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Trintellix vs Lexapro
Introduction
For patients struggling with major depressive disorder (MDD) or other types of depression, there are certain medications available that adjust the levels of neurotransmitters in the brain - chemicals associated with mood. Trintellix and Lexapro are two such drugs frequently prescribed for managing depressive symptoms. Both impact specific neurotransmitters differently but share a common goal: stabilizing mood swings experienced by patients suffering from depression. Trintellix is classified as a serotonin modulator and stimulator, influencing various serotonin receptors to enhance its effects on mood regulation. On the contrary, Lexapro is known as a selective serotonin reuptake inhibitor (SSRI), which primarily increases the level of serotonin in the brain by preventing its reabsorption into neurons.
Trintellix vs Lexapro Side By Side
| Attribute | Trintellix | Lexapro |
|---|---|---|
| Brand Name | Trintellix | Lexapro |
| Contraindications | Cannot be taken with or have recently used monoamine oxidase (MAO) inhibitors. | Cannot be taken with or have recently used monoamine oxidase (MAO) inhibitors. |
| Cost | For the brand name, around $425 for 30 tablets of 10 mg. No generic version available yet. | For the brand name, about $350 for 30 capsules of 10 mg. Generic version (escitalopram) significantly lowers costs, starting from as low as $0.40 per day. |
| Generic Name | Vortioxetine | Escitalopram |
| Most Serious Side Effect | Suicidal thoughts or actions, serotonin syndrome, hyponatremia. | Suicidal thoughts or actions, serotonin syndrome. |
| Severe Drug Interactions | MAO inhibitors | MAO inhibitors |
| Typical Dose | 5–20 mg/day, with 10 mg/day being effective for most adults. | 10 mg/day, can be increased to 20 mg/day depending on response and tolerance. |
What is Trintellix?
Vortioxetine (the generic name for Trintellix) is a newer class of antidepressants known as serotonin modulators and stimulators, marking an advancement from the selective serotonin reuptake inhibitors (SSRIs). Vortioxetine was first approved by the FDA in 2013. Trintellix works by increasing levels of free serotonin similar to how SSRIs work but also affects other types of receptors which can lead to higher effectiveness and fewer side effects. It is prescribed primarily for major depressive disorder.
On the other hand, escitalopram (the generic name for Lexapro), belongs to the SSRI class of antidepressants and was first approved by the FDA in 2002. Lexapro increases levels of free serotonin by preventing its reabsorption, effectively maintaining it in the brain longer than usual. This medication is commonly used to treat depression as well as generalized anxiety disorder. While both drugs interact with serotonin, Trintellix's influence on additional receptors may result in it having fewer sexual side effects compared to Lexapro which has a more targeted effect on serotonin alone.
What conditions is Trintellix approved to treat?
Trintellix is approved for the treatment of different types of depression:
- Major depressive disorder (MDD), which is a significant mental health condition characterized by persistent feelings of sadness, hopelessness and lack of interest in activities.
Lexapro, on the other hand, has been approved to treat:
- Generalized anxiety disorder (GAD)
- Major depressive disorder (MDD)
How does Trintellix help with these illnesses?
Trintellix works to manage depression by modulating the levels of serotonin in synaptic gaps within the brain. It accomplishes this through a dual mechanism: first, it acts as a serotonin reuptake inhibitor (SRI), which means it blocks neurons from absorbing excess serotonin; secondly, it also stimulates specific types of serotonin receptors while blocking others, leading to an overall increase in serotonergic activity. Serotonin is a crucial neurotransmitter that regulates mood, cognition, memory and several other physiological processes. Individuals with depression often have lower-than-average amounts of available serotonin. Consequently, by enhancing serotonergic activity via multiple pathways, Trintellix can mitigate depressive symptoms and help patients maintain more stable moods.
What is Lexapro?
