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Trintellix vs Lexapro

Drug facts and comparison

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Medically reviewed by  Jamie Winn, PharmD

Uses

  • Major depressive disorder (MDD)
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  • Major depressive disorder in adults and adolescents at least 12 years old
  • Anxiety in adults
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Summary

Brand name: Trintellix
Brand name: Lexapro
Manufacturer: Takeda Pharmaceuticals U.S.A., Inc.
Manufacturer: Forest Laboratories
Active ingredient: vortioxetine
Active ingredient: escitalopram
Indication: Major depressive disorder (MDD)
Indication: Major depressive disorder in adults and adolescents at least 12 years old Anxiety in adults

Side Effects

Most common

  • Nausea
  • Vomiting
  • Constipation

Most serious

  • Severe allergic reactions to the medication
  • An increased risk of suicidal thoughts
  • Serotonin syndrome
  • An increased risk of hypomania
  • Hyponatremia

Most common

  • Diarrhea
  • Dry mouth
  • Heartburn
  • Drowsiness
  • Trouble sleeping

More serious

  • Suicidal thoughts and behaviors
  • Sexual problems

Drug Interactions

Severe Interactions
  • Medications for depression – escitalopram, fluoxetine, sertraline
  • Protease inhibitor drugs – ritonavir
Serious Interactions
  • Opioid pain killers – hydrocodone, oxycodone
  • Sulfonylurea antidiabetic medicine – chlorpropamide, glipizide
  • Diuretics – bendroflumethiazide, furosemide
Moderate Interactions
  • Evening primrose
Severe interactions
  • Antipsychotics – clozapine, haloperidol
  • Antiarrhythmics – amiodarone, dronedarone
  • Opioids – buprenorphine, methadone
  • Antibiotics – clarithromycin, erythromycin, ofloxacin
  • Antidepressants – citalopram, fluoxetine, sertraline, venlafaxine
  • Immunosuppressants – fingolimod, siponimod
Serious interactions
  • Diuretics – bendroflumethiazide bumetanide, furosemide
  • NSAIDs – ibuprofen, meloxicam, naproxen
  • Blood thinners – clopidrogel, heparin, warfarin
  • Proton pump inhibitors – esomeprazole, lansoprazole, omeprazole
Moderate interactions
  • Cancer treatments – idelalisib and asciminib
  • Anticonvulsants – carbamazepine
  • Antifungals – clotrimazole, itraconazole, miconazole

 

 

 

Warnings

You should not use Trintellix if you:

  • Are allergic to the active ingredient vortioxetine
  • Are allergic to any of the other ingredients in Trintellix
  • Are currently taking a monoamine oxidase inhibitor (MAOI) antidepressant or have taken one in the last 14 days
  • Are under 18 years of age

Talk to your physician before taking Trintellix if you:

  • Have bipolar disorder or mania
  • Have any liver problems
  • Have or have ever had seizures/convulsions
  • Have or have ever had any problems with bleeding
  • Have low salt (sodium) levels in your blood
  • Regularly drink alcohol
  • Are pregnant or are planning to become pregnant
  • Are breastfeeding or are planning to breastfeed

You should not use Lexapro if you:

  • Are allergic to the active ingredient escitalopram
  • Are allergic to any of the other ingredients in Lexapro
  • If you also take pimozide or citalopram
  • Are breastfeeding

You should talk to your doctor before using Lexapro if you:

  • Have had liver disease
  • Have had kidney disease
  • Have had seizures
  • Have low levels of sodium in your blood
  • Have heart disease
  • Have high blood pressure
  • Have had a stroke
  • Have bleeding problems
  • Have sexual problems
  • Have bipolar disorder (manic depression)
  • Have drug addiction or suicidal thoughts

Dosage

5 to 20 mg once a day maintenance

10 or 20 mg once daily

Cost

30, 20 mg Trintellix tablets will cost around $660.

