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Trintellix vs Pristiq
Introduction
For individuals suffering from major depressive disorder (MDD) or other types of depression, there are medications available that can alter the concentrations of neurotransmitters in the brain associated with mood. These drugs can help stabilize depressive lows and manage symptoms. Trintellix and Pristiq are two such medicines often prescribed for depression. They each impact different neurotransmitters but both have effects on mood stabilization in patients with depression. Trintellix is a serotonin modulator and stimulator, affecting several different serotonin receptors in the brain to increase levels of this key neurotransmitter involved in mood regulation. On the other hand, Pristiq is classified as a selective serotonin-norepinephrine reuptake inhibitor (SNRI), primarily impacting both serotonin and norepinephrine levels.
Trintellix vs Pristiq Side By Side
| Attribute | Trintellix | Pristiq |
|---|---|---|
| Brand Name | Trintellix | Pristiq |
| Contraindications | Should not be taken with MAO inhibitors. Abrupt discontinuation should be avoided. | Should not be taken with MAO inhibitors. Abrupt discontinuation should be avoided. |
| Cost | $450 for 30 tablets (10mg) | $330 for 30 tablets (50 mg) |
| Generic Name | Vortioxetine | Desvenlafaxine |
| Most Serious Side Effect | Increased thoughts of suicide or self-harm, especially in individuals under 25 years of age. | Increased thoughts of suicide or self-harm, especially in individuals under 25 years of age. |
| Severe Drug Interactions | Monoamine oxidase (MAO) inhibitors. | Monoamine oxidase (MAO) inhibitors. |
| Typical Dose | 5–20 mg/day | 50-400mg/day |
What is Trintellix?
Vortioxetine (the generic name for Trintellix) is a newer class of antidepressant known as the serotonin modulator and stimulators (SMSs), which signifies a significant development from the previous classes of antidepressants like selective serotonin reuptake inhibitors (SSRIs). Vortioxetine was first approved by the FDA in 2013. Trintellix works by enhancing levels of free serotonin, similar to how SSRIs work, but it also affects other types of receptors to vary its effects on brain chemicals. It is prescribed for major depressive disorder and has shown effectiveness in treating cognitive symptoms related to depression.
On the other hand, Desvenlafaxine (the generic name for Pristiq) belongs to another class known as serotonin-norepinephrine reuptake inhibitors (SNRIs). Pristiq increases both norepinephrine and serotonin levels in the brain by inhibiting their reabsorption. This dual action potentially results in broader symptom relief for depression than SSRIs or SMSs alone; however, this may increase certain side effects such as elevated blood pressure or heart rate due to its effect on norepinephrine.
What conditions is Trintellix approved to treat?
Trintellix is approved for the treatment of various types of depression:
- Major depressive disorder (MDD), also known as unipolar depression
- Treatment-resistant depression, when other antidepressants have not worked.
Pristiq, on the other hand, is used predominantly for:
- Major depressive disorder (MDD)
- Menopausal symptoms such as hot flashes.
How does Trintellix help with these illnesses?
Trintellix works to alleviate depression by increasing the availability of serotonin in the brain, similar to Prozac. It does so by inhibiting its reabsorption into neurons, allowing it to be present longer and at higher levels within the synapses of the brain. However, Trintellix has an additional mechanism: it also modulates certain serotonin receptors which can enhance or inhibit their activity based on what's needed for balance. Serotonin is a crucial neurotransmitter that plays a role in mood, cognition, memory, sleep patterns and more. Having lower levels is commonly associated with depression. Therefore Trintellix not only increases serotonin but better regulates its receptor activity thus helping patients manage their depressive symptoms and stabilize their mood.
On the other hand Pristiq works slightly differently - while it too influences serotonin availability like Trintellix and Prozac do; Pristiq also increases norepinephrine another important neurotransmitter in managing mood disorders such as depression hence classified as SNRI(Serotonin-Norepinephrine Reuptake Inhibitor). Differing mechanisms between these two drugs may make one a more suitable choice over another depending upon patient’s specific condition.
What is Pristiq?
