Lexapro vs. Trintellix
See how Lexapro and Trintellix compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Lexapro is an SSRI approved for both depression and generalized anxiety disorder, while Trintellix is a serotonin modulator approved only for depression.
Both carry a boxed warning for increased suicidal thoughts in children, adolescents, and young adults, and nausea is a top side effect for each, though Trintellix's rate can run higher.
Lexapro has a generic version available, while Trintellix remains brand-only with no generic option.
Lexapro vs. Trintellix Drug Summary
Lexapro
Lexapro (escitalopram) is an SSRI approved for major depressive disorder in adults and adolescents ages 12 to 17, as well as generalized anxiety disorder in adults. It's taken once daily as a tablet or oral solution, usually starting at 10 mg and increasing to 20 mg after two weeks if needed.
Trintellix
Trintellix (vortioxetine) is a serotonin modulator approved for major depressive disorder in adults only. It's taken once daily as a tablet, typically starting at 10 mg and increasing to 20 mg as tolerated, or reduced to 5 mg if side effects occur.
Lexapro vs. Trintellix Side Effects
Lexapro
Trintellix
Lexapro vs. Trintellix Dosage
Lexapro
Trintellix
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg once daily | At the start |
| Maximum dose | 20 mg once daily | Week 2 onward |
| Dose changes | 1 increase | As tolerated |
| 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 |
Lexapro
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg once daily | At the start |
| Maximum dose | 20 mg once daily | Week 2 onward |
| Dose changes | 1 increase | As tolerated |
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 |
Lexapro vs. Trintellix Indications
Lexapro
Lexapro is FDA-approved for major depressive disorder in adults and adolescents ages 12 to 17, and for generalized anxiety disorder in adults.
Major depressive disorder, adults
Major depressive disorder, adolescents 12-17
Generalized anxiety disorder, adults
Trintellix
Trintellix is FDA-approved only for major depressive disorder in adults, with no approved use in children, adolescents, or for anxiety disorders.
Major depressive disorder, adults
Not approved for children or adolescents
Not approved for anxiety disorders
Lexapro vs. Trintellix Pros and Cons
Lexapro
Lexapro has decades of clinical use, a generic option, and FDA approval for both depression and anxiety. Its main tradeoffs are a relatively high rate of sexual side effects and insomnia.
Pros
Generic version available at much lower cost
Longer track record, FDA approved since 2002
Also approved for generalized anxiety disorder
Cons
Ejaculation disorder in up to 9% of patients
Insomnia in up to 9% of patients
Not approved for anxiety in pediatric patients
Trintellix
Trintellix works through a different mechanism than SSRIs and tends to cause less sexual dysfunction and weight gain. It's only approved for depression, has no generic version, and its main tradeoff is a higher rate of nausea.
Pros
Lower rates of sexual dysfunction than many SSRIs
Lower rates of weight gain than many SSRIs
Distinct mechanism may help those who haven't responded to SSRIs
Cons
No generic version, brand-only medication
Only approved for depression, not anxiety
Not approved for children or adolescents
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