Highlighting uses, dosage, how to take & discontinue, side effects, pros & cons, and more


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Brand & Generic Names; Drug Classes

US brand name: Brintellix
Generic name: vortioxetine

Drug Class(es)

Primary drug class: Antidepressants
Additional drug class(es): Miscellaneous Antidepressants

Approved & Off-Label Uses (Indications)

Brintellix’s US FDA Approved Treatment(s)

Major depressive disorder (MDD) Approved 30 September 2013.

Brintellix is one of very few meds approved as a both short-term (acute) and long-term (maintenance, continuation, chronic) treatment of MDD. It’s the only crazy med I know of that hit the market approved for both, regardless of the condition it was treating.

Uses Approved Overseas but not in the US

In Australia Brintellix is also approved to treat the combination of MDD with high levels of anxiety.

Off-Label Uses of Brintellix

  • Improving cognitive function in depressed adults
  • Generalized Anxiety Disorder (GAD) . In four studies Brintellix failed three times and passed once, so don’t expect to see it approved to treat anxiety.
  • I haven’t found any references for this, but because of its AP-like properties and little-to-no discontinuation symptoms, I’d like to see how 5 mg a day of Brintellix would work to wean people off of Paxil or Effexor who aren’t able to otherwise stop.

When & If Brintellix Will Work

Brintellix’s Usual Onset of Action (when it starts working)

You should feel something within a week. By week 2 you’ll know for sure if it’s going to work or not. Return to Table of Contents

Likelihood of Working

Decent. Based on the few reports from the field I could find, and the amazing amount of clinical trial data Lundbeck and Takeda released, Brintellix is less effective than Cymbalta. But they had the balls to put it up against a real, modern, widely-prescribed med, and not just a placebo. They also put Brintellix head-to-head against Valdoxan (agomelatine) in a clinical trial, an AD with a completely different way of working. Brintellix both worked better and sucked less.

If you experience insomnia or somnolence (excessive fatigue and/or daytime tiredness) that doesn’t go away after a week, you’re either taking too much, or the likelihood of Brintellix working has dropped significantly.

If you had good results with an SSRI, but experienced brain fog or other cognitive issues that wouldn’t go away, Brintellix might be just the med you’re looking for.

Return to Table of Contents

Taking and Discontinuing

How to Take Brintellix

Manufacturers’ Recommendations

Lundbeck and Takeda recommend:

The recommended starting dose is 10 mg administered orally once daily without regard to meals. Dosage should then be increased to 20 mg/day, as tolerated, because higher doses demonstrated better treatment effects in trials conducted in the United States. The efficacy and safety of doses above 20 mg/day have not been evaluated in controlled clinical trials. A dose decrease down to 5 mg/day may be considered for patients who do not tolerate higher doses. --the Brintellix PI sheet

Crazymeds’ Suggestions

First and foremost, unless you have a cast-iron stomach like I have1: TAKE WITH FOOD!!! Because of the way Brintellix works and current reports from the field, the time of day you take it seems to matter less than almost any other AD, so many doctors are recommending “with your largest meal.”

As for how much to take, as always we suggest starting with as low of a dosage as you think you need. They make 5 mg tablets for a reason2, and it’s a lot easier to start at 5 mg and go up to 10 mg than to start at 10 mg, go down to 5 mg, then later go up to 10 mg. However, Brintellix at 2.5 and 5 mg a day vs. placebo or Cymbalta failed 3 out of 4 of their clinical trials, so there’s also a reason why they say to start you at 10 mg a day. 5 mg a day will work for a lot of people, but the odds are you’ll need more. The things you and your doctor need to discuss are your history with medications and how depressed you are.

You’ll need to adjust your dosage if you’re taking a medication than affects CYP2D6 (see drug-drug interactions) or are a poor CYP2D6 metabolizers (see pharmacokinetics). The PI sheet repeatedly tells doctors to adjust the dosage, by cutting it in half, if you’re taking a CYP2D6 inhibitor like Paxil, Prozac, or Wellbutrin - especially the first two - and that the maximum dosage for poor CYP2D6 metabolizers is 10 mg.