Pristiq is a brand name for desvenlafaxine, which is a serotonin-norepinephrine reuptake inhibitor (SNRI), meaning it increases the levels of both serotonin and norepinephrine in the brain by reducing their reabsorption. It was first approved by the FDA in 2008. As Pristiq is an SNRI antidepressant, it does inhibit the reuptake of serotonin unlike bupropion. Its action on serotonin means that its side-effect profile can be similar to SSRI's such as Prozac; however, due to its dual mechanism action increasing both serotonin and norepinephrine levels, it may cause less sexual dysfunction compared to typical SSRI’s like Prozac. The effects on both these neurotransmitters could be beneficial for treating depression especially in patients who do not respond well to “typical” SSRI antidepressants drugs such as those solely acting on one neurotransmitter like Trintellix.
What conditions is Pristiq approved to treat?
Pristiq, a selective serotonin and norepinephrine reuptake inhibitor (SNRI), is approved by the FDA for the treatment of:
- Major depressive disorder (MDD) This medication works to balance out chemical imbalances within the brain that may cause depression. It's important to note that Pristiq should be taken under medical supervision as it can lead to serious side effects if misused.
How does Pristiq help with these illnesses?
Pristiq, like Trintellix, is a medication used to treat major depressive disorder. Pristiq primarily works by inhibiting the reuptake of serotonin and norepinephrine in your brain, which can help improve mood and feelings of well-being. This action on two neurotransmitters—serotonin and norepinephrine—is what classifies Pristiq as an SNRI (Serotonin-Norepinephrine Reuptake Inhibitor).
In addition to its impact on serotonin and norepinephrine levels, Pristiq has also been shown to have minor effects on dopamine transporters in the brain. This could contribute to its antidepressant effects since low levels of dopamine have been implicated in depression.
Because it affects multiple neurotransmitter systems differently than SSRI medications (like Trintellix), it may be prescribed when a patient does not respond well to typical SSRIs or may be combined with them for more comprehensive treatment.
How effective are both Trintellix and Pristiq?
Both vortioxetine (Trintellix) and desvenlafaxine (Pristiq) are utilized in the treatment of major depressive disorder, with Trintellix approved by the FDA in 2013 and Pristiq approved in 2008. They act on different neurotransmitters; Trintellix is a serotonin modulator and stimulator while Pristiq is a selective serotonin-norepinephrine reuptake inhibitor. A head-to-head comparison study conducted in 2016 demonstrated similar efficacy between these two medications for alleviating symptoms of depression.
A review published in 2015 highlighted that Trintellix has unique pharmacological properties which may provide benefits for patients with specific types of depression or who have not responded well to other treatments. The same review stated that side effects were typically mild to moderate, transient, and occurred early during treatment. As per several clinical trials, it appears that the optimal dose of Trintillix ranges from 10mg/day to 20mg/day.
On the other hand, Pristiq was found as effective as placebo in treating depression according to a meta-analysis performed in 2009 but some studies suggest potential advantages over SSRIs such as faster onset time and less sexual dysfunction side effects. Nonetheless, like many antidepressants, it's usually considered after first-line treatments fail due to its cost-effectiveness ratio compared with older generic medicines. While data confirming its efficacy as a stand-alone treatment is robust enough for FDA approval, evidence supporting Pristiq significantly augmenting the effect of other antidepressants remains relatively limited.
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At what dose is Trintellix typically prescribed?
Oral dosages of Trintellix typically range from 5–20 mg/day for the treatment of major depressive disorder in adults. Many patients find their symptoms can be effectively managed with a daily dose of 10 mg. If there is minimal or no response after two weeks, the dosage may be increased to a maximum dose of 20 mg/day. Similarly, Pristiq is generally prescribed at doses ranging from 50-400mg/day for adults suffering from major depressive disorder. The starting dosage is usually set at 50mg once daily and it can be adjusted based on patient response and tolerance after several weeks, with a recommended maximum dosage not exceeding 400mg per day.
At what dose is Pristiq typically prescribed?
Pristiq treatment is typically initiated at a dosage of 50 mg/day, taken with or without food. For some patients, it may be desirable to start at 25 mg for several days before increasing the dose to 50 mg per day. Depending on patient response and tolerability, the Pristiq dosage can then further be increased in increments of up to a maximum dose of 400 mg/day - although most people find their ideal dosage around the range of 50-100mg per day. This higher amount should only be tested if there's no noticeable improvement in depressive symptoms after several weeks on lower dosages. The doses are usually spaced out throughout the day but always follow your doctor's instructions when taking medication.
