The drug vortioxetine (Brintellix) is an effective and safe antidepressant. The drug is used in psychiatric practice for the treatment of clinical depression at different stages - for active therapy, condition stabilization and maintenance therapy. The drug is well tolerated by patients suffering from depressive disorders. Psychotherapists at the Yusupov Hospital take an individual approach to choosing the dose of the drug vortioxetine (Brintellix) and the duration of the course of treatment.
Vortioxetine is the trade name of the drug Brintellix. It has the following clinical features:
- Its own pro-cognitive effect (improves memory, attention, thinking);
- Minimal negative impact on sexual function;
- No significant impact on the ability to drive;
- No significant effect on body weight with long-term use.
Reviews from patients who take the antidepressant vortioxetine (Brintellix) are positive. The drug does not cause sleep disturbances. The drug can be discontinued at the same time, since there is no withdrawal syndrome when stopping treatment. Doctors at the Yusupov Hospital take into account the indications, contraindications for the use of the drug Brintellix, and possible side effects.
Radar
According to the drug registry, Brintellix is an effective medicine for combating depression, i.e. able to actively fight apathy (indifference and indifference to the world around us), anhedonia (lack of positive emotions, inability to enjoy life, anergy (lack of mental, social, physical activity).
The occurrence of depression is dangerous not only due to disturbances in the emotional sphere, but also due to the appearance of somatic pathologies (sleep disorders, appetite, pain, skin manifestations, etc.). More than 300 million people around the world suffer from this disease, so doctors are concerned about the invention of new antidepressant drugs. Brintellix is one of the most modern and effective medications with antidepressant effects. It belongs to a number of thymoanaleptics and has a multimodal effect.
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The modern rhythm of life exhausts the human nervous system. Frequent stress and overload, as well as a lack of healthy sleep and proper rest, contribute to the development of such a popular disease as depression these days. One of the best drugs for treating depressive disorder is Brintellix.
Brintellix is an antidepressant that has many positive effects on the human nervous system. The active substance of this medicine is vortioxetine. Thanks to it, Brintellix affects the transmission of nerve impulses in the brain. Brintellix is not an antipsychotic, as many mistakenly believe. Unlike antipsychotics, which are used for psychosis, Brintellix activates, rather than depresses, the nervous system. How does this drug work and how to take it correctly?
Compound
The antidepressant Brintellix has a convenient tablet form of release of 5, 10, 20 mg.
One five-gram tablet contains 6.355 mg. active ingredient ( vortioxetine hydrobromide ), and in ten grams - 12.71 mg.
Additional components are mannitol, magnesium stearate, starch, etc.; they are added to the medicine to give it shape and enhance the therapeutic effect.
The action of the drug is based on three pharmacological mechanisms:
- blocking the reuptake of monoamine receptors in the synaptic cleft;
- direct serotonergic effects and inhibition of serotonin transport protein;
- inhibition of the destruction of monoamine mediators.
Due to the combination of these effects in the drug, it has a pronounced thymoanaleptic, anxiolytic effect and therefore, in addition to the antidepressant effect, is capable of improving thought processes, memory, and concentration.
The advantages of the medicine include the absence of negative effects:
- on the sexual sphere in both men and women;
- on the quality and duration of sleep;
- on body weight (does not cause its growth);
- on the urinary system.
Absorption of the drug occurs slowly, over nine hours, i.e. the antidepressant gradually accumulates in the body.
The distribution of the drug in tissues and organs occurs quickly, and in the circulatory system it binds to protein fractions that transport its molecules throughout the body.
The drug is excreted mainly by the kidneys, liver and through the intestines; this process is quite slow, since the half-life is more than three days, and the body is completely freed from the drug in about five days.
After 14 days of systematic use of Brinellix, its concentration in the blood becomes maximum.
Chemical properties
Vortioxetine is an antagonist of 5-HT3, 5-HT1D, and 5-HT7; 5-HT1A agonist; and a partial agonist of 5-HT1B serotonin receptors. Its chemical formula is 1-[2-(2,4-Dimethylphenylsulfanyl) - phenyl]-piperazine. It is available in the form of pink, yellow, orange, and red oval tablets (the color depends on the content of the active substance), on one side of which the dosage is printed, and on the other the letters “TL”. Additional components include mannitol, microcellulose, hydroxypropylcellulose, sodium starch glycolate, magnesium stearate, and a protective film consisting of hypromellose, titanium dioxide, polyethylene glycol 400, red iron oxide (5, 15, and 20 mg), and yellow iron oxide (10 and 15 mg).
