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Key takeaways
Trintellix and Prozac both treat clinical depression but differ in cost, availability, and how they work.
Prozac is available as a generic drug and approved for more conditions, including panic disorder and bulimia.
Trintellix is a newer antidepressant that some people may better tolerate, but it is only available as a brand-name product.
Almost everyone feels depression at some point, but when it becomes major depressive disorder (MDD), it can be hard to manage daily life. According to the NIH, about 17.3 million American adults live with MDD. For those who’ve been diagnosed with depression, a healthcare provider may recommend an antidepressant medication like Trintellix (vortioxetine) or Prozac (fluoxetine). Both drugs help balance serotonin levels to improve mood. While they work similarly, they differ in cost, available forms, side effects, and approved uses.
Main differences between Trintellix and Prozac |
||
|---|---|---|
| Trintellix | Prozac | |
| Drug class | Antidepressant
Serotonin modulator and stimulator |
Antidepressant
Selective serotonin reuptake inhibitor (SSRI) |
| Brand/generic status | Brand name only | Generic version available |
| What is the generic name? | Vortioxetine | Fluoxetine |
| What form(s) does the drug come in? | Oral tablet | Oral capsule |
| What is the standard dosage? | 10 mg once daily | 20 mg once daily |
| How long is the typical treatment? | Short-term or long-term, as directed by a physician | Short-term or long-term, as directed by a physician |
| Who typically uses the medication? | Adults 18 years old and older | Adults and children 8 years old and older (for the treatment of MDD) |
What are the main differences between Trintellix and Prozac?
Trintellix is only available as a brand-name drug, whereas Prozac is widely available in a generic form. Because there is no generic alternative for Trintellix, it may be more expensive.
While both antidepressant drugs can be used as a treatment for major depressive disorder, Prozac can also be used to treat other mental health disorders. For example, Prozac can also treat obsessive-compulsive disorder (OCD) among other conditions (see Conditions treated by Trintellix and Prozac below).
Prozac belongs to a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). Trintellix may act as an SSRI but is more often classified as a serotonin modulator and stimulator (SMS) that not only increases serotonin levels but also acts on multiple serotonin receptors to help regulate mood. Trintellix may also be considered an atypical antidepressant.
Trintellix is taken as a once-daily tablet. Although Prozac is often taken once daily, it also comes as a weekly dosed tablet. However, the brand-name versions of Prozac have been discontinued, and it’s now mostly available as a generic drug.
Conditions treated by Trintellix and Prozac
Both Trintellix and Prozac are FDA-approved to treat major depressive disorder, which is characterized by persistent sadness, despair, decreased energy, and changes in appetite, concentration, or self-esteem.
While both medications are used to treat major depression, Prozac is also approved for other mental health conditions, including:
- Obsessive-compulsive disorder (OCD)
- Bulimia nervosa
- Panic disorder
In some cases, Prozac is combined with Zyprexa (olanzapine) to treat depressive episodes linked to bipolar I disorder or depression that hasn’t improved with other treatments.
Off-Label Uses
Both drugs may sometimes be used off-label to treat anxiety disorders. Prozac may also be prescribed off-label for conditions such as premenstrual dysphoric disorder (PMDD), borderline personality disorder, and selective mutism. The American Psychological Association also recognizes fluoxetine as a treatment option for post-traumatic stress disorder (PTSD).
Is Trintellix or Prozac more effective?
According to clinical studies, vortioxetine is effective for treating major depressive disorder in those who don’t experience improvements with other antidepressants. Three studies from a pool of 27 studies found that vortioxetine improved depression in people who didn’t get relief from drugs like Zoloft (sertraline), Wellbutrin SR (bupropion), and Effexor (venlafaxine).
In a large meta-analysis comparing 21 antidepressants, both vortioxetine and fluoxetine were found to be more effective than placebo. Vortioxetine ranked among the more effective and better-tolerated options, while fluoxetine showed slightly lower efficacy but was still well-tolerated overall.
Treatment for depression is highly individualized. Talking with a healthcare provider to find the best treatment option is important.
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Coverage and cost comparison of Trintellix vs. Prozac
Although no generic version is available, Trintellix is covered by most insurance and Medicare Part D plans. The average retail cost of Trintellix is around $676 for a 30-day supply. If you’re looking to purchase Trintellix from your local pharmacy, you can check to see if they will accept a SingleCare savings card. With SingleCare, you may be able to lower the cash price down to $466, depending on the pharmacy you go to.
Prozac is typically prescribed and purchased in its generic form. Like other generic antidepressants, Prozac is covered by most Medicare and insurance plans. The average retail price of generic Prozac is around $67, but prices can drop to around $6 with a SingleCare discount card.
Comparing the cost of Trintellix vs. Prozac |
||
|---|---|---|
| Trintellix | Prozac | |
| Typically covered by insurance? | Yes | Yes |
| Typically covered by Medicare? | Yes | Yes |
| Quantity | 30, 20 mg tablets | 30, 20 mg tablets |
| Typical Medicare copay | Varies | Varies |
| SingleCare cost | $676 | $6 |
Common side effects of Trintellix vs. Prozac
Trintellix and Prozac may cause similar side effects. However, side effects with either drug are usually mild and disappear after consistent use.
