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
Trintellix
Cymbalta vs. Trintellix Dosage
Cymbalta
Trintellix
| 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 |
| 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
| 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
| 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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