Return to Table of Contents

How to Stop Taking Brintellix (discontinuation / withdrawal)

Manufacturers’ Recommendations

2.3 Discontinuing Treatment Although BRINTELLIX can be abruptly discontinued, in placebo-controlled trials patients experienced transient adverse reactions such as headache and muscle tension following abrupt discontinuation of BRINTELLIX 15 mg/day or 20 mg/day. To avoid these adverse reactions, it is recommended that the dose be decreased to 10 mg/day for one week before full discontinuation of BRINTELLIX 15 mg/day or 20 mg/day. --the Brintellix PI sheet

Crazymeds’ Suggestions

Oh hell no. For companies that were doing so much right (unprecedented transparency with clinical trial data, and digging really deep into pharmacology before it was released, e.g.) how could they fuck up so badly with “Sure, just stop taking your 20 mg a day.” before how you’re supposed to do it? I don’t care how mild the discontinuation symptoms were in the clinical trials, it’s irresponsible to write it that way! You don’t want to stop taking any med suddenly unless your life or long-term health depends on it; preferably when qualified medical professional tells you to do so. Like when you’re having a nasty allergic reaction to it.3 Are they not aware that consumers read PI sheets? Or that there are idiot doctors out there?

At 10mg a day you should be able to just stop taking Brintellix, especially since it has such a long half-life and works like an antipsychotic in a lot of ways. But if you’ve gone through SSRI/SNRI discontinuation hell before, you’ll probably want to step down to 5 mg a day before stopping completely. Most people shouldn’t have an issue with discontinuing at 10 mg a day.

Return to Table of Contents

Brintellix’s Pros and Cons


  • It’s like Viibryd on steroids, but even more targeted. So if serotonin is your friend, Brintellix could be your bestest friend ever.
  • Discontinuation symptoms can range from mild to non-existent for most people.
  • Super-low side effect profile.
  • Easy titration.

Return to Table of Contents


  • It’s like Viibryd on steroids, so if serotonin turns out to be your worst enemy Brintellix could be a bit of a nightmare.
  • All the things that make for little to no discontinuation syndrome? Yeah, that just means any unpleasant effects you have from too much serotonin will stick around for at least a week. Maybe two.
  • Anything with a really low side effect profile tends to have something where it’s the worst of any med, or at least crazy med, on the planet. Like Keppra’s suicidal depression or Viibryd’s nausea that gives Felbatol (felbamate) some serious competition.
    • For Brintellix it looks like indigestion worse than Abilify that can become full-on peptic ulcers.
  • Few dosage options.

Return to Table of Contents

Interesting Stuff your Doctor Probably didn’t Tell You about Brintellix

It’s safe for professional guinea pigs to drive after taking 10 mg of Brintellix. Even after taking it for a couple of days in a row.

This is the first time I’ve seen a driving test in a PI sheet. They actually tested the “operation of heavy machinery” scenario. Hats off to Takeda & Lundbeck for some of the most thorough testing done on a med I’ve ever seen. Return to Table of Contents

Best Known for

I don’t know about anyone else, but to me it seems like the drug more incompetent doctors will misprescribe this side of Oxycontin. Return to Table of Contents

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Brintellix’s Potential Side Effects

Potential Side Effects All Crazy Meds Have

No matter which neurological and/or psychiatric drug you take, you’ll probably get one or more of these side effects. These will usually be gone, or at least will diminish to the point where you barely notice it most of the time, within a week or two.

  • Headache
  • Drowsiness / fatigue - even when taking stimulants in some circumstances.
  • Insomnia, instead of or alternating with the drowsiness.
  • Nausea
  • Assorted other minor GI complaints (constipation, diarrhea, etc.)
  • Generally feeling spacey / out of it
    • Which can all add up to the ever-helpful “flu-like symptoms” listed as an adverse event on the PI sheet of practically every medication on the planet used to treat almost any condition humans and other animals could have.4
  • All crazy meds can, and probably will affect your dreams as well. There is no way of telling if that will be good or bad, let alone if this side effect is permanent or temporary.
  • Any of the above side effects you see listed again below means they’re even more likely to happen and/or stick around longer and/or are worse than most other meds.

