Nytenso

Indications

Vortioxetine is used to treat major depression (depressive disorder) in adults. It helps improve low mood, loss of interest, sleep and energy problems, and difficulty concentrating that can come with depression.

How It Works

Vortioxetine increases the amount of serotonin, a chemical messenger in the brain that affects mood. It also acts on several serotonin receptors, which is why it is called a multimodal antidepressant.

Dosage and Administration

• Adults under 65 years: usually 10 mg once a day. The doctor may change it to between 5 mg and 20 mg a day depending on response and side effects.
• Adults 65 years and over: usually started at 5 mg once a day.
• Children and young people under 18: not recommended.

Take at any time of day, with or without food, swallowed with water. It usually takes 2 to 4 weeks to start working. Treatment is usually continued for at least 6 months after you feel better. Do not stop or change the dose without talking to your doctor.

Interactions

Do not take it with, or within 14 days of stopping, an MAO inhibitor such as Phenelzine, Moclobemide, Selegiline or Linezolid. Taking it with other medicines that raise serotonin, such as Tramadol, Sumatriptan, other antidepressants, Lithium, Tryptophan or St John's Wort, can cause serotonin syndrome. Bupropion, Fluoxetine and Paroxetine can raise its level, so the doctor may lower the dose; Rifampicin, Carbamazepine and Phenytoin can lower it. Aspirin, painkillers such as Ibuprofen and blood thinners such as Warfarin increase the risk of bleeding. Avoid alcohol.

Contraindications

• Allergy to vortioxetine or any ingredient.
• Taking an MAO inhibitor now or within the last 14 days.

Side Effects

Very common: nausea, usually mild and settling within the first 2 weeks. Common: vomiting, diarrhoea or constipation, dizziness, itching, unusual dreams and sexual problems.

Get urgent medical help if you have thoughts of harming yourself or ending your life, agitation, high fever, sweating, shaking and a fast heartbeat (signs of serotonin syndrome), a fit, unusual bleeding or bruising, extreme high mood or overactivity, confusion and weakness (which can mean low sodium, especially in older people), or signs of allergy such as swelling of the face or difficulty breathing.

Pregnancy and Lactation

There is limited information about use in pregnancy. Use only if the doctor decides the benefit is greater than the risk. Medicines of this type taken late in pregnancy can cause breathing problems, jitteriness or feeding problems in the newborn. Do not stop suddenly if you become pregnant; talk to your doctor. It passes into breast milk, so ask your doctor before breastfeeding.

Precautions and Warnings

Young adults may have more suicidal thoughts in the first weeks; family members should watch for changes in mood or behaviour. Use with care in epilepsy, bipolar disorder, bleeding problems, severe liver disease, a risk of narrow-angle glaucoma and in older people. It may cause dizziness, so take care when driving until you know how it affects you.

Overdose

An overdose can cause nausea, vomiting, diarrhoea, dizziness, itching, drowsiness and flushing; very large amounts may cause fits. Seek medical help straight away.

Therapeutic Class

Antidepressant (serotonin modulator and stimulator).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.