[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Atypical antidepressants](https://durgical.com/en/pharmacology/classes/atypical-antidepressants/) › Vortioxetine

# Vortioxetine

## Atypical antidepressants?

Atypical antidepressants

A 'multimodal' antidepressant: it blocks serotonin reuptake and acts on several serotonin receptors. Nausea is the main early side effect.

Updated Nov 12, 2026

## Quick facts

**Group**
[Atypical antidepressants](https://durgical.com/en/pharmacology/classes/atypical-antidepressants/)

**Target**
Serotonin transporter (SERT); also 5-HT3, 5-HT7 and 5-HT1D receptors (antagonist) and 5-HT1A and 5-HT1B (partial agonist); the 5-HT3A receptor is shown

**Used for**
Major depressive disorder in adults

**Key effects**
Nausea and vomiting · Constipation · Unusual dreams

**Monitor**
Mood and suicidal thoughts · Bleeding

**ATC**
N06AX26

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

⇄**Serotonin transporter (SERT); also 5-HT3, 5-HT7 and 5-HT1D receptors (antagonist) and 5-HT1A and 5-HT1B (partial agonist); the 5-HT3A receptor is shown**Vortioxetine

ⓘ The figure shows vortioxetine bound to the extracellular domain of the human 5-HT3A receptor, one of the serotonin receptors it blocks.

**Target in 3D:** Serotonin transporter (SERT); also 5-HT3, 5-HT7 and 5-HT1D receptors (antagonist) and 5-HT1A and 5-HT1B (partial agonist); the 5-HT3A receptor is shown. PDB structure 8BLB (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/8BLB) · Drag to rotate · pinch to zoom

Vortioxetine is a potent inhibitor of the serotonin transporter, as SSRIs are, and also acts directly on serotonin receptors: it is a partial agonist at 5-HT1A and 5-HT1B receptors and an antagonist at 5-HT1D, 5-HT3 and 5-HT7 receptors. The antidepressant effect builds over weeks.

- Blocks the serotonin transporter (like an SSRI)
- Blocks 5-HT3, 5-HT7 and 5-HT1D receptors
- Partial agonist at 5-HT1A and 5-HT1B receptors
- Mood improves over several weeks

## Indications

- Major depressive disorder in adults [Major depressive disorder →](https://durgical.com/en/conditions/major-depressive-disorder/)

## Adverse effects

### Common

- Nausea and vomiting
- Constipation
- Unusual dreams
- Sexual problems (lower libido, delayed orgasm or ejaculation)

### Serious (rare, important)

- Suicidal thoughts in people under 24 (boxed warning)
- Serotonin syndrome: fever, agitation, stiffness, twitching, fast heartbeat
- Abnormal bleeding or bruising
- Angle-closure glaucoma; seizures

## Contraindications

- MAO inhibitors (including linezolid and intravenous methylene blue) now or within two weeks
- Hypersensitivity to vortioxetine

## Key interactions

**MAO inhibitors**
Serotonin syndrome; at least 21 days must pass after stopping vortioxetine before an MAOI is started.

**St John's wort, tryptophan and other serotonergic drugs**
Higher risk of serotonin syndrome.

**Alcohol**
Worse side effects.

## What is monitored

- Mood and suicidal thoughts, especially in the first months
- Bleeding, particularly with anticoagulants or antiplatelets
- Symptoms of serotonin syndrome when other serotonergic drugs are added

## Administration and safety

- Oral tablet once a day at about the same time.
- Not stopped abruptly: headache, mood change, dizziness or tingling can follow.
- The dose is changed only by the prescriber.

## Pregnancy and breastfeeding

Pregnancy or plans for pregnancy are discussed with the prescriber, weighing untreated depression against drug exposure.

## Nursing care

- Before: ask about MAOI use, bleeding problems and seizures.
- During: ask about nausea (usually early) and sexual side effects, which can lead to stopping.
- Watch mood and suicidal thoughts; involve family.
- Teach the signs of serotonin syndrome and of angle-closure glaucoma.

## Pharmacokinetics

**Absorption**
Oral tablet, once a day, with or without food.

**Onset and duration**
Full benefit may take several weeks.

## Memory aid

VORTEX of serotonin: one transporter blocked plus a whirl of receptors (1A and 1B partly on; 3, 7 and 1D off).

## Test yourself

Think of the answer, then tap the question to see it.

## Why is vortioxetine called 'multimodal'?

It inhibits the serotonin transporter and also acts directly on several serotonin receptors (antagonist at 5-HT3, 5-HT7, 5-HT1D; partial agonist at 5-HT1A and 5-HT1B).

## What is its most common early side effect?

Nausea.

## How long must one wait after stopping vortioxetine before starting an MAO inhibitor?

At least 21 days.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/vortioxetine/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## Connections

## Related drugs 3

- [Vilazodone](https://durgical.com/en/pharmacology/vilazodone/)
- [Sertraline](https://durgical.com/en/pharmacology/sertraline/)
- [Escitalopram](https://durgical.com/en/pharmacology/escitalopram/)

## Related conditions 1

- [Major depressive disorder](https://durgical.com/en/conditions/major-depressive-disorder/)

[← Back to the class: Atypical antidepressants](https://durgical.com/en/pharmacology/classes/atypical-antidepressants/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Vortioxetine: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a614003.html) (MedlinePlus (U.S. National Library of Medicine), 2025); [Human serotonin 5-HT3A receptor in complex with vortioxetine (nanodiscs, ECD, active/distorted conformation)](https://www.rcsb.org/structure/8BLB) (RCSB Protein Data Bank, 2024); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=N06AX26) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/vortioxetine/
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