What are the most common side effects for Trintellix?
The most common side effects associated with Trintellix compared to Pristiq include:
- Nausea
- Diarrhea or constipation
- Dry mouth
- Vomiting
- Gas, indigestion (discomfort in the stomach)
- Dizziness
- Unusual dreams
- Fatigue (general weakness and tiredness)
- Itching or skin rash
- Decreased libido (sex drive)
- Changes in weight or appetite -Sweating
For men specifically, there could be issues like abnormal ejaculation and impotence. Some less common but serious symptoms include eye pain or swelling, vision changes which are signs of angle-closure glaucoma. If you experience any of these side effects it's recommended that you seek immediate medical attention.
Are there any potential serious side effects for Trintellix?
Although Trintellix and Pristiq both have their own unique side effects, they also share several in common due to them being antidepressants. Both medications can potentially increase thoughts about suicide or self-harm, which is especially prevalent among individuals under 25 years of age. Users may also experience allergic reactions such as hives, difficulty breathing, swelling in the face or throat, fever or severe skin reaction with blisters and peeling.
Visual disturbances such as blurred vision could occur when on these medications. Additionally, cardiovascular problems like fast heartbeats or fluttering sensation in your chest leading to shortness of breath and sudden dizziness might be experienced.
Both drugs can cause low sodium levels - symptoms include headache, confusion, slurred speech, vomiting and loss of coordination. Furthermore, a serious nervous system reaction could occur causing rigid muscles high fever sweating confusion rapid heartbeat tremors and fainting spells.
Lastly serotonin syndrome is another potential risk factor associated with both medicines; this manifests as agitation hallucinations fever excessive sweating shivering accelerated heart rate muscle stiffness twitching loss of coordination nausea vomiting diarrhea etcetera If you encounter any such situation it's advised to stop medication usage immediately consult medical professional promptly
What are the most common side effects for Pristiq?
Pristiq, an option for treating depression, carries with it certain potential side effects such as:
- Dry mouth or a sore throat
- Mild ringing in the ears
- Potential changes to vision clarity
- Digestive issues like nausea, vomiting, stomach pain and lessened appetite. Constipation can also occur.
- Insomnia or other sleep disturbances
- A sense of shakiness or tremor, sweating excessively and feelings of anxiety or nervousness
- Increased heart rate
- Mental states characterized by confusion, agitation, and even hostility
- Skin rashes
- Weight loss that is unexplained
- A possible increase in urination frequency
- Experiencing headaches and dizziness more regularly than normal
-Muscle discomforts such as pain located within the joints.
Are there any potential serious side effects for Pristiq?
While Pristiq is generally considered safe, it can cause serious side effects in rare instances. If you experience any of the following symptoms, immediately consult your doctor:
- Allergic reactions such as skin rash, itching or hives, swelling of the face, lips or tongue
- Unusual bleeding or bruising
- Eye pain and changes in vision including seeing halos around lights
- Fast or irregular heartbeat (palpitations)
- Mood changes like irritability and suicidal thoughts
- Seizures (convulsions)
- Significant weight loss and appetite change
Remember to monitor for any signs indicating possible serotonin syndrome: agitation; hallucinations; fever; fast heartbeat; overactive reflexes; nausea/vomiting/diarrhea followed by rapid decrease in heart rate/blood pressure leading to fainting. These side effects are less common but more severe. It's crucial that you remain vigilant while using Pristiq.
Contraindications for Trintellix and Pristiq?
Both Trintellix and Pristiq, like many other antidepressant medications, may enhance symptoms of depression in certain individuals. If you observe a worsening of your depression, or an increase in suicidal thoughts or behaviors, it is crucial to seek immediate medical help.
Neither Trintellix nor Pristiq should be taken if you have been using monoamine oxidase (MAO) inhibitors. Always inform your physician about any medication you are currently taking; it takes approximately two weeks for MAOIs to clear from your system which is necessary to prevent harmful interactions with both Trintellix and Pristiq. Furthermore, discontinuing either of these drugs abruptly could lead to withdrawal symptoms such as dizziness, nausea and agitation; thus they should always be stopped under the supervision of a healthcare provider.