Typical Potential Side Effects

The usual for anything that affects serotonin. Brintellix’s main problems are GI complaints , especially nausea that’s almost as bad as as Viibryd’s, and the ever-contradictory diarrhea or constipation . There’s also headache , dizziness , and dry mouth . And, like every crazy med ever made, your dreams will be different .

Weight gain doesn’t seem to be a problem. I’m still collecting data to see how bad the sexual side effects are, but so far they seem to be less of an issue than SSRIs and SNRIs. Return to Table of Contents

Uncommon Potential Side Effects

Itchy skin without a rash (pruritus) , sweating , flushing/hot flashes , vertigo , taste perversion (dysgeusia) , fatigue, daytime tiredness (somnolence) , severe indigestion (dyspepsia) and acid reflux that can eventually become ulcers .

One thing I’ve noticed from reading user experiences, the really severe GI problems happen to people who have a history of such things (or this is how they find out their stomachs are especially med-, or serotonergic-med-sensitive), or people are taking too much because their doctors are idiots and prescribed 20mg of Brintellix along with Wellbutrin.

Return to Table of Contents

Freaky Rare Side Effects

Nothing yet. I’m really disappointed. Return to Table of Contents

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What You Really Need to be Careful About

Serotonin syndrome. Every serotonergic medication has a warning about the extremely rare, but greater than zero chance of this painful and potentially, but usually not, fatal reaction. Especially if you mix drugs that act on serotonin in different, but complimentary ways, like SSRIs and triptans. Well, since Brintellix is almost a triptan and does a bunch of other stuff that enhances serotonin, it’s one of the few meds where serotonin syndrome moves from extremely rare to very rare. Or merely uncommon if your doctor does something stupid like prescribe 20 mg a day while you’re taking Paxil or Prozac and you’re a poor, or even intermediate CYP2D6 metabolizer.

Return to Table of Contents

Pregnancy Category

Return to Table of Contents


Brintellix’s Half-Life & How Long Until It Clears Your System

Half-life: 66 hours. Plasma Clearance: About two weeks.

Steady State

Steady state is reached in 14 days.

Half-life is the average time it takes for you to process half of the drug’s active ingredient. If a drug has a half-life of around 24 hours and you take a dose of 100mg, you’ll have roughly the equivalent a 50mg dose after one day, a 25mg dose after two days, and so on. The rule of thumb is: multiply the half-life by five and you get how long it is for the dose you took to be cleared from your bloodstream5, so there’s nothing swimming around to attach itself to your brain and start doing stuff. That’s called “plasma clearance.” Complete clearance is a complex equation based on a lot of factors which may or may not: be published in the PI sheet, include personal data like your weight, or even completely figured out by corporate and independent researchers. It usually winds up being 2–5 days after plasma clearance no matter what6, but can take weeks. Sometimes a drug will clear from your brain and other organs before it clears from your blood.

Steady state is the flipside of half-life. This is when you can expect to get over side effects caused by fluctuating amounts of a medication in your bloodstream. Often, but not always the same amount of time as the plasma clearance above.

Return to Table of Contents

How vortioxetine Works

the current best guess at any rate

Briefly Brintellix is like an oddball second-generation, or “atypical” antipsychotic that doesn’t affect dopamine combined with either an SSRI or an SNRI that has 70 times more effect on serotonin than norepinephrine7. So, based upon our Communications Interference Hypothesis of psychiatric and neurological conditions (or brain cooties as we often call them):

