors
  • nausea
  • sweating more than usual
  • trouble sleeping

What to do

Due to the risk of withdrawal symptoms, it’s important that you do not stop taking Trintellix unless your doctor specifically tells you to do so.

If you and your doctor agree that you’ll stop taking Trintellix, your doctor will lower your dosage over time. They’ll do this until it’s safe for you to stop taking the drug. Lowering your dosage slowly over time helps reduce your risk of withdrawal symptoms.

Nausea

Nausea was the most common side effect reported by people taking Trintellix in clinical studies. Nausea was also the most common side effect that caused people to stop taking the drug in these studies.

Here are some key facts about Trintellix and nausea:

  • The risk of nausea is higher with higher Trintellix doses.
  • In clinical studies, nausea due to Trintellix was more common in females than in males.*
  • Nausea is most common during the first week of treatment, and it can happen as soon as the first day.
  • Nausea often goes away on its own as a person continues their treatment with Trintellix.

Nausea can also be a symptom of more serious side effects of Trintellix. These include serotonin syndrome and withdrawal symptoms. (Serotonin syndrome is a condition in which there’s an increased amount of serotonin in the body.) For more details about withdrawal symptoms, see “Withdrawal symptoms” directly above.

* Sex and gender exist on spectrums. In this article, use of the terms “male” and “female” refers to sex assigned at birth.

What to do

Nausea often goes away on its own after a few days or weeks. You may find this article helpful for learning ways to ease nausea.

However, if your nausea is bothersome or won’t go away, talk with your doctor. They may prescribe an antiemetic, which is a medication used for nausea. If your nausea still doesn’t go away, your doctor may suggest that you stop treatment with Trintellix.

Itching

Itching is a possible side effect of Trintellix. However, this side effect wasn’t common in the drug’s clinical studies.

The risk of itching increases slightly with higher doses of Trintellix. However, there’s not a major difference between doses of the drug.

What to do

Itching caused by Trintellix may go away on its own within a few days. For tips on how to relieve itching, see this article.

If your itching is bothersome or doesn’t go away, call your doctor. They can evaluate your symptoms and check for other possible causes. Your doctor may also prescribe a topical cream or other medication to help relieve your itching.

It doesn’t appear that anyone who took Trintellix in clinical studies stopped the medication due to itching. However, it’s possible your doctor may suggest doing so if no other method works to relieve your symptoms.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Trintellix. A more severe allergic reaction is rare but possible.

Allergic reactions don’t appear to have occurred in clinical studies of Trintellix. However, they have been reported since the drug was approved for use.

Possible symptoms of mild and serious allergic reactions are listed in the table below.

Mild allergic reaction symptoms Serious allergic reaction symptoms
• itching trouble breathing
rash • swelling in your throat or mouth
flushing • swelling under your skin, possibly in your hands, feet, lips, or eyelids

If you have an allergic reaction to Trintellix, call your doctor right away. This is important to do because the reaction could become severe.

However, if you’re having a medical emergency or your symptoms feel life threatening, call 911 or a local emergency number.

Trintellix: Common questions about side effects

Here are some common questions about the drug’s side effects and answers to them. Talk with your doctor if you have other questions about this drug.

Does Trintellix cause weight gain?

Weight gain wasn’t a side effect reported in clinical studies of Trintellix.

However, weight gain has been reported in a few people taking Trintellix since the drug was approved for use. Because this side effect happened after clinical studies were completed, it’s hard to know whether it was caused by Trintellix or other factors.

Weight gain is a known side effect of many antidepressants, and some are more likely to cause this side effect than others. Trintellix is an antidepressant. However, it has a lower risk of weight gain compared with other antidepressants.

Talk with your doctor if you’re concerned about weight changes with Trintellix. They can recommend ways to manage a healthy weight.

Are side effects of Trintellix 10-mg doses different from side effects of other doses?

The side effects of Trintellix 10-milligram (mg) doses aren’t different from the side effects of other doses.

However, the risk of certain side effects can vary slightly with different doses of the drug. Higher doses of Trintellix have a higher risk of causing these side effects:

  • nausea
  • diarrhea
  • constipation
  • vomiting
  • dizziness
  • unusual dreams
  • itching

To view a complete list of side effects and learn how often they occurred with certain doses, see the full prescribing information for Trintellix. Your pharmacist or doctor can also tell you more.

Is fatigue a side effect of Trintellix?

No, fatigue isn’t a known side effect of Trintellix. Fatigue wasn’t reported by people taking Trintellix in clinical studies.

Fatigue can be caused by depression, which Trintellix is used to treat.

In addition, certain other antidepressants can cause fatigue, particularly older ones such as amitriptyline. Fatigue is less common with newer antidepressants, but it can still occur. That said, Trintellix isn’t expected to cause this side effect.

Talk with your doctor if you’re experiencing fatigue. If this is a symptom of depression, it may go away during treatment with Trintellix. Your doctor can also suggest ways to relieve your fatigue.