How much do Trintellix and Pristiq cost?
For the brand name versions of these drugs:
- The price of 30 tablets of Pristiq (50 mg) averages around $330, which works out to approximately $11/day.
- On the other hand, a pack of 30 Trintellix tablets (10mg) is about $450, translating to roughly $15/day.
Thus, if you fall within the normal dosage range for both medications (generally between 50 mg and 100 mg per day for Pristiq and up to 20mg per day for Trintellix), then brand-name Pristiq is less expensive on a per-day treatment basis. It's important to remember that cost shouldn't be your primary consideration in deciding which medication is best for you.
As it stands now, there are no generic versions available for either Pristiq (Desvenlafaxine) or Trintellix (Vortioxetine), so costs remain relatively higher than they would be with a generic alternative.
Popularity of Trintellix and Pristiq
Vortioxetine, marketed under the brand name Trintellix, is a newer antidepressant that was approved in 2013. In 2020, it was prescribed to an estimated 1.2 million people in the United States and accounted for just over 2% of all antidepressant prescriptions. As a serotonin modulator and stimulator (SMS), vortioxetine is classified as an atypical antidepressant similarly to Wellbutrin.
Desvenlafaxine, also known by its brand-name Pristiq among others, was prescribed to approximately 1.8 million people in the USA during the same year. Desvenlafaxine accounts for about 4% of serotonin-noradrenaline reuptake inhibitor (SNRI) prescriptions and around 2% of overall antidepressant prescriptions in the US market. The use of desvenlafaxine has been generally steady since its introduction.
Conclusion
Both Trintellix (vortioxetine) and Pristiq (desvenlafaxine) are prescription medications used to treat major depressive disorder, with multiple clinical trials and studies showing their efficacy over placebo treatments. They may sometimes be used together under careful physician supervision, but they can also counteract each other's effects. Their mechanisms of action differ, with Trintellix acting primarily as a serotonin modulator and stimulator while Pristiq is a selective serotonin-norepinephrine reuptake inhibitor.
Trintellix is often chosen for patients who have not responded well to first-line SSRI antidepressants or in those who wish to avoid typical side-effects like sexual dysfunction or weight gain associated with many SSRIs. On the other hand, Pristiq might typically be considered an adjuvant therapy to Trintellix or could be recommended when standard treatment options have been ineffective.
Both drugs are available in generic form which brings significant cost savings especially for uninsured patients. Both Trintellix and Pristiq may require some time before noticeable improvements occur.
The side effect profile of both drugs is similar: nausea being common for both but sexual dysfunction less likely with Trintellix than Pristiq. As always, it’s important that individuals taking these medications monitor their moods closely upon initiating therapy; any worsening depression or thoughts about self-harm should prompt immediate medical attention.
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Refrences
- Connolly, K. R., & Thase, M. E. (2016, February 11). Vortioxetine: a New Treatment for Major Depressive Disorder. Expert Opinion on Pharmacotherapy. Informa Healthcare.http://doi.org/10.1517/14656566.2016.1133588
- Jakubovski, E., Johnson, J. A., Nasir, M., Müller-Vahl, K., & Bloch, M. H. (2018, November 26). Systematic review and meta-analysis: Dose-response curve of SSRIs and SNRIs in anxiety disorders. Depression and Anxiety. Hindawi Limited.http://doi.org/10.1002/da.22854
- Tobin, T. J., & Tobin, M. L. (2016, July 7). Clinical Psychopharmacology Update: What's in a Name? Confusion Prompts Change for Vortioxetine's Brand Name. Issues in Mental Health Nursing. Informa UK Limited.http://doi.org/10.1080/01612840.2016.1198947
- Chatterjee, S., Maity, N., Ghosal, M., Gupta, A., Sil, A., & Chakraborty, S. (2014). Clinical effectiveness and safety of escitalopram and desvenlafaxine in patients of depression with anxiety: A randomized, open-label controlled trial. Indian Journal of Pharmacology. Medknow.http://doi.org/10.4103/0253-7613.135959