Nausea, Constipation, and Dizziness: 8 Trintellix Side Effects You Should Know About

Trintellix (vortioxetine) is a prescription medication that treats depression in adults. It’s part of a group of medications called atypical antidepressants. It works by boosting the effects of serotonin, a chemical in your body that’s essential for regulating mood, memory, and more.

Antidepressants like Trintellix are often taken long term. So if your healthcare professional prescribes this medication, it can be helpful to know what side effects to expect. Here, we’ll cover 8 Trintellix side effects and how to manage them if they occur.

Trintellix side effects at a glance

Most Trintellix side effects are mild and go away as your body adjusts to the medication. Some common mild Trintellix side effects include: 

• Nausea

• Vomiting

• Constipation

• Dizziness

• Dry mouth

• Diarrhea

• Sexual side effects

• Abnormal dreams

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Some rare, but more serious Trintellix risks to be aware of include:

• Serotonin syndrome

• Antidepressant discontinuation syndrome if stopping Trintellix abruptly

• Increased risk of bleeding

• Low sodium (hyponatremia)

• Glaucoma

• Activation of mania or hypomania in people with bipolar disorder

This medication also has a boxed warning for an increased the risk of suicidal thoughts and behaviors in people who are 24 years old or younger. A boxed warning is the FDA’s strictest warning for medications. However, keep in mind that Trintellix is not approved for children younger than 18 years.

1. Nausea and vomiting

Nausea is the most common Trintellix side effect. It’s also possible to experience vomiting with Trintellix, but it’s not as common as nausea.

Nausea is most likely to start within your first week of taking Trintellix. Women tend to experience nausea more than men. Higher Trintellix doses are also more likely to cause nausea. While it can be bothersome, there are a few things you try to relieve nausea, such as:

• Taking Trintellix with food

• Taking Trintellix at bedtime (with your prescriber’s approval)

• Avoiding foods that worsen nausea, such as fried or spicy foods

• Drinking ginger or peppermint tea

• Staying hydrated

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• How to take Trintellix: Taking the right Trintellix dose can help manage or prevent some side effects. This dosage guide explains typical dosages and when a dose adjustment might be needed.

• Which type of antidepressant is right for you? Trintellix is an atypical antidepressant. Learn more about four other types of commonly used antidepressants

If your nausea is affecting your daily life, your prescriber may recommend over-the-counter (OTC) or prescription nausea medications for short-term use. If your nausea continues, however, Trintellix may not be the best option for you. So make sure to stay in touch with your prescriber about how you’re feeling.

2. Constipation

Trintellix can cause constipation, but it’s typically mild. And there are a few things you can do to help prevent or manage it:

• Exercise regularly. Increasing your physical activity can help relieve or prevent constipation.

• Stay hydrated. Drinking enough water helps soften your stool, making it easier to pass.

• Prioritize fiber-rich foods. Eating more high-fiber foods — such as beans, whole grains, and vegetables — can also help make your stool easier to pass.

If following these steps doesn’t relieve your constipation, your prescriber may temporarily recommend OTC laxatives, such as bisacodyl (Dulcolax). But be sure to talk with your prescriber or pharmacist before taking any OTC medications. They can tell you if they interact with Trintellix. If your constipation continues longer than a week or so, keep your prescriber in the loop. It may be a sign something else is going on.

3. Dizziness

Dizziness is also one of the more commonly reported Trintellix side effects. It typically goes away as your body gets used to the medication.

If you have dizziness, ask your prescriber if you can take Trintellix at bedtime to reduce the impact on your day to day life. Your prescriber may also reduce your dosage or if dizziness doesn’t improve. However, if dizziness doesn’t improve, or is interfering with your daily life, Trintellix may not be the best option for you long term. Additionally, it may be a sign something else is going on. So make sure to keep your prescriber in the loop.

4. Sexual problems

Many antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), can cause sexual side effects. Trintellix is less likely to cause sexual side effects compared with most other antidepressants. In fact, research has shown that sexual dysfunction with Trintellix is similar to placebo (a pill with nothing in it).