30, 20mg Lexapro tablets will cost around $100

 

FAQs

Trintellix and Lexapro are brand names for prescription drugs used for the treatment of mental health disorders such as depression. Here we will explain how they work, their similarities and differences, their side effects, and more. This should provide you with the basics to better understand your options.

What is Trintellix?

Trintellix (previously known as Brintellix) is an FDA (U.S. Food and Drug Administration) approved medication manufactured by Takeda. It is an antidepressant drug prescribed to adults to treat major depressive disorder (MMD). If you have MDD, your doctor may prescribe Trintellix to you, in addition to recommending other treatments. Trintellix works by increasing levels of a natural substance that regulates your brain activity called serotonin. This can reduce the severity of depressive episodes and help keep them at bay. You take Trintellix as a tablet you swallow.

The active ingredient in Trintellix is called vortioxetine. It’s a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI). When you swallow a Trintellix tablet, it releases vortioxetine into your bloodstream. Vortioxetine is then carried in your blood to your brain, where it slows down how quickly your brain cells reabsorb a substance called serotonin.

Serotonin is a neurotransmitter that helps regulate your brain function, particularly areas of your brain involved in mood, learning, and memory. Your brain cells reabsorb excess serotonin, but vortioxetine slows down how quickly this happens, causing serotonin levels to rise. This can rebalance your serotonin levels, Research has shown this can help to reduce depressive symptoms.

Trintellix dosage

Trintellix is available as immediate-release tablets, in the following doses: 5 mg, 10 mg, and 20 mg. The recommended starting dose is 10 mg once daily with or without meals and increased as tolerated. Do not discontinue Trintellix treatment abruptly. Reduce doses of 15 mg/day or 20 mg/day to 10 mg/day for one week before complete discontinuation.

What is Lexapro?

Lexapro (escitalopram oxalate) is an FDA (U.S. Food and Drug Administration) approved antidepressant medication manufactured by Forest Laboratories. Lexapro is a selective serotonin reuptake inhibitor (SSRI) used for:

  • Acute and maintenance treatment of Major Depressive Disorder (MDD) in adults and adolescents aged 12-17 years
  • Acute treatment of Generalized Anxiety Disorder (GAD) in adults

Lexapro is not recommended for use in pediatric patients less than 12 years of age, due to an increased risk of suicidal thoughts and behavior in children, adolescents, and young adults.

Lexapro dosage

Lexapro is available in tablet or oral solution form, in the following doses: 5 mg, 10 mg, 20 mg, and 1 mg per mL. As with Trintellix, when discontinuing Lexapro, withdrawal symptoms such as agitation may occur. Taper off the drug slowly and do not stop abruptly.

Always speak with a healthcare professional for medical advice about any changes to your dose so they can monitor and evaluate your condition.

Common side effects of Trintellix and Lexapro

The most common side effects of Trintellix in clinical trials compared to placebo include:

  • Nausea
  • Vomiting
  • Constipation

More serious side effects of Trintellix include:

  • Severe allergic reactions to the medication
  • An increased risk of suicidal thoughts and suicide, particularly in young adults
  • Serotonin syndrome – a potentially life-threatening condition caused by high levels of serotonin
  • An increased risk of bruising and bleeding, especially if taken with medications that can reduce blood clotting, like blood thinners, aspirin, or NSAIDs like ibuprofen
  • An increased risk of developing eye problems, including eye pain, swelling, and changes in vision
  • An increased risk of hypomania (manic episodes)
  • Hyponatremia – low sodium levels in your blood that can cause serious health problems and death

The most common side effects of Lexapro in clinical trials include:

  • Sexual side effects such as sexual dysfunction (ejaculatory delay, decreased libido, inability to orgasm)
  • Nausea
  • Increased sweating
  • Fatigue
  • Somnolence, drowsiness
  • Painful urination
  • Dizziness
  • Anxiety
  • Trouble sleeping (insomnia)
  • Dry mouth, increased thirst, loss of appetite
  • Constipation
  • Nosebleed, heavy menstrual periods

More serious side effects of Lexapro include

  • Weight gain
  • Clinical worsening of suicide risk
  • Serotonin syndrome especially when co-administered with other serotonergic agents (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, and St. John’s Wort)
  • Seizures
  • Activation of mania/hypomania
  • Hyponatremia
  • Abnormal bleeding
  • Interference with cognitive and motor performance
  • Angle-closure glaucoma

These aren’t all the side effects Trintellix or Lexapro can cause. You can find more details in the patient leaflet that comes with your medication. If you have any concerns about side effects, talk to your physician or a pharmacist.

