Lulu asked
Can you take Trintellix and Pristiq together?
At a glance
- Taking Pristiq and Trintellix together increases the risk of serotonin syndrome. They aren't often prescribed together but combined use isn't contraindicated.
Answer
There is an interaction to be concerned about between Trintellix (vortioxetine) and Pristiq (desvenlafaxine).
Although they aren't in the same class of medication, both cause increases in the neurotransmitter serotonin, which can increase the risk of a rare but serious disorder known as serotonin syndrome.[1]
They generally aren't prescribed together due to the similarity in how they work and their side effect profile.
Serotonin Syndrome
Taking Trintillix with Pristiq puts you at risk for additive adverse effects, with serotonin syndrome being the most concerning.
Serotonin syndrome is rare, but serious if it occurs. The biggest risk factor for serotonin syndrome is combining drugs that can increase concentrations of the neurotransmitter in the brain (like Pristiq and Trintellix do).
Serotonin syndrome is characterized by a variety of symptoms, including:[2]
- Increased body temperature
- Increased blood pressure
- Sweating
- Delerium
- Confusion
- Muscle spasms
- Coma
If any of these symptoms occur while taking a serotonergic drug, it should be stopped and immediate medical attention should be sought.
There haven't been any studies evaluating the risk of serotonin syndrome with Trintellix and Pristiq specifically, but it is generally accepted that taking more than one drug that increases serotonin puts you more at risk.
The prescribing information for both drugs warns about the use of more than one serotonergic drug.
The following is from the prescribing information for Trintellix:[3]
References
- ^ Elsevier ClinicalKey: Interactions. ClinicalKey
- ^ Serotonin Syndrome. PubMed
- ^ Trintellix Prescribing Information. Takeda
- ^ Elsevier ClinicalKey: Pristiq Monograph.. ClinicalKey
- ^ Elsevier ClinicalKey: Trintellix Monograph. ClinicalKey