Contraindications
- Sensitivity to vortioxetine or additional components of the drug.
- Patients are under 18 years of age.
- State of pregnancy.
Brintellix is carefully prescribed to patients with kidney and liver pathologies, obsessive fixation on one thought or idea, manic disorders, convulsive and epileptic seizures that are not relieved by taking medications, cirrhosis, and blood diseases.
special instructions
Depression is associated with an increased risk of suicidal ideation, self-harm, and suicidal behavior. This danger persists until significant remission is achieved, as a result of which patients should be under constant monitoring until a significant improvement in their condition occurs.
Patients with a history of suicidal tendencies also require careful monitoring. Patients and their caregivers should be informed of the need to immediately consult a doctor in the event of clinical signs of deterioration, suicidal thoughts, or unusual changes in behavior.
If seizures occur or their frequency increases, drug therapy should be discontinued.
Potentially life-threatening conditions such as serotonin syndrome (SS) or neuroleptic malignant syndrome (NMS) may occur with the use of Brintellix.
Symptoms of SS may include: autonomic instability (hyperthermia, tachycardia, blood pressure lability), changes in mental status (hallucinations, agitation, coma), gastrointestinal disorders (diarrhea, vomiting, nausea), neuromuscular disorders (coordination disorders, hyperreflexia ). If such conditions occur, you should immediately stop taking vortioxetine and begin symptomatic therapy.
If a manic state develops, treatment should be discontinued.
It should be borne in mind that the resulting pupillary dilation caused by taking a number of antidepressants (including Brintellix) can cause an attack of angle-closure glaucoma in the presence of an anatomically narrow anterior chamber angle in patients who have not undergone peripheral iridectomy.
During the period of use of the drug, you must refrain from drinking ethanol-containing drinks.
Impact on the ability to drive vehicles and complex mechanisms
When taking vortioxetine, there may be a very slight effect on the ability to concentrate and the speed of reactions. However, patients are still advised to exercise caution when driving a car and operating other complex machinery.
Instructions for use
The antidepressant is taken orally and washed down with a small amount of liquid.
The standard daily dose of the drug is 10 mg.
If necessary, specialists increase the dose to 20 mg or reduce to 5 mg.
Treatment with Brintellix is long-term and lasts for six months. But this antidepressant, unlike others, can be discontinued not gradually, but immediately. His withdrawal symptoms
Side effects
- from the gastrointestinal tract: very often (≥ 1/10) – nausea; often (from ≥ 1/100 to < 1/10) – constipation/diarrhea, vomiting;
- on the part of the skin and subcutaneous tissues: often – itching (including generalized); uncommon (from ≥ 1/1000 to < 1/100) – night sweats;
- from the psyche: often – unusual dreams;
- from the nervous system: often – dizziness; frequency unknown - serotonin syndrome;
- from the blood vessels: infrequently - hot flashes.
Adverse reactions usually occur during the first 2 weeks of treatment, are temporary and do not require discontinuation of Brintellix.
Side effects such as nausea are more common in women than in men.
Brintellix and alcohol: compatibility
Although the use of this antidepressant with alcohol is not recommended, in practical studies on their compatibility, no adverse reactions or changes in the pharmacological effects of Brintellix were identified.
But when taking the drug with irreversible and reversible non-selective monoamine oxidase inhibitors, the development of serotonin intoxication is possible.
Drug interactions
- inhibitors of the CYP2D6 isoenzyme (bupropion, fluoxetine, quinidine, paroxetine) strong inhibitors of the CYP3A4 isoenzyme (conivaptan, clarithromycin, itraconazole, telithromycin, voriconazole, nefazodone, HIV protease inhibitors) - possible increase in vortioxetine exposure (AUC) and the development of adverse reactions (dose reduction may be required vortioxetine);
- cytochrome P450 inhibitors - in case of combination with treatment of strong inhibitors of the CYP2D6 isoenzyme, dose adjustment of vortioxetine may be required;
- strong inducers of broad-spectrum cytochrome P450 (carbamazepine, rifampicin, phenytoin) - it is possible to reduce the exposure of vortioxetine and adjust its dose;
- acetylsalicylic acid - with repeated administration of this drug at a dose of 150 mg per day, no changes in the pharmacokinetics of vortioxetine were observed.