Lexapro is a brand name for escitalopram, a selective serotonin reuptake inhibitor (SSRI), meaning it works by increasing the levels of serotonin in the brain by reducing its reabsorption. This can have an antidepressant effect as serotonin is involved in mood regulation. Escitalopram was first approved by the FDA in 2002 and since then has been widely used to treat major depressive disorder and generalized anxiety disorder.
Its action on serotonin means that Lexapro's side-effect profile includes symptoms related to this neurotransmitter system, such as nausea, fatigue, and sexual dysfunction (common side effects of SSRIs). However, compared to other SSRI antidepressants like Trintellix (vortioxetine), Lexapro does not affect norepinephrine or dopamine levels significantly. The benefits of Lexapro’s specific focus on serotonergic modulation may be more advantageous for individuals whose depression primarily involves low mood states rather than cognitive deficits or who do not respond well to therapies involving multiple neurotransmitter systems.
What conditions is Lexapro approved to treat?
Lexapro, also known as escitalopram, is an antidepressant medication that the FDA has approved for treating:
- Major depressive disorder (MDD)
- Generalized anxiety disorder (GAD)
It's important to note that Lexapro may help reduce symptoms of both conditions and can contribute significantly towards improving a patient's quality of life.
How does Lexapro help with these illnesses?
Serotonin is a neurotransmitter that plays an important role in mood regulation, sleep, appetite, and other bodily functions. Low levels of serotonin have been associated with depression. Lexapro works by increasing the levels of serotonin available in the brain to help alleviate some symptoms of depression and anxiety. It accomplishes this by inhibiting the reuptake of serotonin, thereby allowing more to be available in the synaptic gap where it can exert its effects on mood. Additionally, Lexapro's action may extend beyond simply boosting serotonin levels as it has also shown promise for generalized anxiety disorder (GAD) treatment. This sets it apart from other SSRIs such as Trintellix which also increase serotonin but might not address GAD as effectively. Therefore, Lexapro may be prescribed when a patient needs both anti-depressant and anti-anxiety benefits or if they do not respond well to atypical antidepressants like Trintellix.
How effective are both Trintellix and Lexapro?
Both vortioxetine (Trintellix) and escitalopram (Lexapro) have proven efficacy in treating patients with depression, although they were approved by the FDA nearly a decade apart. Since they act on different neurotransmitters, their uses may differ depending on individual circumstances. The effectiveness of vortioxetine and escitalopram in managing depression was directly studied in a double-blind clinical trial in 2014; both drugs demonstrated similar efficacy regarding depressive symptoms and had comparable safety profiles. In this study, no significant differences were observed between patients receiving Trintellix and those receiving Lexapro.
A 2008 review of meta-analysis reports on escitalopram found it effective from the first week of treatment, offering a favorable side effect profile over many other antidepressants, including being well-tolerated even among elderly populations. Escitalopram has become one of the most prescribed selective serotonin reuptake inhibitors (SSRIs).
A 2016 review indicated that vortioxetine seems to be more effective than placebo at treating depression and is similar in efficacy to other common antidepressants. Nonetheless, its use typically follows or supplements SSRIs or other first-line treatments due to its multimodal action – acting not only as an SSRI but also modulating several different types of serotonin receptors – providing additional benefits like improved cognitive function for some individuals who didn't respond optimally to standard SSRIs such as escitalopram.
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At what dose is Trintellix typically prescribed?
Oral dosages of Trintellix range from 5–20 mg/day, but research has shown that a dose of 10 mg/day is usually effective for treating major depressive disorder in most adults. Adolescents and children are generally not prescribed this medication due to lack of safety data. If the initial dosage isn't eliciting a response after several weeks, it can be increased under medical supervision. However, the maximum dosage that should not be exceeded in any case is 20 mg/day.
At what dose is Lexapro typically prescribed?
Lexapro therapy typically begins at a dosage of 10 mg/day. This dose can be increased to 20 mg/day, depending on the patient's response and tolerance. The maximum dose is 20 mg/day, usually taken once in the morning or evening. It is recommended to maintain this regimen for at least one to two weeks before considering an increase in dosage; however, if there is no improvement in symptoms after several weeks of treatment at 20 mg/day, alternative treatments may need to be explored.
