Is Trintellix (vortioxetine) good for anxiety?

• Although Trintellix is not approved for anxiety, it has been used off-label to treat generalized anxiety disorder (GAD).
• It appears to work best in those with severe GAD (HAMA of >25).
• People with anxiety who were taking Trintellix were more likely to experience a response and remission than those taking placebo.

Although Trintellix is only approved for treating depression, it may be used off-label to treat anxiety. Off-label means the drug is being used for a different purpose than that which it has been approved for.

An analysis of four well-conducted trials investigating the effects of Trintellix for generalized anxiety disorder showed:

• Patients with severe GAD (Hamilton Anxiety Rating Scale [HAMA] total score of at least 25 had a significantly greater effect from Trintellix than those without.
• People were more likely to experience response (Odds ratio: 1.2) and remission (Odds ratio: 1.05) with Trintellix than they were taking a placebo (pretend) pill.
• People taking Trintellix were more likely to discontinue it than people taking placebo.

The authors concluded that because of the limited number of trials, more trials are needed before Trintellix is given routinely for GAD.

What is Trintellix?

Trintellix (vortioxetine) is an antidepressant that is usually used to treat the symptoms of major depressive disorder. Trintellix was previously called Brintellix but the name was changed in 2016 after confusion in the marketplace between Brintellix and another medicine.

Trintellix only needs to be taken once a day. You can choose whether you take Trintellix in the morning or at night; however, if you find Trintellix interferes with your sleep or makes you restless or energized, try taking it in the morning.

How does Trintellix work?

Experts aren’t sure exactly how Trintellix works but it is thought to be due to its increasing levels of a neurotransmitter, called serotonin in the brain. It also has effects on other serotonin receptors, such as 5-HT1A (agonist effects) and 5-HT3 (antagonist effects), although experts are not sure if this action contributes to vortioxetine’s antidepressant effect.

Trintellix is different from other antidepressants currently on the market because of its direct effects on various serotonin receptors as well as inhibiting serotonin reuptake. Because it acts as an antagonist/agonist and partial agonist, this is thought to enhance its antidepressant effects and prevent desensitization of the presynaptic neuron. It aims to reduce depressive symptoms and prevent them from returning.

Trintellix is classified as a miscellaneous antidepressant, although some classify it as an SSRI (selective serotonin reuptake inhibitor) and a serotonin receptor modulator.