Is Trintellix affected by genetics?

Yes — the active ingredient is metabolized by a gene known to vary between individuals.

Relevant genes: CYP2D6

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Trintellix is affected by pharmacogenetics through the CYP2D6 gene. Your genotype for this gene can change how your body processes Trintellix, which can affect both how well it works and how well you tolerate it. The strongest evidence level on this page is Strong, based on CPIC or FDA guidelines.

What's in Trintellix

vortioxetine affected by CYP2D6

Affected by CYP2D6 · CPIC, FDA · Strong evidence

Read the full vortioxetine genetics guide →

Vortioxetine phenotype recommendations

Published guidance from CPIC and FDA on how vortioxetine should be dosed or substituted based on your CYP2D6 phenotype.

Phenotype	What it means	Recommendation	Evidence
Ultrarapid Metabolizer CYP2D6	Your body clears this drug very quickly, so you may need a higher dose or a different medication for it to work well.	CPIC Select alternative drug not predominantly metabolized by CYP2D6. If vortioxetine use is warranted, initiate therapy at standard starting dose and titrate to maintenance dose based on efficacy and side effects. Increasing the target maintenance dose by 50% or more may be needed for efficacy. FDA Initiate therapy with recommended starting dose.	Optional
Normal Metabolizer CYP2D6	Your body is expected to process this drug normally; standard dosing is recommended.	CPIC + FDA Initiate therapy with recommended starting dose.	Strong
Intermediate Metabolizer CYP2D6	Your body may process this drug a bit slower, but no change in dose is currently recommended.	CPIC + FDA Initiate therapy with recommended starting dose.	Moderate
Poor Metabolizer CYP2D6	Your body clears this drug much more slowly, so a lower starting dose or an alternative medication may be safer.	CPIC Initiate 50% of starting dose (e.g., 5 mg) and titrate to the maximum recommended dose of 10 mg or consider a clinically appropriate alternative antidepressant not predominantly metabolized by CYP2D6. FDA Use a reduced maximum dose of 10 mg. Refer to FDA labeling for specific dosing recommendations.	Strong
Indeterminate CYP2D6	The impact of your genotype on response to this drug is unknown.	CPIC No recommendation. FDA Initiate therapy with recommended starting dose.	—
Not available CYP2D6	The impact of your genotype on response to this drug is unknown.	CPIC No recommendation. FDA Initiate therapy with recommended starting dose.	—

Sources: CPIC, FDA

The gene behind the guidance

CYP2D6 Cytochrome P450 2D6

CYP2D6 is the most clinically important pharmacogene. It metabolizes around a quarter of all prescription drugs, including many antidepressants, opioids, and stimulants. The gene is unusually variable: roughly 7 percent of people are poor metabolizers (they barely activate CYP2D6), and another 1 to 3 percent are ultrarapid metabolizers (their enzyme is overactive).

For most CYP2D6 drugs, poor metabolizers feel stronger effects and more side effects at standard doses, while ultrarapid metabolizers may feel almost nothing. For prodrugs like codeine, the relationship flips: poor metabolizers feel less effect because they can't activate the drug.

See all drugs affected by CYP2D6 →

Browse the full drug-class: SSRI antidepressants.

Related medications

Find out how your genetics affect Trintellix

This page describes the general pharmacogenetics. A Gene2Rx report analyzes your own DNA to tell you which metabolizer group you fall into, across every medication.

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Informational only — not medical advice. Pharmacogenetic guidance describes population-level patterns; your individual response depends on many factors. Never start, stop, or change a medication without talking to your prescribing clinician.