What are the most common side effects for Trintellix?
Common side effects of Trintellix may include:
- Nausea
- Vomiting
- Constipation
- Dry mouth
- Dizziness
- Feeling tired or drowsy (somnolence)
- Unusual weight loss or gain
- Decreased sex drive, impotence, difficulty having an orgasm
On the other hand, Lexapro can cause some similar and additional side effects such as:
-Nervousness
-Anxiety
-Increased sweating
-Tremor (unintentional trembling or shaking)
-Difficulty sleeping (insomnia)
-Sinusitis (inflammation of the sinus cavities in the head)
-Yawning
Always consult with a healthcare provider for any adverse reactions while taking these medications.
Are there any potential serious side effects for Trintellix?
While Trintellix and Lexapro are both used to treat depression, they can have different side effects. For Trintellix, you should be aware of the following potential severe reactions:
- Suicidal thoughts or actions
- Allergic responses: hives, difficulty breathing, swelling in your face or throat
- Visual changes: blurred vision, eye pain or changes in eyesight
- Rapid heartbeat; feeling like you may faint due to a sudden drop in blood pressure when standing from sitting position (orthostatic hypotension)
- Hyponatremia - low sodium levels which could lead to headache, confusion, slurred speech, severe weakness and vomiting.
- Serotonin Syndrome: symptoms can include agitation, hallucinations, rapid heartbeat (tachycardia), fever sweating and muscle rigidity among others.
If any of these side effects are experienced while taking Trintellix it is crucial that you seek medical attention immediately.
What are the most common side effects for Lexapro?
Lexapro, an antidepressant in the selective serotonin reuptake inhibitor (SSRI) class, has a variety of potential side effects:
- Dry mouth or throat discomfort
- Unusual sweating or feeling nervous and jittery
- Changes in sleep patterns such as insomnia
- Gastrointestinal issues like nausea, vomiting, stomach pain, constipation and changes in appetite
- Headache and dizziness can occur
- Ringing sensation may be felt in the ears
- There might be blurred vision at times
- Muscle or joint pain is also possible. In some cases more severe symptoms like fast heartbeat, confusion or agitation could arise. Rashes may appear on the skin. Some people even experience weight fluctuations and increased frequency of urination.
Remember that not all individuals will experience these side effects; it varies from person to person based on their body's reaction to Lexapro. Always consult with your healthcare provider for advice about side effects.
Are there any potential serious side effects for Lexapro?
Lexapro, while generally well-tolerated, can produce some serious side effects in rare cases. Be vigilant for the following symptoms:
- Signs of an allergic reaction such as skin rash, itching or hives; swelling of the face, lips or tongue
- Unusual changes in mood or behavior: agitation, panic attacks, hostility, impulsivity
- Symptoms associated with a cardiac event like chest pain and fast/irregular heartbeats
- Visual disturbances including blurred vision
- Seizures (convulsions)
- Increased suicidal thoughts or feelings of self-harm
- Serotonin Syndrome symptoms: restlessness, hallucinations, rapid heartbeat, fever; nausea/vomiting/diarrhea; muscle rigidity
If any of these occur after taking Lexapro it is vital to seek medical attention immediately.
Contraindications for Trintellix and Lexapro?
Like most antidepressants, both Trintellix and Lexapro may exacerbate symptoms of depression in some individuals. If you observe an escalation in your depressive symptoms or experience increased thoughts about suicide, please immediately seek medical assistance.
Neither Trintellix nor Lexapro can be taken if you are using or have recently used monoamine oxidase (MAO) inhibitors. It is crucial to inform your doctor about any medications that you are currently taking; MAOIs will necessitate a clearance period of approximately 5 weeks to avoid hazardous interactions with Trintellix and Lexapro.
How much do Trintellix and Lexapro cost?
For the brand name versions of these drugs:
- The price for 30 tablets of Trintellix (10 mg) averages around $425, which works out to approximately $14–28/day, depending on your dose.
