Trintellix (Vortioxetine) Side Effects: What Is Common and What Passes
Nausea is the most common, and it usually lasts about two weeks. Weight barely changed in the trials, and sexual side effects rise at higher doses.
By withClaro Editorial · Medically reviewed by Dr. Jason Tan , Consultant Psychiatrist · 2026-11-09 · 10 min read
Key takeaways Nausea is the most common Trintellix side effect. In the FDA trials, 21% to 32% of people had it, depending on dose, against 9% on placebo. The nausea usually starts in the first week and lasts about two weeks. Few people stopped the drug because of it. Weight barely changed in the short trials. Sexual side effects were close to placebo at 5 and 10 mg. At 15 and 20 mg they were more common, reaching about a third of women. Psychiatrist Daniel Suter is right that vortioxetine rarely causes drowsiness and does not prolong the QT interval. He called sexual side effects less likely than on typical SSRIs, not ruled out. In 100 r/trintellix threads, stomach trouble was the most common complaint, named by 138 of 343 people. On this page
What are the most common side effects of Trintellix (vortioxetine)? How long does Trintellix nausea last, and does the dose matter? Does Trintellix cause sexual side effects? Does Trintellix make you tired or affect sleep? What side effects do people on r/trintellix report? Was the psychiatrist right about Trintellix side effects? When should you call your doctor about Trintellix side effects? Keeping track of side effects in the first weeks on Trintellix Trintellix side effects are mostly about the stomach. Nausea is the most common of the vortioxetine side effects, reaching about a third of people at higher doses. It usually fades within about two weeks. Weight barely changed in the trials, while sexual side effects became more common as the dose went up.
Psychiatrist Daniel Suter talked about vortioxetine in a January 2026 episode of the Collaborative Psychiatry QuickTakes podcast, made for primary care clinicians. He covered two newer antidepressants, vilazodone and vortioxetine. He said they carry a lower risk of weight gain and sexual side effects than typical SSRIs, though not zero. This page is about vortioxetine only. We check his claims against the FDA label and trials, and add what people on r/trintellix say about their own side effects.
What are the most common side effects of Trintellix (vortioxetine)?
Nausea leads by a wide margin. The FDA label covers trials of 6 to 8 weeks. In them, 21% to 32% of people on vortioxetine had nausea, against 9% on placebo. Vomiting and constipation came next, each at up to 6%. Most other side effects were only a little more common than on placebo.
In the same trials, women reported new sexual problems more often than men, on placebo as well. The share rose with the dose.
Other side effects on the label, against placebo:
diarrhea in 7% to 10%, against 6% dizziness in 6% to 9%, against 6% dry mouth in 6% to 8%, against 6% itching in 1% to 3%, against 1% abnormal dreams in up to 3%, against 1% Headache is often listed too, but a 2016 analysis of 11 trials found it just as often on placebo. It affected 13.1% on placebo and 12.5% to 14.7% on vortioxetine. In the trials on the FDA label, 5% to 8% of people stopped vortioxetine because of side effects, against 4% on placebo. If one is still there after the first few weeks, tell your prescriber which one and when it started. For how the early weeks usually go, see what the first weeks on an antidepressant feel like .
How long does Trintellix nausea last, and does the dose matter?
Two weeks is the typical length of Trintellix nausea in the FDA label, not an upper limit. It is the median, so for some people the nausea lasts longer. A 2016 analysis of 11 trials put the typical length at 9 to 16 days. It was usually mild or moderate, and it was more common at the higher doses.
The FDA label breaks the trial results down by dose:
Dose Nausea Stopped because of side effects 5 mg 21% 5% 10 mg 26% 6% 15 mg 32% 8% 20 mg 32% 8% Placebo 9% 4%
Nausea was the most common reason people stopped, though few stopped for it. In the 2016 analysis, 1.2% to 3.8% left the trials because of nausea, depending on dose.
Food does not change how the body absorbs vortioxetine, so the label lets you take it with or without a meal. Whether a meal eases nausea, the label does not say.
Note which days the nausea is worse, what time you took your dose and whether you had eaten. If it lasts past the first few weeks or you are vomiting, bring those notes to your prescriber. The dose is their call, so ask about it rather than skipping doses.
Does Trintellix cause sexual side effects?
It can, and more often at higher doses. The trials on the FDA label asked people with no sexual problems at the start about desire, arousal and orgasm. At 5 and 10 mg, new problems were close to placebo. At 15 and 20 mg, about a third of women had them, and in men the rise was clearest at 20 mg.
People on placebo reported new problems too, so part of what shows up in these trials is not the drug:
Dose Women Men 5 mg 22% 16% 10 mg 23% 20% 15 mg 33% 19% 20 mg 34% 29% Placebo 20% 14%
If you left an SSRI because of sexual side effects, a 2015 trial is the most direct test. It took 447 adults whose depression was under control but who had sexual problems on an SSRI. Over 8 weeks, sexual function improved more on vortioxetine than on escitalopram, 8.8 points against 6.6. The makers of vortioxetine funded it, and it compared against one SSRI only.
