Trintellix Withdrawal & Tapering Guide
vortioxetine
Boxed Warning
Suicidality risk in children, adolescents, and young adults under 25 during initial treatment.
In short
Trintellix (vortioxetine) is an SSRI with a half-life of 66 hours. Relatively long half-life. It is also sold as Brintellix.
- Class
- SSRI
- Half-life
- 66 hours
- Common doses
- 5mg, 10mg, 20mg
Educational reference only. Dose changes are decided with the prescriber who knows your history.
Overview
Vortioxetine is a multimodal serotonergic antidepressant approved for major depressive disorder. Beyond SERT inhibition, it has direct activity at multiple serotonin receptors, which may contribute to pro-cognitive effects.
5mg, 10mg, 20mg
Tablets: 5mg, 10mg, 20mg
No assigned category; see FDA labeling (approved post-2015 PLLR rule)
Mechanism of Action
Multimodal serotonergic agent: inhibits the serotonin transporter (SERT) and also acts as a 5-HT3, 5-HT7, and 5-HT1D receptor antagonist, 5-HT1B partial agonist, and 5-HT1A agonist.
Taper Notes
Relatively long half-life. Tablets can be split. Limited withdrawal data compared to older SSRIs.
Hyperbolic Tapering Guidance
Newer drug with less tapering data. Apply general SSRI hyperbolic tapering principles. Tablets may be split.
Summary written by TaperCommunity, informed by the Maudsley Deprescribing Guidelines (Horowitz & Taylor) and related literature — see Sources & References below. Not affiliated with or endorsed by the Maudsley.
Common Withdrawal Symptoms
Interactions & Safety
Drug Interactions
- MAOIs — contraindicated (serotonin syndrome risk)
- Strong CYP2D6 inhibitors (e.g., bupropion, fluoxetine, paroxetine) increase vortioxetine levels — reduce dose by 50%
- Strong CYP inducers (e.g., rifampin, carbamazepine) decrease vortioxetine levels — consider dose increase
Food Interactions
- No significant food effect on pharmacokinetics
- Avoid alcohol during treatment
Contraindications
- MAOIs within 21 days
- Known hypersensitivity to vortioxetine
Toxicity
Serotonin syndrome with serotonergic combinations. Generally well tolerated; nausea is the most common adverse effect.
Pharmacokinetics
ADME Profile
Well absorbed orally. Absolute bioavailability ~75%. Tmax 7–11 hours. Food does not affect pharmacokinetics.
~2600 L (~33 L/kg)
Extensively metabolized hepatically via CYP2D6 (primary), CYP3A4/5, CYP2C9, CYP2C19, CYP2A6, and CYP2C8. Major metabolite is pharmacologically inactive.
Renal (~59%) and fecal (~26%). Negligible unchanged drug in urine.
~98%
~33 L/hr (oral clearance)
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Other Drug Profiles
The arithmetic of a proportional reduction
The Maudsley Deprescribing Guidelines and NICE NG222 describe reducing SSRI medications by a proportion of the previous dose rather than by a fixed amount, so each cut is smaller than the last. The table shows what that arithmetic produces at 10% per step, using 10 mg only as a worked example. How large each step is, how long it is held, and whether this pattern applies at all are decisions for the person and their prescriber.
| Step | % of starting dose | Worked example (10 mg start) |
|---|---|---|
| Start | 100% | 10 mg |
| Step 1 | 90% | 9 mg |
| Step 2 | 81% | 8.1 mg |
| Step 3 | 73% | 7.29 mg |
| Step 4 | 66% | 6.56 mg |
| Step 5 | 59% | 5.9 mg |
| Step 6 | 53% | 5.31 mg |
| Step 7 | 48% | 4.78 mg |
| Step 8 | 43% | 4.3 mg |
This is an illustration of a published method, not a schedule for anyone. It does not account for how long you have taken Trintellix, your current dose, formulation, or history. TaperCommunity does not recommend doses or dose changes; those are agreed with your prescriber.
Frequently asked questions about Trintellix
What are the withdrawal symptoms of Trintellix (vortioxetine)?
Common withdrawal symptoms of Trintellix (vortioxetine) include: dizziness, nausea, headache, irritability. Symptom severity varies by individual, dose, and duration of use.
How should I taper off Trintellix (vortioxetine)?
Relatively long half-life. Tablets can be split. Limited withdrawal data compared to older SSRIs. Newer drug with less tapering data. Apply general SSRI hyperbolic tapering principles. Tablets may be split.
Can I stop Trintellix cold turkey?
Stopping Trintellix abruptly is not recommended. Its half-life is 66 hours, and the receptor adaptations built up during treatment do not reverse at that speed, so a sudden stop tends to produce the sharpest withdrawal. Prescribing guidance favours gradual, proportional reductions agreed with your prescriber.
How long does Trintellix stay in your system?
Trintellix (vortioxetine) has a half-life of 66 hours. A drug is mostly cleared after about five half-lives, so Trintellix is largely out of the body about 14 days after the last dose, longer in older adults or with liver or kidney impairment. Withdrawal symptoms often begin before the drug has fully cleared and continue after it has, because the adaptations the brain made during treatment reverse more slowly than the drug leaves the blood.
Recent discussions about Trintellix
What members tapering Trintellix are asking and reporting right now. Personal experience, not medical advice.
Sources & References
Trintellix (vortioxetine) information on this page is sourced from peer-reviewed research, regulatory bodies, clinical guidelines, and patient-advocacy organizations.
Encyclopedic & chemical databases
Neutral, high-authority entity references.
Peer-reviewed research
Primary literature cited in this taper guide.
- Horowitz MA, Taylor D 2019 — Tapering of SSRI treatment to mitigate withdrawal symptoms (hyperbolic taper) (The Lancet Psychiatry)
- Davies J, Read J 2019 — A systematic review into the incidence, severity and duration of antidepressant withdrawal effects (Addictive Behaviors)
- Framer A 2021 — The patient voice: an exploration of the experience of withdrawal from antidepressants (Therapeutic Advances in Psychopharmacology)
Clinical guidelines
Evidence-based deprescribing and prescribing standards.
Deprescribing-specific resources
Clinician-facing references on tapering protocols.
- Deprescribing.org — Evidence-based deprescribing algorithms from the Bruyère Research Institute
- Royal College of Psychiatrists — Stopping antidepressants — UK clinical guidance on safely discontinuing antidepressants
Patient-advocacy & lived-experience
Long-running communities documenting withdrawal experience.
- Surviving Antidepressants — tapering forum — Long-running community archive of antidepressant taper experiences
- Inner Compass Initiative — Withdrawal Project — Peer-led resources for psychiatric drug withdrawal
- Mad in America — antidepressant withdrawal archive — Journalism and personal narratives on SSRI/SNRI discontinuation
- RxISK — adverse drug reaction reporting — Independent database of patient-reported adverse effects
TaperCommunity does not provide medical advice. Always consult a qualified prescriber before adjusting psychiatric medication.