Despite the low risk, sexual side effects with Trintellix are still possible. Men may experience decreased sex drive, trouble ejaculating, or trouble keeping an erection. Women may experience decreased sex drive or trouble having an orgasm.

If you have sexual problems while taking Trintellix, don’t be embarrassed to bring it up to your prescriber. They can help you determine if Trintellix is the true cause and what to do next.

5. Antidepressant discontinuation syndrome

Antidepressant discontinuation syndrome describes withdrawal symptoms that may occur if you suddenly stop taking an antidepressant. Symptoms may include:

• Headache

• Dizziness

• Flu-like symptoms, like fatigue and muscle aches

• Nausea and upset stomach

• Trouble sleeping

• Mood changes, such as increased anxiety, irritation, and restlessness

To avoid these symptoms, your prescriber will typically recommend lowering your Trintellix dose over a week or longer if you wish to stop taking it and are taking a daily dose above 10 mg.

6. Suicidal thoughts and behavior

All antidepressants carry a warning for an increased risk of suicidal thoughts and behavior in young adults and children. This is largely based on a specific review of studies.

However, the results of this review are considered controversial. And recent research has shown that this warning has led to fewer children and young adults seeking treatment for depression. Of note, this review didn’t include Trintellix, which was FDA approved in 2013. And Trintellix is approved only for adults ages 18 years and older.

It’s important to seek care if you or your child has depression. It's also important to watch for mood changes, or an increase in suicidal thoughts or behaviors, if you or your child starts an antidepressant. The risk may be higher risk during the first few months of starting an antidepressant, or after dosage changes.

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.

7. Serotonin syndrome

Medications that increase serotonin levels, including Trintellex, may cause serotonin syndrome. This is a rare but potentially severe condition where serotonin levels in the body rise to dangerous levels. Taking several medications that increase serotonin increases your risk. Examples of medications that increase serotonin include:

• Other antidepressants, such as fluoxetine (Prozac)

• Certain anti-anxiety medications, such as buspirone 

• Certain pain medications, such as tramadol (ConZip)

• Certain migraine medications, like sumatriptan (Imitrex)

• Mood stabilizers, such as lithium (Lithobid)

• Some supplements, such as St. John’s Wort

• Monoamine oxidase inhibitors (MAOIs), such as selegiline (Emsam, Zelapar)

This isn’t a complete list of medications that can increase serotonin. Let your prescriber or pharmacist know if you start any new prescription or OTC medications. They can tell you whether they increase serotonin and therefore may interact with Trintellix.

Symptoms of serotonin syndrome can range from mild to severe and may even become life-threatening. For example, you may experience dizziness, rapid heart rate, and increased sweating. More severe risks include seizure and coma. If you experience symptoms that feel severe, seek emergency care.

8. Bleeding

Taking Trintellix may increase your risk of bleeding. This is because Trintellix may interfere with part of your body’s blood clotting process.

Taking Trintellix with other medications that increase your bleeding risk can make this side effect more likely. Examples include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Motrin, Advil), naproxen (Naprosyn, Aleve), and aspirin

• Anticoagulants, such as warfarin (Jantoven) and apixaban (Eliquis)

• Antiplatelet medications, such as clopidogrel (Plavix)

This isn’t a complete list of medications that can increase bleeding. So check with your prescriber and pharmacist before you start Trintellix (or if you start a new medication while taking Trintellix). They can let you know if you’re at risk of an interaction.

Signs of abnormal bleeding may include nosebleeds, bruising, or reddish brown spotting on your skin. Blood in your urine is also possible. If you have bleeding that doesn’t stop, large amounts of blood in your urine or stool, or extreme weakness, seek emergency care.

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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:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Alex Brewer, PharmD, MBA

Alex Brewer, PharmD, MBA, is a licensed pharmacist specializing in chronic disease and health and wellness. Upon completing his residency, he worked in the managed care field, conducting medication therapy management and adherence counseling sessions with Medicaid, Medicare, and private insurance patients, before transitioning to a career in medical writing.

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