Vortioxetine (brintellix) for the treatment of depression.

The safety profile of vortioxetine is similar to that of other selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors. As with other antidepressants in this class, vortioxetine includes a black box warning of increased risk of suicidal thoughts and behavior in children, adolescents, and young adults. It may also cause clinical worsening or activation of mania or hypomania.2 However, current data show no increase in suicidality in the first year of use.3 Vortioxetine should not be used with monoamine oxidase inhibitors, linezolid (Zyvox), intravenous methylene blue, or other serotonergic drugs because of the risk of serotonin syndrome. Vortioxetine may increase the risk of bleeding events, particularly when taken with nonsteroidal anti-inflammatory drugs or other medications that affect coagulation. It also may cause hyponatremia, which is rare but can be severe. This is more likely to happen in older adults, persons taking diuretics, and those who are volume depleted. Vortioxetine is a U.S. Food and Drug Administration pregnancy category C drug.2