  • Brintellix treats depression by effectively raising serotonin levels in your brain.
  • It does so by letting your synapses soak in those brain juices for longer than usual by slowing (inhibiting) the mechanism of serotonin transmission deeper into the neurons (reuptake).
    • At 20 mg a day it might do the same for norepinephrine to enough of an extent to make a difference.
      • At least that’s how I read the pharmacodynamics data.
  • Depending on where, and to what extent that effect occurs, your brain is happier.
    • Unlike most meds, Lundbeck & Takeda have done a lot of work identifying where that happens.8
    • A lot of Brintellix’s serotonergic action happens in your hippocampus, prefrontal cortex, and the dorsal and medial raphe nuclei.
  • In addition to boring reuptake inhibition, Brintellix is also a 5HT1A agonist (Like BuSpar and Viibryd) and a 5HT1B partial agonist.
    • In English Brintellix enhances serotonin reception where it makes you happy and moderates reception where it … uh ….
      • 5HT1B, while less of a mystery than many of the others, still isn’t well-understood. Right now it’s known to suppress pain and affect the action of serotonin at other locations.
      • The triptan class of migraine abortives are all 5HT1B & 5HT1D agonists.
  • Brintellix is also an antagonist, in that it inhibits some of the serotonin your brain gets, at several receptors just like many second-generation antipsychotics (SGAs) do. The receptors Brintellix blocks are just different from most SGAs.
    • It blocks 5HT1D, which is the conjoined twin of 5HT1B. Geodon is the only other med I’m aware of that is a 5HT1D antagonist, and Stahl thinks that has something to do with why Geodon is the AP least likely to cause weight gain and mess with your blood sugar.
      • Does that mean Brintellix won’t cause weight gain? Only time will tell.
      • That may mean Brintellix doesn’t have much of a future as a pain med.
    • It blocks 5HT3, which Remeron does. 5HT3 antagonists are used to prevent puking (anti-emetics), so Brintellix keeps the GI problems most people have the first few days/weeks/months/years when they take an SSRI (or any other medication) from being worse than they could be.
      • No, really. If it weren’t a 5HT3 you’d probably never be able to keep it down. All the serotonin receptors in your gut would be going batshit.
    • 5HT3 may also affect how cells transmit serotonin.
    • And it blocks 5HT7, which is linked to your sleep cycle and circadian rhythm, and thus indirectly to depression. Too much or too little serotonin here can cause problems, so it’s a coin-toss as to this being a good or bad thing when it comes to effects and side effects. Assuming it has any affect upon how you sleep in the first place.
      • Given the utter lack of insomnia or somnolence (too much sleep, daytime tiredness, etc.) side effects reported in the clinical trials, regulating your sleep cycle might be part of the reasons why Brintellix works.

Vortioxetine Pharmacokinetics

Since they did more work than most drug companies, I’d feel remiss if I didn’t include all the PK data.

  • vortioxetine is extensively metabolized by CYP2D6, CYP2C9, CYP3A4/5, CYP2C19, CYP2A6, CYP2C8 and CYP2B6
    • That’s more than amitriptyline!
    • From the PI sheet: poor metabolizers of CYP2D6 have approximately twice the vortioxetine plasma concentration of extensive [normal] metabolizers
  • PK is linear and dosage-dependent
  • Cmax values were 9, 18, and 33 ng/mL following doses of 5, 10, and 20 mg/day.
  • Tmax is 7 to 11 hours
  • AUC is 244 ng·h/mL
  • Apparent volume of distribution is 2600 L
  • Absolute bioavailability is 75%
  • Plasma protein binding is 98%
    • This, combined with being super-serotonergic in several different ways, is why you have to be extra careful when mixing vortioxetine and warfarin, NSAIDs, or anything else than deals with plasma.

The PI sheet says no dosage adjustment is required for any ethnic group, but with the data being mixed on the extent to which CYP2C9 is involved, and the reports I’ve read involving Zoloft, a weak-to-moderate inhibitor of CYP2D6, CYP2C9 and CYP3A4/5, my money is on a lot of Asians maxing out at 15 mg a day, if not 10 mg.

Return to Table of Contents

Active Ingredient

vortioxetine hydrobromide

The active ingredient is usually the same as the generic name, but more often than not it’s a chemical salt of the substance identified as the generic. E.g. Fluoxetine is the generic for Prozac, but the active ingredient is fluoxetine hydrochloride (or HCl). It usually doesn’t make much of a difference outside of the more esoteric aspects of a drug’s pharmacology, but not always.

Return to Table of Contents

Shelf Life

30 months in a bottle, 4 years in a blister pack Return to Table of Contents

Brintellix’s Noted Drug-Drug, Drug-Food & Drug-Supplement Interactions

will require a dosage adjustment. I’ve read too many reports of people taking Brintellix with Prozac, Paxil, or Wellbutrin who weren’t able to tolerate the side effects because their doctor had them at 20 mg a day. That’s the equivalent of 40 mg! It’s just like Lamictal and Depakote and is on the very first page of the PI sheet.

