Trintellix and Alcohol: Is This A Risky Combination?

Treating depression typically involves some combination of therapy and medication. There are different types of antidepressant medications that your healthcare professional may prescribe for you. SSRIs are one common type of prescription antidepressant. But if they don’t work or have unwanted side effects, you may be told to switch to a different medication.

Trintellix (vortioxetine) is a newer antidepressant that treats depression in adults. It’s part of a group of drugs called atypical antidepressants. Trintellix has been found to work as well as some selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), but it may come with fewer side effects. Yet, a common question is whether it’s safe to combine alcohol with Trintellix. 

Some people living with depression turn to alcohol as a coping mechanism or a way to self-medicate. But in the long run, drinking alcohol can actually worsen your depression. Keep reading to learn more about why combining Trintellix with alcohol may not be a good idea.

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Can I take Trintellix with alcohol?

It’s best to avoid or limit the combination, if possible.

Studies that contributed to Trintellix’s initial FDA approval didn’t find a true interaction between alcohol and the medication. But people in these studies only took one Trintellix dose. This makes it difficult to predict how alcohol will affect you if you’re taking the medication every day over time.

That being said, alcohol may counteract Trintellix’s effects in different ways. Alcohol can affect your mood and worsen your depression symptoms. Due to this, drinking alcohol may make it harder for Trintellix to be effective.

Trintellix and alcohol also share some similar side effects. And you’re more likely to have these side effects if you combine the two.

Is having one or two drinks OK?

It’s hard to say. Everyone reacts differently to alcohol. And there’s little research available about how much alcohol, if any, is safe to drink with Trintellix.

For instance, one study looked at whether there’s an interaction between Trintellix and alcohol. In this study, volunteers took one dose of Trintellix or a placebo (pill with no medication) followed by three alcoholic or non-alcoholic drinks.

EXPERT PICKS: WHAT TO READ NEXT

• How does alcohol affect depression? People with depression are more likely to drink alcohol, which can worsen depression. Learn more about the two-way relationship between alcohol and depression.

• What are my options for treating depression? Trintellix is one of many available antidepressants. This guide describes other medications and treatments for depression.

• Coping with depression without alcohol: Alcohol doesn’t actually treat depression. Here are some effective coping strategies you can try instead.

The results showed no difference in people’s ability to perform tasks requiring attention and memory whether they took Trintellix with alcohol or just drank alcohol. However, more people who took Trintellix with alcohol had side effects, such as headache and nausea, compared with people who just drank alcohol.

This study gives some insight into how the two interact, but there are still details that aren’t fully understood. For that reason, talk with a healthcare professional before drinking alcohol while also taking Trintellix. They can talk with you about how much alcohol, if any, is safe for you to consume. They can also offer ways to help you reduce how much you drink.

Are certain people more at risk when combining alcohol and Trintellix?

Yes. Some groups of people have a higher risk of experiencing side effects when combining alcohol and Trintellix. These include:

People who take blood thinners: Trintellix and alcohol interfere with your body’s natural clotting process, meaning they both increase the risk of bleeding. This bleeding risk is even higher among people who also take blood thinners, such as warfarin (Coumadin, Jantoven) or apixaban (Eliquis).

People with alcohol use disorder: Trintellix may cause hyponatremia (low blood sodium). Hyponatremia is also common in people living with alcohol use disorder. The risk of developing  low blood sodium may be higher if combining alcohol with Trintellix.

People with low metabolizing protein levels: Trintellix is metabolized (broken down) by a liver protein called CYP2D6. Some people naturally have lower levels of this protein. Trintellix is broken down more slowly in this group of people. This may cause the medication to build up and cause side effects — especially when paired with alcohol.

How does alcohol interact with Trintellix?

Alcohol doesn’t directly interact with Trintellix. But drinking alcohol while taking Trintellix may increase the likelihood of having certain side effects (or worsen them if you already have them). This is because Trintellix and alcohol have some similar side effects, such as:

• Nausea

• Vomiting

• Dizziness

• Upset stomach

• Stomach pain

• Diarrhea

• Dry mouth

Are there any serious side effects or risks?

While rare, combining alcohol with Trintellix may increase the risk of more serious side effects. Call 911 or go to the nearest ER if you’re having any of these symptoms:

• Severe or long-lasting vomiting

• Extreme tiredness

• Hallucinations

• Bleeding that doesn’t stop

• Blood in your stool or urine

• Worsening or new suicidal thoughts or actions

Also seek emergency medical care if you have any of the following symptoms of alcohol poisoning:

• Clammy, blue, or pale skin

• Confusion

• Vomiting

• Low body temperature

• Slowed or abnormal breathing

• Seizures

• Loss of consciousness

When can I start drinking after taking Trintellix?

Healthcare professionals usually prescribe Trintellix as a maintenance treatment for depression. So, you shouldn’t stop taking Trintellix without checking with your prescriber first.

It’s also important to not skip a dose of Trintellix in order to have a drink. Stopping Trintellix suddenly could lead to withdrawal symptoms, including:

• Dizziness

• Headache

• Nausea

• Mood changes, such as anxiety and irritation

• Sensations of “pins and needles”

• Flu-like symptoms, such as muscle aches and fatigue

Even after stopping Trintellix, it can take some time for the medication to completely leave your body. This is because Trintellix has a long half-life. A half-life refers to the amount of time it takes for half of the medication to be cleared from your body. It generally takes about 2 weeks for the average person to completely clear Trintellix from their body.

If you want or need to stop taking Trintellix, talk with your healthcare professional. They can recommend a way to decrease your Trintellix dosage before stopping the medication. They can also talk with you about when it’s safe to start drinking alcohol after stopping Trintellix.

Are there any antidepressants that aren’t affected by alcohol?

No antidepressant is entirely safe to take with alcohol. Each type comes with its own risks.

For example, you’re more likely to experience side effects such as dizziness and sleepiness when pairing an SSRI, such as sertraline (Zoloft), with alcohol. And combining alcohol with SNRIs such as duloxetine (Cymbalta) can increase the risk of liver harm.

It’s also risky to drink alcohol while taking tricyclic antidepressants (TCAs) such as amitriptyline. Doing so can make severe dizziness and blackouts more likely. You should also avoid combining alcohol with monoamine oxidase inhibitors (MAOIs), such as phenelzine (Nardil). This is because consuming certain types of alcohol within 2 weeks of taking an MAOI can lead to dangerously high blood pressure.

No matter which antidepressant you take, drinking alcohol has the potential to worsen your depression symptoms. This includes thoughts of suicide. Drinking alcohol disrupts your thought process and impulse control, which can place you in a risky situation if you’ve been having thoughts of harming yourself.

If you or someone you know is having thoughts of suicide, you’re not alone, and help is available. Call the National Suicide Prevention Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line.

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Written by:

Rosanna Sutherby, PharmD

Rosanna Sutherby, PharmD, has been a community pharmacist in North Carolina for over 23 years. Before beginning her work as a medical writer, she held positions as a pharmacy manager, staff pharmacist, and immunizer.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Bailey E. Eason, PharmD, MS, BCPS

Bailey Eason has been licensed for 6 years and has held licenses in three states (North Carolina, Virginia, and Illinois). She has held positions as a health-system pharmacy administration resident, operating room pharmacy manager, pharmacy manager of clinical operations: surgery, neurology and controlled substances, and most recently as program director  of drug diversion for a large academic health system.

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