Cymbalta vs. Trintellix

See how Cymbalta and Trintellix compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Cymbalta is an SNRI approved for depression, anxiety, and several chronic pain conditions, while Trintellix is approved only for major depressive disorder.

  • Both drugs carry a boxed warning for suicidal thinking in young people and can cause nausea, dizziness, constipation, and dry mouth.

  • Cymbalta is available as a lower-cost generic, while Trintellix remains brand-only and is generally more expensive.

Cymbalta vs. Trintellix Drug Summary

Cymbalta

Cymbalta (duloxetine) is a serotonin and norepinephrine reuptake inhibitor (SNRI) approved for major depressive disorder, generalized anxiety disorder, and several chronic pain conditions including diabetic neuropathy and fibromyalgia. It is taken as a delayed-release capsule, usually once or twice daily.

Trintellix

Trintellix (vortioxetine) is a serotonin modulator, a newer antidepressant class with a distinct mechanism from SSRIs and SNRIs. It is FDA approved only for major depressive disorder in adults and is taken as a once-daily oral tablet.

Cymbalta vs. Trintellix Side Effects

Cymbalta

Most common
nausea (up to 30%)
dizziness (up to 17%)
somnolence (up to 21%)
headache (up to 18%)

Trintellix

Most common
nausea (20% to 32%)
dizziness (3% to 5%)
constipation (3% to 6%)
vomiting (3% to 6%)

Cymbalta vs. Trintellix Dosage

Cymbalta

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 30 mg once daily Week 1
Maximum dose 60 mg twice daily If needed
Dose changes 2 increases Every week

Trintellix

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 10 mg once daily At the start
Maximum dose 5 mg once daily If needed
Dose changes 2 increases As tolerated

Cymbalta vs. Trintellix Indications

Cymbalta

Cymbalta is approved for major depressive disorder and generalized anxiety disorder, as well as chronic pain conditions like diabetic nerve pain, fibromyalgia, and musculoskeletal pain. This dual psychiatric and pain approval makes it a common choice when depression or anxiety overlaps with chronic pain.

  • Major depressive disorder

  • Generalized anxiety disorder

  • Diabetic peripheral neuropathic pain

  • Fibromyalgia

Trintellix

Trintellix is approved only for major depressive disorder in adults. Unlike some other antidepressants, it does not carry FDA approval for anxiety disorders or chronic pain conditions.

  • Major depressive disorder in adults

  • Not approved for children or adolescents

  • No FDA-approved anxiety indication

  • No FDA-approved pain indication

Cymbalta vs. Trintellix Pros and Cons

Cymbalta

Cymbalta's broad approval across psychiatric and pain conditions makes it useful when depression or anxiety coexists with chronic pain. It has a long track record and is available as a generic, though it carries a higher rate of common side effects than Trintellix.

Pros

  • Approved for multiple conditions, including chronic pain and fibromyalgia

  • Available as a lower-cost generic (duloxetine)

  • Long history of use since FDA approval in 2004

Cons

  • Higher rates of nausea, somnolence, and headache than Trintellix

  • Not recommended for people with liver disease or severe kidney impairment

  • Can cause pronounced discontinuation symptoms if stopped abruptly

Trintellix

Trintellix works through a distinct mechanism and tends to cause less sexual dysfunction and weight gain than many older antidepressants. It has a narrower approval, covering only depression, and remains more expensive since no generic exists.

Pros

  • Lower rates of sexual dysfunction and weight gain than many SSRIs/SNRIs

  • Simple once-daily tablet with no twice-daily dosing option

  • Milder gastrointestinal and CNS side effects at approved doses

Cons

  • No generic version available, brand-only

  • Only approved for depression, not anxiety or chronic pain

  • Specific risks of angle-closure glaucoma and hyponatremia

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