While you will require the same dosage adjustment if you’re a CYP2D6 poor metabolizer, you may need a similar one if you’re a poor metabolizer of CYP2C9 and taking one or more meds that also affect CYP2C9 and CYP3A4, such as Zoloft.

Like all serotonergic meds, you need to be careful if you take NSAIDs like aspirin or Celebrex on a regular basis. The same goes for other types of blood thinners, from warfarin to omega-3 fish oils . Based on the pharmacokinetic data, you need to be more careful than with SSRIs.

Mixing St. John’s Wort - assuming you’re even taking St. John’s Wort and not ground-up basil that’s too old to have a scent - and serotonergic drugs is always dicey. Taking it with Brintellix can be especially problematic, especially since St. John’s Wort induces CYP2C9 and CYP3A4. Would that require a dosage adjustment? Probably not, but it’s still a dumb idea to take the two at the same time. Return to Table of Contents

Check for Other Drug-Drug, Drug-Food & Drug-Supplement Interactions Brintellix may have at

Drugs.com’s drug-drug and drug-food interaction checker

It’s always a good idea to check for drug-drug interactions yourself. Just because most people in the crazy meds business know about really important interactions (e.g. MAOIs and a lot of stuff, warfarin and everything on the planet) doesn’t mean the person who prescribed your meds told you about them, or the pharmacist has all the meds you take at their fingertips like they’re supposed to. Or they have the time to do their jobs properly when not dealing with complete idiots or playing Angry Farmers on teh Faecesbooks.
Learn more about drug-everything interactions on our page of tips about taking crazy meds.

Name, Address, Serial Number (Generic and Overseas Availability)

Available in the US as a generic? No

Other Trade Names and Overseas Availability

Not including controlled/extended/sustained release suffixes (Efexor ER, Trevilor retard e.g.) or branded generics that are a hyphenate of the generic name and the drug company name (Apo-Citalopram e.g.).

Available as Brintellix in:

  • Australia
  • Great Britain
  • The EU (but not Ireland)
  • Japan

Overseas Trade Names

  • Trintellix - Canada

Pending approval in:

  • Ireland
  • New Zealand

Alternate INNs (because one isn’t good enough)

  • vortioxetina - Spanish
  • vortioxétine - French
  • vortioxetinum - Latin

Return to Table of Contents

Shapes & Sizes (How Supplied)

  • 5 mg pink tablets
  • 10 mg yellow tablets
  • 15 mg orange tablets
  • 20 mg red tablets

Tablets have the dosage on one side and TL (for Takeda and Lundbeck, I guess) on the other. Return to Table of Contents

Comments, PI Sheet, Ratings, Reviews and More


Brintellix is the new and shiny AD with a severe identity crisis. Is it basically an SSRI or SNRI? Is it part triptan or part antipsychotic? Is it a floor wax or desert topping?

In answer to the first question, I think its basic mechanism of action (MOA) is being as much of an SNRI as Effexor is, but since the maximum recommended dosage tops off at 20 mg, and 30 mg a day seems to be the maximum tolerable dosage9, it might work as an SNRI at 20 mg day. I’m pretty sure it would at 25 mg a day. One of the key indicators of too much norepinephrine are physical and psychological symptoms of anxiety, and many people have complained about Brintellix making their anxiety worse. That’s an all-too-common side effect when an SNRI is prescribed for anxiety, with or without depression. But as all the research done has focused on its serotonergic effects, and all of its bonus material involves serotonin receptors, few people will consider vortioxetine’s primary mechanism of action to be anything but serotonergic. So I’m seeing it called an SSRI even though it isn’t an SSRI. Viibryd isn’t technically an SSRI, but even I’ll call it one, because Viibryd’s MOA is pretty much the equivalent of taking a cocktail of Paxil and BuSpar. Brintellix does way too much to be called an SSRI, so people are going to be surprised, in good ways and bad, by thinking of it as one.

I’m being facetious when I’m comparing triptans with antipsychotics. Triptans are 5HT1B and 5HT1D agonists. Vortioxetine is a 5HT1B partial agonist and 5HT1D antagonist. Along with all the other stuff it does that makes Brintellix like one of the oddest APs around.

