Brintellix

Vortioxetine

Major depressive disorder in adults.

Initially 10 mg once daily. May be increased to a max of 20 mg once daily or decreased to a min of 5 mg once daily. Recommended treatment for at least 6 mth after depressive symptoms resolve.

May be taken with or without food.

Hypersensitivity. Concomitant use w/ non-selective MAOIs or selective MAO-A inhibitors.

Discontinue in any patient who develops seizures or w/ increased seizure frequency; if serotonin syndrome symptoms include mental status changes (eg, agitation, hallucinations, coma), autonomic instability (eg, tachycardia, labile BP, hyperthermia), neuromuscular aberrations (eg, hyperreflexia, uncoordination) &/or GI symptoms (eg, nausea, vomiting, diarrhoea) occurs; w/ history of mania/hypomania; symptomatic hyponatraemia. Increased risk of suicidal thoughts, self-harm & suicide (suicide related events); postpartum haemorrhage. Monitor patients w/ history of suicide-related events or those exhibiting a significant degree of suicidal ideation during treatment; for any clinical worsening, suicidal behaviour or thoughts & unusual changes in behaviour. Patients w/ increased IOP, or at risk of acute narrow-angle glaucoma. May experience feelings of aggression, anger, agitation & irritability. Concomitant use w/ anticoagulants &/or medicinal products affecting platelet function (eg, atypical antipsychotics & phenothiazines, most TCAs, NSAIDs, ASA; medicinal products causing hyponatraemia. May affect ability to drive & use machines. Severe renal impairment. Hepatic impairment. Pregnancy & lactation. Not to be used in adolescents 12-17 yr w/ major depressive disorder. Not recommended for treatment of depression in childn 7-11 yr.

Nausea. Abnormal dreams; dizziness; diarrhoea, constipation, vomiting; generalised pruritus; hyperhidrosis.

Risk of serotonin syndrome w/ irreversible non-selective MAOIs; reversible, selective MAO-A inhibitor eg, moclobemide; linezolid; irreversible, selective MAO-B inhibitor eg, selegiline, rasagiline; serotonergic medicinal products eg, opioids (tramadol, sumatriptan); antidepressants w/ serotonergic effect & herbal remedies containing St. John's wort (Hypericum perforatum). Concomitant use w/ antidepressants (eg, TCAs, SSRIs, SNRIs), neuroleptics (phenothiazines, thioxanthenes & butyrophenones), mefloquin, bupropion, tramadol. Increased exposure w/ bupropion. Increased AUC w/ ketoconazole, fluconazole. Increased exposure w/ strong CYP3A4 & CYP2C9 inhibitors, CYP2D6 poor metabolisers. Decreased AUC w/ CYP450 inducers eg, rifampicin, carbamazepine, phenytoin. Potential increased risk of bleeding w/ oral anticoagulants or antiplatelet medicinal products. Enhanced effect w/ lithium or tryptophan. False +ve results in urine enzyme immunoassays for methadone.

Antidepressants

N06AX26 - vortioxetine ; Belongs to the class of other antidepressants.

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