Analogs
- Alventa
- Venlaxor
- Velaxin
- Deprexor
- Medofaxin
- Prefaxin
Among the selective serotonin reuptake inhibitors, along with Brintellix, the following are very popular: Cellex, Paxil, Fluoxetine, Prozac, Zoloft, Sarafem, Escitalopram.
These drugs are recognized as the most modern means in the fight against depression and anxiety. They have a pronounced therapeutic effect and the mildest side effects.
New a different series (serotonin and norepinephrine reuptake inhibitors) include: Venlafaxine, Desvelafaxine, Duloxetine, Fetzima.
To treat depression, there are also drugs from a number of tricyclic antidepressants (Amitriptyline, Desipramine, Tofranil, Aventil, Trimipramine), as well as monoamine oxidase inhibitors (Nardil, Isocarboxazid, Selegiline).
In their action, these drugs are similar to Brintellix, but they are considered more toxic to the body, as they cause serious adverse reactions.
Clinical effectiveness
Brintellix has a pronounced antidepressant effect, which increases with increasing dosage of the drug.
Standard prescriptions of the drug (5-20 mg) also performed well on the Anxiety and Depression Scale (MADRS, HAM-A).
In practice, Danish scientists determined the safety and severity of the action of Vortioxetine in volunteers suffering from moderate depression.
At the initial and final stages of the experiment the following were carried out:
- assessment of anxiety and depressive symptoms using the HADS scale;
- determination of cognitive impairment using the PDQ questionnaire;
- distortions of social aspects of behavior using the UPSA-B method;
- manifestations of adverse reactions according to the DOTESS scale.
All data was analyzed over a period of 8 weeks and as a result, pharmacologists proved that the drug is effective against mild and moderate forms of depression and can be used as drug therapy for people suffering from acute and chronic depression.
When taken, the frequency of recurrences of episodes of the disease decreases and the symptoms of the disorder disappear.
In addition to the main effect, this antidepressant can have a positive effect on the cognitive functions of patients (memory, thinking, perception, etc.). The minimal frequency of adverse reactions allows us to recommend the drug for use in outpatient settings.
Overdose
To date, experts have rather poor knowledge about the effects of the drug in case of overdose. When taking the drug orally at a dosage of 40-75 mg, the following symptoms may occur or worsen:
- dizziness;
- discomfort in the abdominal area;
- nausea;
- diarrhea;
- generalized itching;
- tides;
- drowsiness.
The drug is intended primarily to eliminate symptoms, necessarily with regular monitoring by a specialist to monitor the patient’s condition.
Reviews
Toporischev Gennady, 48 years old, psychiatrist:
Among the advantages of the drug, I would like to emphasize the speed of onset of the effect, the absence of sedative effects and the positive dynamics in the patients’ condition. Among the disadvantages, the most important one is the high cost of the medicine; not many can afford to be treated with it constantly.
In general, the antidepressant is one of the best in outpatient and outpatient practice. The drug acts quite gently, so that, according to patients, they do not even notice how they are returning to their previous full life.
Alina, 35 years old, manager:
The medicine is certainly expensive, but it has many advantages: it does not affect weight, sleep, libido. I went to see a doctor because I had fallen into severe depression due to problems at work. I felt disgusting, everything was falling out of my hands, my mood was depressed, something was constantly bothering me (headaches, itchy skin, body aches). The doctor prescribed Brintellix, I took it for three months and my emotional background was restored.
In general, the drug suited me, although the first days there was nausea. And after 7 days, my health began to return to normal, desires, positive emotions and physical activity appeared.
Konstantin, 19 years old, student:
I have been prone to depression for a long time, but I turned to and started receiving treatment only now. I have been taking Brintellix 10 mg for two months now. It got better on the 12th day. The mood lifted, sadness and despondency receded. I had no adverse reactions. In general, an expensive drug, but effective.