And it’s both a floor wax and a desert topping. Duh.

One thing I’ve noticed is how few people are using this med. On one hand it’s nice to see doctors not jumping on something new and shiny just because it’s new and shiny, on the other Brintellix has a lot of potential. Sure, it’s not as effective as Cymbalta, but for a highly-targeted serotonergic med, with just a little norepinephrine action on the side, it might be just the thing for some people. As with too many drugs I’ve noticed the usual story: inappropriate prescribing. A lot of people for whom Brintellix did not work due to intolerable side effects were taking 20mg a day and Wellbutrin - didn’t their dipshit doctors or pharmacists read the PI sheets? That’s the equivalent of 40 mg a day! Unless you’ve had a gene test showing you have at least half-a-dozen copies of the CYP2D6 gene10, 30 mg is the highest you should go. Or they were also taking a high dosage of a CYP2D6-inhibiting SSRI (Paxil or Prozac) and got serotonin syndrome! Well, duh. What sort of quacks are doing the prescribing? Don’t those morons know it’s not approved as a fucking add-on? If they want to exploit its more-than-an-SSRI effects they should be prescribing 5 mg, not 15 to 20 mg. The R&D people at Takeda and Lundbeck bent over backwards to provide some of the most complete information possible about a med I’ve seen when it first came out - I’m really sorry I didn’t write about it sooner - and idiot doctors are ruining it by prescribing it at 20 mg a day with meds where, on the very first page of the PI sheet it says to cut the dosage in half! It also looks as if some poor CYP2D6 metabolizers are being prescribed too much. Intermediate metabolizers probably shouldn’t go above 15 mg a day, so a lot of them are being screwed by rigid thinking and target dosages.

One thing’s for sure, Brintellix should not be the first serotonergic med you try. If you’re taking an SSRI or SNRI now and it more-or-less works, but also caused one or more of:

  • “brain fog” (fuzzy thinking, feeling mentally tired but not physically tired) and/or other cognitive issues
  • messing with your sleep,
  • a lot of weight gain
  • ruining your love life

then you and your doctor might want to discuss Brintellix. Especially if your problem was the brain fog. But if you’re looking for your first AD, stick with Celexa, Lexapro, or Wellbutrin. Unless you know your doctor is a genius psychopharmacologist Brintellix’s long-ass half-life makes it one of the worst meds to try first.

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Pages and Forum Topics Google Thinks are Relevant to Your Mental Health

Full US PI sheet, Global SPCs & PILs, Other Consumer Review & Rating Sites, and Other Sites that may be of Interest

Discussion board

If you have any questions not answered here, please see the Crazymeds Brintellix discussion board. Return to Table of Contents