If sex has changed since you started, tell your prescriber what changed and since when: desire, arousal or orgasm. Don't stop on your own, since a different dose or medication is often an option. For what that change involves, see how switching antidepressants works .
Does Trintellix make you tired or affect sleep?
Not often in the trials. In a 2016 analysis of 11 trials, sleepiness affected 2.6% to 3.2% of people on vortioxetine and 2.4% on placebo. Fatigue was also close to placebo. On duloxetine, both were far more common, at 8.5% and 8.0%. Insomnia came up in 2.0% to 5.1%, against 4.0% on placebo.
Abnormal dreams reached 3% at the top dose in the trials, against 1% on placebo.
In our count of 100 r/trintellix threads, tiredness was the second most common complaint, after stomach trouble. The trials compared people with a placebo group, which takes out tiredness they would have had anyway. The Reddit threads have no such comparison, and people who are struggling are more likely to post.
The label does not set a time of day for the dose. If Trintellix makes you drowsy, note when the tiredness hits and how long after your dose. Then ask your prescriber whether a different time of day would suit you.
What side effects do people on r/trintellix report?
Stomach trouble came first, well ahead of tiredness and anxiety
We read 100 recent threads about side effects on r/trintellix, comments included. Between the posts and the replies, 343 people wrote about their own time on Trintellix. Nausea or another stomach problem was the complaint they named most.
What people named People Nausea, vomiting or other stomach trouble 138 Tiredness or sleepiness 58 More anxiety or restlessness 52 Lower sex drive or trouble with orgasm 44 Trouble sleeping 27 Feeling emotionally flat 20 Headache 18 Weight gain or a bigger appetite 15
One person can be in several rows. People with a problem are more likely to post, so these threads lean toward the hard cases.
Ninety people said how long their side effects lasted. For 33, they eased within the first eight weeks, and 54 said theirs were still there when they wrote. That is how things stood when they posted, not how they ended: we don't know how far into treatment each person was. For some, the change was sudden. One person on r/trintellix wrote:
at the 3-week mark it was like a switch flipped and the nausea went from a constant 7/10 to a very bearable 1/10 or 2/10
Of the 343, 109 named something that helped. A different time of day came up for 23, and waiting it out for 16.
Some people had no trouble at all. Another person on r/trintellix wrote:
I've never really had side effects from Trintellix
What helped one person may not suit you. If you want to try a different time of day, agree on it with your prescriber first.
Was the psychiatrist right about Trintellix side effects?
Mostly, yes. Psychiatrist Daniel Suter was right that vortioxetine does not prolong the QT interval and rarely makes people drowsy. Weight also barely changed in short trials. He simplified two things. Headache was no more common than on placebo. Sexual side effects were clearly more frequent at 15 and 20 mg than his summary suggests.
On the early weeks, he said:
We still have the potential for GI and headache side effects on initiation, just like the rest of the SSRIs.
Most of the trials behind these checks were funded by the drug's makers, Takeda and Lundbeck.
What Suter said What the research found Does it hold up? Stomach and headache side effects at the start, as with SSRIs Nausea in 21% to 32% against 9% on placebo, mostly in the first week. Headache in 12.5% to 14.7% against 13.1% on placebo Partly: stomach yes, headache no more often than placebo Weight gain and sexual side effects are not typical Weight did not change significantly in short trials. New sexual problems in 22% to 34% of women and 16% to 29% of men, against 20% and 14% on placebo Weight, mostly yes. Sexual side effects, not at the higher doses The risk is much lower than with typical SSRIs, not zero In a 2015 trial of 447 people with sexual problems on an SSRI, moving to vortioxetine improved sexual function more than moving to escitalopram over 8 weeks Yes, though it rests on one trial against one SSRI No QTc prolongation In the label's heart rhythm study of 340 healthy men, the effect stayed under the 10 ms level regulators watch for Yes Daytime tiredness is relatively rare, and then he moves the dose to night Sleepiness in 2.6% to 3.2% against 2.4% on placebo. An evening dose was not tested in the trials Rare, yes. The evening dose is his practice, not trial data Start at 5 mg, 10 mg after a week, up to 20 mg The label starts at 10 mg, then 20 mg as tolerated, with 5 mg for people who do not tolerate more. Doses above 20 mg were not studied Partly: the maximum matches, the 5 mg start is his own cautious practice Vortioxetine works the same with or without food The label says food had no effect on how the body absorbs it Yes
His comparison is with older SSRIs, and on that he is mostly right. He also said plainly that the risk does not drop to zero:
just that the risk is significantly reduced when compared with your typical SSRIs
If you chose Trintellix to avoid a side effect you had on an SSRI, tell your prescriber which one. Then you both know what to watch for. For what people report about weight over months, see Trintellix and weight gain .
When should you call your doctor about Trintellix side effects?
