| Major depressive disorder. View labelExact | Initiate 10 mg once daily; increase to 20 mg once daily after at least 7 days if tolerated.[label_vortioxetine] | Multimodal antidepressant: SERT inhibition plus 5-HT receptor modulation. | CYP2D6, CYP3A4, CYP2C19 | Single-dose mean 66 h; Steady-state mean 66 h | No | — | - Suicidality and psychiatric activation during initiation and dose changes, especially in younger adults.[label_vortioxetine]
- Nausea and early GI tolerability during the first 1–2 weeks; supportive care and dosing time adjustments can prevent premature discontinuation.
- Sodium in older adults or patients on diuretics if symptoms suggest hyponatremia (confusion, fatigue, falls).[label_vortioxetine]
- Medication reconciliation for CYP2D6 inhibitors/inducers that can shift exposure and tolerability.[label_vortioxetine]
- Mood elevation or mixed features in bipolar-spectrum illness; coordinate monitoring plans via the bipolar disorder hub.
| No | 2026-02-22 |
|---|
| Major depressive disorder. View labelExact | Initiate 10 mg once daily with food for 7 days, increase to 20 mg once daily for 7 days, then advance to 40 mg once daily with food if tolerated. | Serotonin reuptake inhibitor and 5-HT1A partial agonist. | CYP3A4, CYP2C19 (minor), CYP2D6 (minor) | Single-dose mean 25 h; Steady-state mean 25 h | No | — | - Monitor clinical response, adverse effects, and interactions; see the drug page for details.
| No | 2026-02-22 |
|---|
| Major depressive disorder; generalized anxiety disorder; diabetic peripheral neuropathic pain; fibromyalgia; chronic musculoskeletal pain. View labelExact | Major depressive disorder (clinical depression) and generalized anxiety disorder: typical initiation is 30 mg once daily for one week for tolerability, then 60 mg once daily. If needed, 90–120 mg/day is sometimes used (divide when >60 mg/day), though antidepressant benefit often plateaus beyond 60 mg/day. | Serotonin-norepinephrine reuptake inhibitor (SNRI). | CYP1A2, CYP2D6 | Single-dose mean 12 h; Single-dose range 8–17 h; Steady-state mean 12 h | No | — | - Blood pressure and heart rate at baseline and periodically, especially during titration and at higher doses.
- Liver-injury symptoms (jaundice, dark urine, abdominal pain, pruritus), particularly in patients with alcohol use disorder or hepatic disease; LFTs are obtained when clinically indicated.
- Sodium in older adults or diuretic users if symptoms suggest hyponatremia (confusion, fatigue, falls).
- Medication reconciliation for serotonergic combinations and for CYP2D6 substrates (TCAs, antipsychotics, beta-blockers, tamoxifen).
| No | 2025-10-05 |
|---|