Vortioxetine
Antidepressant
Vortioxetine
Trintellix
Experience
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Effects
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Interactions
Pharmacogenomic + mechanism interactions
Pharmacogenomic guideline recommendationsCPIC and Dutch Pharmacogenetics Working Group clinical guidelines
CPIC rec 8095308 [Strong]: Initiate therapy with recommended starting dose. CPIC pair-level A (CYP2D6, CYP2C19, CYP2B6, SLC6A4, HTR2A and Serotonin Reuptake Inhibitor Antidepressants) [PMID 37032427]
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CPIC rec 8095315 [Moderate]: Initiate 50% of starting dose (e.g., 5 mg) and titrate to the maximum recommended dose of 10 mg or consider a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2D6. CPIC pair-level A (CYP2D6, CYP2C19, CYP2B6, SLC6A4, HTR2A and Serotonin Reuptake Inhibitor Antidepressants) [PMID 37032427] FDA labeling (Dosage and Administration, Clinical Pharmacology)
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CPIC rec 8095312 [Moderate]: Initiate therapy with recommended starting dose. CPIC pair-level A (CYP2D6, CYP2C19, CYP2B6, SLC6A4, HTR2A and Serotonin Reuptake Inhibitor Antidepressants) [PMID 37032427]
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CPIC rec 8095295 [Optional]: Select alternative drug not predominantly metabolized by CYP2D6. If vortioxetine use is warranted, initiate therapy at standard starting dose and titrate to maintenance dose based on efficacy and side effects. Increasing the target maintenance dose by 50% or more may be needed for efficacy. CPIC pair-level A (CYP2D6, CYP2C19, CYP2B6, SLC6A4, HTR2A and Serotonin Reuptake Inhibitor Antidepressants) [PMID 37032427] FDA labeling (Dosage and Administration, Clinical Pharmacology)
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Clinical relevance: does this interaction matter in practice?trivialcritical
Mechanism description, if it needs work:
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Your own experience with this combination:
Experience (1 a little, 5 a lot)
Outcome (-100 worst, +100 best)
Patient experience
Fluoxetine via Category:Antidepressants exp n/a/5 outcome n/a (n=1) exp 1.0/5 outcome +33.0 (n=1)
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Summary
Classes
Antidepressant
Common uses
Pharmacy
Pharmacology
Purported mechanism
Multimodal serotonergic agent