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  1. Brintellix Full US Prescribing Information
  2. Brintellix EU EPAR
  3. Boulenger, Jean-Philippe, Henrik Loft, and Christina Kurre Olsen. “Efficacy and safety of vortioxetine (Lu AA21004), 15 and 20 mg/day: a randomized, double-blind, placebo-controlled, duloxetine-referenced study in the acute treatment of adult patients with major depressive disorder.” International Clinical Psychopharmacology 29.3 (2014): 138. Published online 4 April 2014
  4. Montgomery, Stuart A., Rebecca Z. Nielsen, Lis H. Poulsen, and Lars Häggström. “A randomised, double‐blind study in adults with major depressive disorder with an inadequate response to a single course of selective serotonin reuptake inhibitor or serotonin–noradrenaline reuptake inhibitor treatment switched to vortioxetine or agomelatine.” Human Psychopharmacology: Clinical and Experimental 29, no. 5 (2014): 470-482. Published online: 3 August 2014
  5. Katona, Cornelius L., and Cara P. Katona. “New generation multi-modal antidepressants: focus on vortioxetine for major depressive disorder.” Neuropsychiatric Disease and Treatment 10 (2014): 349.
  6. Sanchez, Connie, Karen E. Asin, and Francesc Artigas. “Vortioxetine, a novel antidepressant with multimodal activity: Review of preclinical and clinical data.” Pharmacology & Therapeutics (2014).
  7. McIntyre, Roger S., Søren Lophaven, and Christina K. Olsen. “A randomized, double-blind, placebo-controlled study of vortioxetine on cognitive function in depressed adults.” The International Journal of Neuropsychopharmacology (2014): 1-11.
  8. Mørk, A., Alan Pehrson, Lise Tottrup Brennum, S. Møller Nielsen, Huailing Zhong, Anders B. Lassen, Silke Miller et al. “Pharmacological effects of Lu AA21004: a novel multimodal compound for the treatment of major depressive disorder.” Journal of Pharmacology and Experimental Therapeutics 340, no. 3 (2012): 666-675. Published online 9 December 2011
  9. Alvarez, Enric, Victor Perez, and Francesc Artigas. “Pharmacology and clinical potential of vortioxetine in the treatment of major depressive disorder.” Neuropsychiatric Disease and Treatment 10 (2014): 1297.
  10. Bétry, Cécile, Alan L. Pehrson, Adeline Etiévant, Bjarke Ebert, Connie Sánchez, and Nasser Haddjeri. “The rapid recovery of 5-HT cell firing induced by the antidepressant vortioxetine involves 5-HT3 receptor antagonism.” The International Journal of Neuropsychopharmacology 16, no. 05 (2013): 1115-1127.
  11. Chen, Grace, Ronald Lee, Astrid-Maria Højer, Jeppe Klint Buchbjerg, Michael Serenko, and Zhen Zhao. “Pharmacokinetic drug interactions involving vortioxetine (Lu AA21004), a multimodal antidepressant.” Clinical Drug Investigation 33, no. 10 (2013): 727-736. Published online: 23 August 2013
  12. Adell, Albert. “Lu-AA21004, a multimodal serotonergic agent, for the potential treatment of depression and anxiety.” IDrugs: the investigational drugs journal 13.12 (2010): 900-910.
  13. Stahl, Stephen M. Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications (Essential Psychopharmacology Series) Third edition Cambridge University Press 2008. ISBN:978–0521673761

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1 When it comes to meds. I have food allergies and sensitivities up the wazoo, but my digestive system has yet to meet a med it didn't like.

2 And that reason is drug-drug interactions and poor metabolizers. If you're taking Wellbutrin, Paxil, or some non-crazy meds then you need to start at, or even take no more than, 5 mg a day.

3 Don't allergic reactions happen immediately? Or at least soon after you start taking a medication? Usually, but not always.

4 As well as being an indication of half of said conditions.

5 Based on Julien's calculations from A Primer of Drug Action, the half-life multiplied by five is the generally accepted estimate of how long it takes a single dose of any given drug to be eliminated from the blood stream/plasma of someone with a normal metabolism. That's also the rough estimate for steady state if they can't get, or won't provide a number for that.

6 For crazy meds. I have no idea what the average complete clearance is for other types of medications. For all I know there are drugs that utterly vanish from your system in under five passes, and others that won't let go of your squishy bits for years after you stop taking them.

7 Hence it is one of the few ADs to which the term "atypical antidepressant" truly applies.

8 As far as serotonin is concerned. Everyone is ignoring norepinephrine.

9 Again, unless you're like me and your stomach hasn't met a med it didn't like. And you take it with meals. And you aren't mixing it with anything that is also harsh on your GI system.

10 I don't know how many extra copies of the CYP2D6 gene rapid metabolizers tend to have. If you need to take Paxil CR twice a day or you start to get discontinuation symptoms, you probably have a few extra ones. Around 1-2% of the Caucasian population does.

11 Thank you! I'll be here all weak. Be sure to tip your content provider. And don't try the veal, it's cruelicious!

If you have any questions not answered here, please see the Crazymeds Brintellix discussion board. We welcome criticisms of the articles, notifications of bad links, site problems, consumer experiences with medications, etc. I’m not always able to write back. Hence I never answer questions about meds via e-mail that are answered by this or other articles. Especially if they have been repeatedly asked on the forum. That’s why we write these damn things. Questions about which meds are best for your condition should also be asked on the forum; because this is a free site, so the price of admission is making things easier for somebody else searching for the same answer. We don’t deal with children on the forum or in private because after doing this for ten years I don’t have the emotional stamina to deal with kids who have brain cooties. How to contact Crazymeds. — Jerod Poore, CME, Publisher Crazymeds (crazymeds.us)