Common side effects of Trintellix
- Nausea
- Vomiting
- Constipation
- Diarrhea
- Dizziness
- Dry mouth
- Sexual dysfunction
- Abnormal dreams
- Gas
- Itching
The most common side effects of Prozac
- Nausea
- Headache
- Insomnia
- Fatigue
- Loss of appetite
- Dry mouth
- Anxiety
- Diarrhea
The frequency and severity of these side effects can vary by person. Serious side effects are also possible. For example, allergic reactions, such as rash, swelling, or difficulty breathing, require immediate medical attention.
Source: DailyMed (Trintellix), DailyMed (Prozac)
Drug interactions and warnings
Both drugs are processed by CYP enzymes in the liver. Other medications that affect these enzymes can change how Trintellix or Prozac are processed, potentially leading to increased drug levels and an increased risk of adverse effects.
Some medications like bupropion and quinidine can increase Trintellix levels, which may lead to increased side effects. On the other hand, medications like rifampin or carbamazepine can lower the effectiveness of Trintellix. Fluoxetine can increase levels of certain drugs, such as tricyclic antidepressants, antipsychotics, benzodiazepines, and some anticonvulsants.
Serotonin syndrome risk
Because Trintellix and Prozac increase levels of serotonin, they should be used with caution while taking other serotonergic drugs. Taking either medication with triptans (such as sumatriptan or rizatriptan) or certain opioids (like fentanyl or tramadol) can increase the risk of serotonin syndrome, a serious, potentially fatal condition.
Warning signs include agitation, sweating, tremor, high fever, or diarrhea. Seek medical attention if these occur.
Other major warnings
- Suicidal thoughts: Using antidepressants may increase the risk of suicidal thoughts, especially in young adults and children.
- Bleeding risk: Taking Trintellix or Prozac with blood thinners like aspirin or warfarin can increase the risk of bleeding or stomach ulcers.
- Mania or hypomania: Both drugs can trigger manic episodes in people with bipolar disorder. Therefore, screening for bipolar disorder is recommended before starting treatment.
- Hyponatremia: Low sodium levels are possible, especially in older adults or those taking diuretics.
- Angle-closure glaucoma: Both may trigger an increase in eye pressure, leading to a condition called angle-closure glaucoma.
- QT prolongation: Prozac may affect heart rhythm, so it should be used with caution in people with heart rhythm disorders or those taking other QT-prolonging drugs.
Frequently asked questions about Trintellix vs. Prozac
Are Trintellix and Prozac the same?
No. Although both treat major depressive disorder, Trintellix is a newer antidepressant for adults, while Prozac is an older option available in generic forms for adults and certain children.
Is Trintellix or Prozac better?
Currently, there are limited clinical trials comparing Trintellix and Prozac. However, both prescription drugs work well to manage symptoms of depression. A healthcare provider may prescribe one over the other depending on a person’s overall condition.
Can I use Trintellix or Prozac while pregnant?
Trintellix or Prozac should only be used during pregnancy if the benefits outweigh the risks. Taking these drugs late in pregnancy may increase the risk of high blood pressure in the lungs and breathing or feeding problems in newborns. Seek medical advice from a healthcare provider for treatment options while pregnant or breastfeeding.
Can I use Trintellix or Prozac with alcohol?
It is not generally recommended to use antidepressants with alcohol. Taking Trintellix or Prozac while drinking alcohol can increase the risk of adverse effects like dizziness and drowsiness.
How long does it take for Trintellix to start working?
Like other antidepressants, Trintellix does not start working immediately. While it may take a couple of weeks to start feeling the benefits of Trintellix, it can often take four weeks or longer to feel the full effects of the drug.
What are the side effects of Trintellix?
The most common side effects of Trintellix are nausea, vomiting, and constipation. Other potential side effects of Trintellix include dry mouth and dizziness.
Does Trintellix help with focus?
Trintellix may indirectly help with focus. It is primarily used to treat depression symptoms, which can include fatigue, changes in appetite, and problems with concentration. By balancing serotonin levels and managing depression symptoms, Trintellix may help with focus.
- Major depression, National Institute of Mental Health (2023)
- Trintellix highlights of prescribing information, U.S. Food and Drug Administration (2023)
- Prozac highlights of prescribing information, U.S. Food and Drug Administration (2023)
- Treatment guidelines for PTSD: a systematic review, Journal of Clinical Medicine (2021)
- Efficacy and tolerability of switching therapy to vortioxetine versus other antidepressants in patients with major depressive disorder, Current Medical Research and Opinion (2016)
- Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis, Lancet (2018)
- Serotonin syndrome, MedlinePlus (2024)
- Suicidality in children and adolescents being treated with antidepressant medications, U.S. Food and Drug Administration (2018)
- Association of antidepressant use during pregnancy and pregnancy-induced hypertension: a systematic review and meta-analysis, BMC Pregnancy and Childbirth (2025)
- Practical advice for primary care clinicians on the safe and effective use of vortioxetine for patients with major depressive disorder (MDD), Neuropsychiatric Disease and Treatment (2022)