Most early side effects of antidepressants ease within the first weeks, while a few tend to last and are worth raising.
Side effects that often pass include nausea, an upset stomach, headache, sleep changes and feeling restless. If sexual side effects, weight change or feeling emotionally flat appear, they tend to stay while you take the medication. A change of dose or medication often helps with these, so mention them instead of putting up with them.
Call 911 or 988 now if you feel you might act on thoughts of suicide, or you have a seizure, a very high temperature with stiff muscles, or swelling of the face or throat.
Call your prescriber the same day, or get urgent care, if you notice:
new or worse thoughts of suicide or self-harm, especially early on, after a dose change, or in people under 25 agitation, heavy sweating, fever, muscle twitching or confusion, which can be signs of serotonin syndrome unusual bleeding or bruising, black or tarry stools, or vomiting blood a sudden burst of energy, little need for sleep, racing thoughts or unusual risk-taking, especially if you or a close relative has bipolar disorder headache, confusion, weakness or unsteadiness, especially if you are older (a sign of low sodium) eye pain, changes in vision, or swelling or redness in or around the eye fainting, or a fast or irregular heartbeat Hormonal changes across the menstrual cycle, pregnancy and menopause can change how a medication feels. Any side effect that bothers you is reason enough to bring it up.
Medical review Medically reviewed by Dr. Jason Tan, Consultant Psychiatrist, on 27 October 2026, this section only. Next review: 27 October 2027.
For side effects that are not urgent, a short record makes the call faster. Your prescriber will want to know when each one started, whether it is fading and what you have tried. Before you call or go to your appointment, write down:
which side effect you have and the week it started your dose and the time of day you take it whether you take it with food whether it's easing, steady or getting worse what you have tried, such as eating first or moving the dose any change in sex, mood or sleep since you started If you're having thoughts of harming yourself, contact emergency services or a crisis line straight away. In the US, call or text 988. In the UK, call Samaritans on 116 123. Elsewhere, find a crisis line near you .
Keeping track of side effects in the first weeks on Trintellix
Side effects on Trintellix tend to change from week to week, and memory blurs which day was bad. A short daily note on nausea, sleep and energy shows whether things are settling. It also shows whether a change of timing or a meal made a difference.
withClaro app lets you log mood, energy, sleep and appetite each day. It links side effects to your dose and turns the record into a report for your prescriber.
Download on the App Store Nausea, tiredness and sleep changes on Trintellix often shift from one week to the next. withClaro app lets you log mood, energy, sleep and appetite each day, track side effects against your dose and share a report with your prescriber.
Frequently asked questions Is vortioxetine stimulating or sedating? Neither, for most people. In the trials, sleepiness and insomnia were both close to placebo. If you feel wired or drowsy, note the time of your dose and when the feeling comes, and tell your prescriber.
What are the long-term side effects of vortioxetine? The longest data come from open-label studies of up to a year, which had no placebo group. In them, average weight rose by 0.7 to 0.8 kg. Raise any side effect that lasts past the first weeks at your next appointment.
Does Trintellix cause itching? Sometimes. In the trials, 1% to 3% of people had itching, against 1% on placebo. Tell your prescriber about a rash or itching, and get urgent care for swelling of the face or throat.
Can Trintellix cause anxiety? On r/trintellix, more anxiety or restlessness was the third most common complaint, after stomach trouble and tiredness. Tell your prescriber if it is hard to manage, and call the same day if it comes with agitation, fever or confusion.
How to avoid nausea with Trintellix? The label allows Trintellix with or without a meal and says nothing on whether eating eases nausea. On r/trintellix, a different time of day was one of the changes people said helped with side effects. Try one change at a time, note the result, and ask your prescriber before changing your dose.
Does vortioxetine prolong the QT interval? No. In a study of 340 healthy men, the effect on heart rhythm stayed under the 10 ms level regulators watch for. If you have a heart rhythm problem, still mention it to your prescriber before starting.
Related articles
Sources TRINTELLIX (vortioxetine) prescribing information, Takeda, revised 2/2025, US Food and Drug Administration via DailyMed Daniel Suter, MD. Two New Antidepressants You're Probably Not Using But Should Consider. Collaborative Psychiatry QuickTakes, January 12, 2026 Baldwin DS, et al. The safety and tolerability of vortioxetine: analysis of data from randomized placebo-controlled trials and open-label extension studies. Journal of Psychopharmacology, 2016 Jacobsen PL, et al. Effect of vortioxetine vs. escitalopram on sexual functioning in adults with well-treated major depressive disorder experiencing SSRI-induced sexual dysfunction. Journal of Sexual Medicine, 2015 Claro articles are for self-monitoring and educational purposes only. They are not a medical device, therapist, or diagnostic tool, and do not replace care from your prescribing clinician. If you are in crisis, contact your care team, emergency services, the Samaritans (UK: 116 123), or the Crisis Text Line (US: text HOME to 741741).