- The price for 30 capsules of Lexapro (10 mg) is about $350, working out to roughly $11.67/day.
Thus, if you are in the higher dosage range for Trintellix (i.e., 20 mg/day), then brand-name Lexapro is less expensive on a per-day treatment basis. As always, remember that cost should not be the primary factor in determining which medication is right for you.
For generic versions of these drugs:
-
Vortioxetine (the active ingredient in Trintellix) doesn't have a generic version available yet and thus its pricing remains relatively high.
-
Escitalopram (generic form of Lexapro), however significantly lowers costs: it's available with approximate costs starting from as low as $0.40 per day up to around $1.50 per day depending on dosages ranging between 5mg -20mg daily.
Popularity of Trintellix and Lexapro
Vortioxetine, also known by the brand name Trintellix, is a newer antidepressant that was approved in 2013. It's estimated to have been prescribed to about 2 million people in the US in 2020. Vortioxetine accounts for just under 4% of SSRI prescriptions, and about 2% of overall antidepressant prescriptions in the US. Since its introduction seven years ago, vortioxetine has seen a steady increase in use.
Escitalopram, which goes by Lexapro among other brands, has been around longer with an approval date back to 2002 and is more widely used as compared to vortioxetine. In fact, it was prescribed to nearly 10 million people in the USA during 2020 alone. Escitalopram accounts for approximately one-fifth of all SSRI prescriptions and close to one-eighth of total antidepressants dispensed throughout America. The usage rate for escitalopram has remained fairly consistent over recent years.
Conclusion
Both Trintellix (vortioxetine) and Lexapro (escitalopram) are widely utilized in the management of depression, with numerous clinical studies indicating that they are more effective than placebo treatments. In some circumstances, these drugs may be used together, but this requires careful evaluation by a physician due to potential drug interactions. Their mechanisms of action differ; while Lexapro is an SSRI that primarily increases serotonin levels in the brain, Trintellix not only increases serotonin but also modulates several other types of serotonin receptors.
Lexapro has been available as a generic medication for many years, providing significant cost savings particularly for patients paying out-of-pocket. Trintellix does not yet have a generic version available which makes it significantly more expensive.
The side effect profiles between the two drugs show similarities and differences. Both medications can cause nausea and sexual dysfunction, however Trintellix has demonstrated less impact on sexual function compared to most SSRIs including Lexapro in some studies. The adjustment period varies from person to person; effects might not be noticeable immediately after starting either medication.
For both medicines, it's crucial for patients to monitor their moods closely when initiating therapy or modifying dosage levels. Medical attention should be sought promptly if depression symptoms worsen or if there are emerging thoughts about suicide or self-harm.
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Refrences
- Kirino, E. (2012, December). Escitalopram for the management of major depressive disorder: a review of its efficacy, safety, and patient acceptability. Patient Preference and Adherence. Informa UK Limited.http://doi.org/10.2147/ppa.s22495
- Waugh, J., & Goa, K. L. (2003). Escitalopram. CNS Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00023210-200317050-00004
- Schloss, P., & Williams, D. C. (1998, March). The serotonin transporter: a primary target for antidepressant drugs. Journal of Psychopharmacology. SAGE Publications.http://doi.org/10.1177/026988119801200201
- Lee, S.-H., Jeon, S. W., Shin, C., Pae, C.-U., Patkar, A. A., Masand, P. S., … Han, C. (2022, April 25). Acute Efficacy and Safety of Escitalopram Versus Desvenlafaxine and Vortioxetine in the Treatment of Depression With Cognitive Complaint: A Rater-Blinded Randomized Comparative Study. Psychiatry Investigation. Korean Neuropsychiatric Association.http://doi.org/10.30773/pi.2021.0368
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- Gibb, A., & Deeks, E. D. (2013, December 6). Vortioxetine: First Global Approval. Drugs. Springer Science and Business Media LLC.http://doi.org/10.1007/s40265-013-0161-9