Trintellix Module 7

Question 1

What is the indication for Trintellix?

Answer 1

The treatment of MDD

Question 2

List the recommended starting dose for Trintellix.

Answer 2

10mg once daily without regards to meals.

should then be increased to 20mg a day as tolerated.

Question 3

What are the dosage considerations for pregnant women?

Answer 3

pregnancy category C: there are no adequate and well controlled studies.
should only be use if the benefit justifies the risk to the fetus.

Question 4

What are the dosage considerations for geriatric patients?

Answer 4

no does adjustment

Question 5

What are the dosage considerations for hepatic impairment.

Answer 5

trintellix has not been studied in patients with severe hepatic impairment.

Question 6

What are the dosage considerations for Renal Impairment.

Answer 6

no dose adjustment necessary.

Question 7

What is the MOA of vortioxetine?

Answer 7

not fully understood but thought to be related to its enhancement of serotonergic activity in the CNS through inhibition of the reuptake of 5-HT.
Also, has several other activities including 5-HT3 receptor antagonism and 5-HT1a receptor agonism.

Question 8

What is the half life of vortioxetine?

Answer 8

66 hours

Question 9

Describe the affinities and binding sites of vortioxetine.

Answer 9

binds with high affinity to the human serotonin transporter.
potentially and selectivity inhibits reuptake of serotonin
BInds to the 5-HT3,5-HT1a,5-HT7, 5-HT1d receptors and is a 5-HT3, 5HT1d, an 5-HT7 receptor antagonist. 5-HT receptor partial agonist, adn 5-HT1a receptor agonist.

Question 10

List the 5-HT transporter SERT occupancy by dose.

Answer 10

5mg-50%
10mg-65%
20mg-80%

Question 11

In____ short term placebo controlled studies in subjects________ years, Trintellix was ______to placebo in improvement of depressive symptoms as measured by______________to endpoint on the primary efficacy measurement.

Answer 11

5,18-75,superior. mean change from baseline.

Question 12

The efficacy of Trintellix for the treatment of MDD was also demonstrated in a ______________________ of Trintellix in elderly patients aged_____with MDD.

Answer 12

randomized, double blind, placebo controlled, fixed dose.

64-88 years

Question 13

In a long term maintenance study, patients on trintellix experienced a ______________________longer time to have recurrence of depressive episodes than did patients on placebo.

Answer 13

statistically significantly.

Question 14

What are the contraindications for Trintellix?

Answer 14

Those with a hypersensitivity to vortioxetine.
The Use of MAOI intended to treat psychiatric disorders.or within 21 days of stopping trintellix becuase of an increased risk of serotonin syndrome.
The use of trintellix within 14 days of stopping MAOI.
Also those using MAOI such as linzoloid or intravenous methylene blue is also contraindicated.

Question 15

List the warnings and precautions of Trintellix.

Answer 15

Suicidal thoughts and behaviors
clinical worsening and suicide risk
serotonin syndrome
abnormal bleeding
activation of mania/hypomania 
hyponatremia
angle closure glaucoma

Question 16

What are the most commonly observed adverse reactions associated with Trintellix. ( >5% an at least twice that of placebo)?

Answer 16

Nausea
constipation
vomiting

Question 17

Summarized the drug interactions for Trintellix.

Answer 17

MAOIs: Reactions can be serious or fatal
Serotongergic drugs: because of the risk of serotonin toxicity. serotonin syndrome may occur.
Strong inhibitors of CYP2d6: reduce the dose of trintellix in half when a strong CYP2D6 is administered.
Strong CYP inducers. consider increasing the dose of trintellix when a strong CYP inducer is co administered for more than 14 days.

Question 18

What are the dosage forms and strengths for Trintellix?

Answer 18

immediate release, film coated tablets. in 5mg,10,mg,20mg.