3rd inst. of our antidepressant review looks at one of the newest on the market - Brintillex®
Posted by Eamonn Brady on
Anti-depressants Part 3
More on the newest antidepressant on the market
As vortioxetine is the newest antidepressant on the market (over 5 years ago), I am going to discuss it in a little more detail than other antidepressants.
Serotonin Modulator
Serotonin Modulator is a relatively new class of anti-depressant used to describe the vortioxetine (Brintillex®) which is the only drug in this class. How is works is not fully clear but it is thought to act as a serotonin reuptake inhibitor (SRI), agonist of the 5-HT1A receptor, and antagonist of the 5-HT3 and 5-HT7 receptors. It is indicated for major depressive illness and is generally reserved when other antidepressants were not successful; generally, where at least two other antidepressants were not successful. There was no convincing clinical‑effectiveness evidence to show that vortioxetine was more effective than other antidepressants but it may have a better overall safety profile than other antidepressants. Nausea is a very common side effect with the following being a common side effect of vortioxetine: dizziness, serotonin syndrome, flushing, diarrhoea, constipation, vomiting, pruritis and night sweats. It is recommended treatment with vortioxetine is continued for at least six months after symptoms improve. Vortioxetine is not associated with discontinuation symptoms, so it can be stopped abruptly without the need to taper the dose.
Serotonin Syndrome (SS) or Neuroleptic Malignant Syndrome (NMS), potentially life-threatening conditions, may occur with vortioxetine. The risk of SS or NMS is increased with concomitant use of serotonergic-active substances (including triptans), medicinal products that impair the metabolism of serotonin (including MAOIs), antipsychotics, and other dopamine antagonists. Patients should be monitored for the emergence of signs and symptoms of SS or NMS. Serotonin Syndrome symptoms include mental status changes (e.g., agitation, hallucinations, coma), autonomic instability (e.g., tachycardia, labile blood pressure, hyperthermia), neuromuscular aberrations (e.g., hyperreflexia, incoordination) and/or gastrointestinal symptoms (e.g., nausea, vomiting, diarrhoea). If this occurs, treatment with vortioxetine should be discontinued immediately and symptomatic treatment should be initiated.
The safety of vortioxetine in combination with other antidepressants has not been fully studied, but concomitant use should be avoided whenever possible. Serotonin Syndrome (SS) would be a risk if given with other antidepressants.
I will talk about Vortioxetine (Brintollex) and even newer antidepressant a different day; its licenced for major depressive episodes.
To be continued next week
Call in to Whelehans Pharmacies, log on to www.whelehans.ie or dial 04493 34591 (Pearse St) or 04493 10266 (Clonmore).