Vortioxetine

Multimodal (SERT + 5HT1A/3/7)·Psychiatry - Antidepressants

Major Depressive Disorder

Authority requiredPBSMULTIMODALBrintellix5 mg tablet+2

Max Dose

20 mg/day

Half-life

66 h

Nausea

COMMON

Cognition

IMPROVES

Rapid Summary

Overview

Modern 'Multimodal' antidepressant. Combines SSRI activity with direct modulation of multiple other serotonin receptors. Clinically proven to improve cognitive fog in depression.

Maximum Dose

Max 20 mg/day.

Clinical Focus

Exceptionally high rates of nausea, but boasts zero weight gain and virtually zero sexual dysfunction.

Bottom Line

Vortioxetine is a multimodal antidepressant with pro-cognitive effects and good tolerability, but is expensive and nausea is common at higher doses.

Formulation & Access

Brand Names

Brintellix

Oral Routes

Tablets (5 mg, 10 mg, 20 mg).

Prescribing & PBS

Authority Required (PBS).

Indications & Use

Primary

PBSTGA

Major Depressive Disorder.

Clinical Place

Excellent 2nd-line option for patients who suffer from severe sexual dysfunction on SSRIs, or those complaining of profound 'brain fog' and poor concentration from their depression.

Quick reference

Class & Role

Multimodal (SERT + 5HT1A/3/7) — Modern 'Multimodal' antidepressant.

Route / Formulation

Tablets (5 mg, 10 mg, 20 mg). (Brintellix)

Usual Dose & Max

Start PO 10 mg OD. May increase to 20 mg/day or reduce to 5 mg/day based on response/nausea. Max 20 mg/day.

Key Indication Doses

Major Depressive Disorder: Start PO 10 mg OD. May increase to 20 mg/day or reduce to 5 mg/day based on response/nausea. Elderly (> 65 yrs): Start at 5 mg OD. Max 10 mg/day.

Best Uses

Vortioxetine is a multimodal antidepressant with pro-cognitive effects and good tolerability, but is expensive and nausea is common at higher doses.

Avoid / Cautions

Concurrent MAOI use. Pregnancy Category B3.

Key Risks

Gastrointestinal: Nausea (Affects up to 30% of patients, often transient but can be severe enough to cause cessation), vomiting, constipation. Neurological: Dizziness, abnormal dreams. Endocrine: Incidence of sexual dysfunction is at placebo levels (a massive advantage over SSRIs).

Key Interactions

Strong CYP2D6 inhibitors (Bupropion, Fluoxetine) double the blood levels of Vortioxetine. Halve the dose. Strong CYP inducers (Rifampicin, Carbamazepine) wipe out the drug. Must double the dose. Additive risk of Serotonin Syndrome with Tramadol or St John's Wort.

Monitoring

Counsel the patient to take the tablet with a large meal to blunt the intense nausea. No specific routine laboratory tests required.

Clinical Pearl

In clinical trials, Vortioxetine significantly improved executive function, processing speed, and memory in depressed patients independently of its mood-lifting effects. Great for working professionals.

Access

Authority requiredBrintellix5 mg tablet

Brand: Brintellix
PBS status: Authority required
Formulation: Tablets (5 mg, 10 mg, 20 mg)

Vortioxetine

Multimodal (SERT + 5HT1A/3/7)·Psychiatry - Antidepressants

Major Depressive Disorder

Authority requiredPBSMULTIMODALBrintellix5 mg tablet+2

Max Dose

20 mg/day

Half-life

66 h

Nausea

COMMON

Cognition

IMPROVES

Rapid Summary

Overview

Modern 'Multimodal' antidepressant. Combines SSRI activity with direct modulation of multiple other serotonin receptors. Clinically proven to improve cognitive fog in depression.

Maximum Dose

Max 20 mg/day.

Clinical Focus

Exceptionally high rates of nausea, but boasts zero weight gain and virtually zero sexual dysfunction.

Bottom Line

Vortioxetine is a multimodal antidepressant with pro-cognitive effects and good tolerability, but is expensive and nausea is common at higher doses.

Formulation & Access

Brand Names

Brintellix

Oral Routes

Tablets (5 mg, 10 mg, 20 mg).

Prescribing & PBS

Authority Required (PBS).

Indications & Use

Primary

PBSTGA

Major Depressive Disorder.

Clinical Place

Excellent 2nd-line option for patients who suffer from severe sexual dysfunction on SSRIs, or those complaining of profound 'brain fog' and poor concentration from their depression.

Quick reference

Class & Role

Multimodal (SERT + 5HT1A/3/7) — Modern 'Multimodal' antidepressant.

Route / Formulation

Tablets (5 mg, 10 mg, 20 mg). (Brintellix)

Usual Dose & Max

Start PO 10 mg OD. May increase to 20 mg/day or reduce to 5 mg/day based on response/nausea. Max 20 mg/day.

Key Indication Doses

Major Depressive Disorder: Start PO 10 mg OD. May increase to 20 mg/day or reduce to 5 mg/day based on response/nausea. Elderly (> 65 yrs): Start at 5 mg OD. Max 10 mg/day.

Best Uses

Vortioxetine is a multimodal antidepressant with pro-cognitive effects and good tolerability, but is expensive and nausea is common at higher doses.

Avoid / Cautions

Concurrent MAOI use. Pregnancy Category B3.

Key Risks

Key Interactions

Monitoring

Counsel the patient to take the tablet with a large meal to blunt the intense nausea. No specific routine laboratory tests required.

Clinical Pearl

Access

Authority requiredBrintellix5 mg tablet

Brand: Brintellix
PBS status: Authority required
Formulation: Tablets (5 mg, 10 mg, 20 mg)