Last modified on Wednesday, 04 May, 2016 at 16:42:05 by JerodPoorePage Author Date created Thursday, 02 October 2014 at 15:17:50
“Brintellix (vortioxetine): a Review for the Educated Consumer.” by Jerod Poore is copyright © 2014 Jerod Poore Published online 2014/10/02
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Plain text:Poore, Jerod. “Brintellix (vortioxetine): a Review for the Educated Consumer.” Crazymeds (crazymeds.us). (2014).
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Brintellix, and all other drug names on this page and used throughout the site, are a trademark of someone else. Brintellix’s PI Sheet will probably have the name of the manufacturer and trademark owner (they’re not always the same company) at or near the very bottom. Or ask Google who the owner is. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of the trademark may have changed without my noticing. It may of changed hands by the time you finished reading this article.

Page design and explanatory material by Jerod Poore, copyright © 2003 - 2016. All rights reserved.
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Almost all of the material on this site is by Jerod Poore and is copyright © 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, and 2016 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and something along the lines of following disclaimer, I’m usually cool with it.

All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
The information on Crazymeds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else. Plus we are big pottymouths and talk about S-E-X a lot.
Know your sources!
Nobody on this site is a doctor, a therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. While it’s not as bad as it used to be, some doctors still get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication1. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
All information on this site has been obtained from the medications’ product information / summary of product characteristic (PI/SPC) sheets and/or medication guides - which is all you get from sites like WebMD, RxList, NAMBLA NAMI, etc., the sources that are referenced throughout the site, our personal experience and the experiences family, friends, and what people have reported on various reputable sites all over teh intergoogles. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or medication guide/patient information leaflet (PIL) that comes with your medications and never ever throw them away. OK, you can throw away duplicate copies, but keep at least one, as that’s your proof of purchase of having taken a med in case a doctor doubts your medical history. Plus they take up less space than a bottle, although keeping one inside of a pill bottle is even better.
Crazymeds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
Very little information about visitors to this site is collected or saved. From time to time I look at search terms used and which pages they bring up in an effort to make the information I present more relevant. And the country of origin, just because I’m geeky like that. That’s about it. Depending on how you feel about Schrodinger, our privacy policy should either assuage or exacerbate your paranoia.
Crazymeds is optimized for ridiculously large screens and browsers that don’t block ads. I use Firefox and Chrome, running under Windows 72. On a computer that sits on top of my desk. With a 23 inch monitor. Hey, at least you can make the text larger or smaller by clicking on the + or - buttons in the upper right hand corner. If you have Java enabled. Like 99% of the websites on the planet, Crazymeds is hosted on domain running an open source operating system with a variety of open source applications, including the software used to display what you’ve been reading. As such Crazymeds is not responsible for whatever weird shit your browser does or does not do when you read this site3.
Crazymeds now uses a secure server, but it is not so secure that you can discuss anything having to do with nuclear power facilities, air traffic control systems, aircraft navigation systems, weapons control systems, or any other system requiring failsafe operation whose failure could lead to injury, death or environmental damage. Just so you know. So if you’re mentally interesting and have a job that deals with that sort of thing, talk about said job elsewhere. Otherwise feel free to discuss your meds and brain cooties.
No neurologists, psychiatrists, therapists or pharmacists were harmed in the production of this website. Use only as directed. Void where prohibited. Contains nuts. Certain restrictions may apply. All data are subject to availability. Not available on all mobile devices, in the 12 Galaxies Guiltied to a Zegnatronic Rocket Society, or in all dimensions of reality. Hail Xenu!

‘Everything is true, nothing is permitted.’ - Jerod Poore

1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.

2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.

3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?* I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion as anonymity on teh Intergoogles. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.

* Yes, I know I’m using open source browsers. I also test the site using the now-defunct IE and Safari browsers. Their popularity - and superiority - killed IE and Safari, so that’s why I rely on the open source browsers. It’s like brand vs. generic meds. Sometimes the generic is better than the brand.

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