Can Trintellix cause euphoria?

No, Trintellix doesn’t cause euphoria.

Some drugs are misused because they produce feelings of euphoria, causing a person to feel “high.” There are reports of misuse with bupropion (Wellbutrin SR, Wellbutrin XL) and certain other antidepressants in attempts to cause euphoria. (Misuse means a drug is taken in a way other than how it was prescribed.)

However, Trintellix isn’t known to cause euphoria. If you’d like to know more about what to expect with Trintellix, talk with your doctor.

Will I have joint pain with Trintellix?

Joint pain wasn’t a side effect reported by people taking Trintellix in clinical studies.

Depression can cause physical symptoms, including joint pain. And Trintellix is prescribed to treat depression. So, depression treatments such as Trintellix may actually relieve joint pain if it’s related to depression.

If you’re experiencing joint pain with Trintellix, talk with your doctor. They may suggest ways to help ease your discomfort.

Trintellix: Precautions

There are certain precautions to consider before beginning treatment with Trintellix. This includes a boxed warning, which is described below.

Boxed warning: Risk of suicidal thoughts and behaviors in certain people

This drug has a boxed warning for risk of suicidal thoughts and behaviors in children and young adults. This is a serious warning from the Food and Drug Administration (FDA). For details, see the “Trintellix: Side effects explained” section above. Also, keep in mind that Trintellix is only approved for use in adults.

Other precautions

Be sure to talk with your doctor about your health history before you take Trintellix. This drug may not be the right treatment option for you if you have certain medical conditions or other factors that affect your health.

The conditions and factors to consider include those described below.

Bipolar disorder. Antidepressants such as Trintellix may lead to mania in people with bipolar disorder if the drug is used to treat a depressive episode. Due to this risk, doctors most likely will not prescribe Trintellix to people with bipolar disorder.

Bleeding problems. Antidepressants such as Trintellix can increase the risk of bleeding. If you already have a bleeding problem, such as hemophilia, taking Trintellix may increase your risk of bleeding. And this includes major bleeds, such as hemorrhage. Your doctor can determine whether Trintellix is safe to take if you have a bleeding problem.

Glaucoma. In people with glaucoma, Trintellix can cause an eye problem called angle-closure glaucoma. This is a medical emergency that can cause vision loss within a day if left untreated. Before prescribing Trintellix, your doctor may examine your eyes to see if you’re at risk of angle-closure glaucoma. If so, there are procedures that can help reduce your risk. Your doctor can tell you more about the safety of taking Trintellix if you have glaucoma.

Low sodium level. Treatment with Trintellix can cause low sodium level. If your sodium level is already low, taking Trintellix may worsen your condition. Your doctor may want to treat your low sodium level before prescribing Trintellix to you.

Epilepsy or seizures. Trintellix may trigger seizures in people with epilepsy or those who already have seizures. Talk with your doctor about the safety of taking Trintellix if you have seizures. They may monitor you closely during treatment if they prescribe this drug to you.

Allergic reaction. If you’ve had an allergic reaction to Trintellix or any of its ingredients, your doctor will likely not prescribe Trintellix. Ask your doctor what other medications may be better options for you.

Consuming alcohol during Trintellix treatment

There’s no known interaction between consuming alcohol and taking Trintellix.

However, alcohol and Trintellix can cause some of the same side effects. Combining alcohol and Trintellix may increase the risk of these side effects or increase their severity. These side effects include:

If you drink alcohol, talk with your doctor about whether it’s safe to do so while you’re taking Trintellix.

* To learn more about these side effects with Trintellix, see “Trintellix: Side effects explained” section above.

Pregnancy and breastfeeding during Trintellix treatment

The safety of taking Trintellix during pregnancy isn’t fully understood. Some studies have found that taking antidepressants during the third trimester can cause complications in a newborn. These include difficulty feeding and trouble breathing.

If you and your doctor decide you’ll take Trintellix while pregnant, consider joining the drug’s pregnancy registry. Pregnancy registries collect information about the safety of taking medications such as Trintellix during pregnancy. You can join the registry or learn more by calling 844-961-2388 or visiting this site.

It’s not known whether Trintellix passes into breast milk or whether it could cause side effects in a child who’s breastfed. Talk with your doctor about feeding options for your child if you’re taking Trintellix.

Trintellix: What to discuss with your doctor

Talk with your doctor or pharmacist to find out more about Trintellix. If you have questions about the drug’s side effects, your pharmacist or healthcare professional can help answer them for you.

In addition to discussing Trintellix with your doctor, you may find the following articles helpful in learning more.

  • Overview of Trintellix. To read an overview of Trintellix, see this article.
  • Drug comparison. To learn how Trintellix compares with Viibryd, read this article.
  • Details about depression. To learn more about depression, which Trintellix is used to treat, see this article.

Disclaimer: Healthgrades has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Medical Reviewer: Melissa Badowski, PharmD, MPH, FCCP
Last Review Date: 2022 May 31
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.