Trintellix and Lexapro drug interactions

Trintellix can interact with other medications. These include:

  • Monoamine oxidase inhibitor (MAOI) medications, taken most often as antidepressants
  • Tricyclic antidepressants
  • Any selective serotonin reuptake inhibitor (SSRI) antidepressants
  • Any serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressants
  • Lithium
  • Any other medications taken to treat major depressive disorder
  • Any other medications that can affect your serotonin levels
  • Buspirone, taken most often to treat anxiety disorders
  • Any antipsychotic medications
  • Opioid painkillers, like tramadol or fentanyl
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen or naproxen
  • Triptans used to treat migraines
  • Aspirin
  • Warfarin, an anticoagulant (blood thinner) taken to reduce the risk of blood clots
  • An herbal supplement called St. John’s Wort
  • Any anticonvulsant medicines, such as carbamazepine or phenytoin
  • Rifampin
  • Quinidine, taken to treat certain heart rhythm problems

Lexapro can interact with other medications. These include:

  • Antiplatelet drugs such as clopidogrel
  • NSAIDs such as ibuprofen, naproxen
  • Blood thinners such as warfarin
  • Monoamine Oxidase Inhibitors (MAOIs) – isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, selegiline, tranylcypromine
  • St. John’s wort
  • Other SSRIs such as fluoxetine, paroxetine, sertraline
  • SNRIs such as duloxetine, venlafaxine
  • Alcohol
  • Lithium
  • Pimozide and Celexa

Trintellix and Lexapro can interact with other medications. This can change how Trintellix and Lexapro and other medications work and can make side effects more likely. Tell your prescribing physician about all your drugs, including vitamins and dietary supplements.

Trintellix and Lexapro contraindications

You should not use Trintellix if you:

  • Are allergic to the active ingredient vortioxetine, or any of the other ingredients in Trintellix
  • Are currently taking a monoamine oxidase inhibitor (MAOI) antidepressant or have taken one in the last 14 days
  • Are under 18 years of age

Talk to your doctor before using Trintellix if you:

  • Have bipolar disorder or mania
  • Have any liver problems
  • Have or have ever had seizures/convulsions
  • Have or have ever had any problems with bleeding
  • Have low salt (sodium) levels in your blood
  • Regularly drink alcohol
  • Are pregnant or are planning to become pregnant
  • Are breastfeeding or are planning to breastfeed

You should not use Lexapro if you:

  • Are allergic to the active ingredient escitalopram, or citalopram
  • Have had an allergic reaction to any of the other ingredients in Lexapro
  • Are pregnant or are planning to become pregnant

Talk to your doctor before using Lexapro if you:

  • Are taking any of the medications that could interact with Lexapro
  • Have liver or kidney disease
  • Suffer from seizures
  • Have low blood sodium levels
  • Have heart disease or high blood pressure
  • Have had a stroke
  • Have bleeding problems
  • Have sexual problems
  • Have bipolar disorder
  • Have suicidal thoughts
  • Have a drug addiction
  • Are breastfeeding or are planning to breastfeed – This medication passes into breast milk

Other drugs for mental health disorders

If you have any concerns about Trintellix or Lexapro side effects, talk to your physician, or pharmacist for medical advice. Also inform your healthcare provider about any medical conditions, supplements, and over-the-counter meds you are taking. You are also encouraged to report side effects to the FDA: visit http://www.fda.gov/medwatch or call 1-800-FDA-1088.

The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.
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