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Trintellix- why need previous failed end trials?

singasongofjoy

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I’ve recently begun seeing a client who was on Trintellix in the past and is considering re-starting medication (has an upcoming appt with PCP but I’m trying to help him hook up with a psychiatrist- right now i am just feeding my own curiosity about meds). I’m unfamiliar with this med as I haven’t ever had anyone who has been on it. Curious to know why one must have failed previous med trials to be on it - I haven’t gone on a deep dive to research it (yet) but is this still the case in the US? I didn’t come across anything yet that appeared to indicate it has a substantially higher risk profile than other meds. Pros/cons from a professional perspective?


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clausewitz2

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I’ve recently begun seeing a client who was on Trintellix in the past and is considering re-starting medication (has an upcoming appt with PCP but I’m trying to help him hook up with a psychiatrist- right now i am just feeding my own curiosity about meds). I’m unfamiliar with this med as I haven’t ever had anyone who has been on it. Curious to know why one must have failed previous med trials to be on it - I haven’t gone on a deep dive to research it (yet) but is this still the case in the US? I didn’t come across anything yet that appeared to indicate it has a substantially higher risk profile than other meds. Pros/cons from a professional perspective?


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Trintellix is great, it lets me identify other people prescribers as extremely gullible based on the extent to which they wax enthusiastic about it. Bonus points if they repeat the incredibly specious claim that it treats cognitive dysfunction in MDD. If I ever do end up being asked to supervise NPs for some reason asking "what are your thoughts about Trintellix" would be a great question to determine how worried I have to be about their ability to have thoughts not put in their heads by pharma promotional materials.

The drug itself is...fine. All much of a muchness with other serotonin reuptake inhibitors. Like @tr said it is expensive at the moment so would be very strange as a first or even second choice but if someone's tried multiple serotonergic meds and are dead set against anything from a markedly different class why not?
 
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I have only seen this medicine prescribed by ARNP and it has had not had any benefits, and by the time I see the patients, I get them on sertraline, escitaloprame, venlafaxine etc, and usually have better response.

So far I'm not impressed by this medicine.
 
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CalmAndCollected

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Newer drug, still on patent, therefore expensive, causing insurance companies to balk and demand evidence that cheaper alternatives were tried. Standard story. Price will come down once patent expires and generics become available.
Ironically, the only patients I have ever encountered on it where low income patients who were getting samples from their doctor for free.
 
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Basis

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I have only seen this medicine prescribed by ARNP and it has had not had any benefits, and by the time I see the patients, I get them on sertraline, escitaloprame, venlafaxine etc, and usually have better response.

So far I'm not impressed by this medicine.

Same. I haven't used it at all after residency. But in residency, people would always come to us on it from their PCP. Not only was it never effective, all of them felt jittery and spacey. Don't quote me, but I think it's some partial agonist for one serotonin receptor? Even Stahls (which attributes many magical and weird properties to drugs) has some kind of warning about this effect.

Also had a few 65+ year old patients who had intermittent double vision from it. Worthless med imo.
 
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