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Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ
Ask your closest friends or family and you’ll find that almost everyone has experienced depression at some point in their lives. When depression turns into a debilitating and long-lasting condition, it can greatly impact life in all aspects. According to the NIH, major depressive disorder (MDD) affects around 17.3 million American adults. If you’ve been diagnosed with major depression, you may be prescribed a medication like Trintellix or Prozac.
Trintellix (vortioxetine) and Prozac (fluoxetine) are two antidepressant medications that work in similar ways. Both drugs increase the effects of serotonin, an important neurotransmitter in the brain. Trintellix and Prozac block the reuptake of serotonin so that it is available to regulate mood. Although both drugs are similar, they have differences in cost, side effects, and how they’re used.
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 to purchase.
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) while Trintellix is not grouped into a particular class of antidepressants. Trintellix belongs to a group of “other” antidepressants.
Trintellix is taken as a once-daily tablet. Prozac is often taken once daily although it also comes as a weekly dosed tablet. However, the brand-name Prozac weekly tablet has been discontinued. Instead, some doctors may prescribe a generic delayed-release form of Prozac instead.
| Main differences between Trintellix and Prozac | ||
|---|---|---|
| Trintellix | Prozac | |
| Drug class | Antidepressant Other |
Antidepressant Selective serotonin reuptake inhibitor (SSRI) |
| Brand/generic status | Brand name only | Brand and 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 treatment of MDD) |
Conditions treated by Trintellix and Prozac
Trintellix is FDA-approved to treat major depressive disorder. Major depressive disorder, also known as major depression or clinical depression, is characterized by symptoms such as persistent feelings of sadness or despair as well as decreased energy, appetite, concentration, and self-esteem. Major depression can also lead to thoughts of suicide and other behavioral changes.
Prozac is also FDA-approved to treat major depressive disorder. Prozac can also be used as treatment for other mental health disorders such as obsessive-compulsive disorder (OCD) and panic disorder. Prozac can also be used to treat Bulimia Nervosa, a serious eating disorder that involves binge eating and purging. When used with an antipsychotic drug called Zyprexa (olanzapine), Prozac can treat depressive episodes of bipolar disorder as well as treatment-resistant depression.
Both drugs may sometimes be used off-label for anxiety and other disorders such as ADHD. See the chart below for other off-label uses of these drugs.
| Condition | Trintellix | Prozac |
| Major depressive disorder | Yes | Yes |
| Obsessive-compulsive disorder (OCD) | Off-label | Yes |
| Panic disorder | Off-label | Yes |
| Depression associated with bipolar I disorder | No | Yes |
| Bulimia Nervosa | No | Yes |
| Binge-eating disorder | No | Off-label |
| Anxiety | Off-label | Off-label |
| Attention deficit hyperactivity disorder (ADHD) | Off-label | Off-label |
Is Trintellix or Prozac more effective?
Trintellix and SSRI antidepressants like Prozac have been shown to be effective for alleviating symptoms of depression compared to no treatment at all. Because Trintellix is a relatively newer drug compared to Prozac, there are currently no studies directly comparing the two.
According to clinical studies, vortioxetine is effective for treating major depressive disorder in those who are not experiencing improvement with other antidepressants. Three studies from a pool of 27 studies found that vortioxetine improved depression in people who were not experiencing relief from drugs like Wellbutrin SR (bupropion SR) and Effexor (venlafaxine).
In one study, antidepressant treatment with fluoxetine, the active ingredient of Prozac, improved overall quality of life in those with depression and/or anxiety disorders. While this study did not specifically include Trintellix, it also included other SSRIs like Lexapro (escitalopram) and Paxil (paroxetine).
Treatment for depression is highly individualized. It’s important to talk with your doctor to decide the best treatment option for you.
Coverage and cost comparison of Trintellix vs. Prozac
Trintellix can be purchased as a 5 mg, 10 mg, or 20 mg tablet. Although there is no generic version available yet, Trintellix is covered by Medicare Part D and most insurance plans. The average retail cost of Trintellix without insurance is can run $400-$600. 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 can lower the cash price down to $377.35 depending on the pharmacy you go to.
Prozac can be purchased in both brand and generic forms. If you are prescribed Prozac, your doctor will most likely prescribe the generic fluoxetine. Like Trintellix and other common antidepressants, Prozac is covered by most Medicare and insurance plans. The average retail price of generic Prozac is around $100. With a SingleCare discount card, you can expect to pay as low as $4.
| Trintellix | Prozac | |
| Typically covered by insurance? | Yes | Yes |
| Typically covered by Medicare? | Yes | Yes |
| Standard dosage | 10 mg tablets (30-day supply) | 20 mg tablets (30-day supply) |
| Typical Medicare copay | $40.19 | $0-$12 |
| SingleCare cost | $377.35 | $4 |
Common side effects of Trintellix vs. Prozac
Trintellix and Prozac, like other antidepressants, can cause similar side effects that affect the digestive system, central nervous system (CNS), and body as a whole.
The most common side effects of Trintellix include nausea, diarrhea, dizziness, and dry mouth. The most common side effects of Prozac include nausea, headache, insomnia, nervousness, anxiety, and diarrhea. Side effects with either drug are usually mild and disappear after consistent use.
Both antidepressants can also cause sexual side effects such as sexual dysfunction or decreased libido (sex drive).
Prozac can cause weight loss which can manifest as anorexia in some cases. Trintellix has not been shown to cause any weight changes such as weight gain or weight loss.
Other serious side effects of either drug may include allergic or hypersensitivity reactions. If you experience trouble breathing, severe rash, or hives, seek medical attention immediately.
| Trintellix | Prozac | |||
| Side Effect | Applicable? | Frequency | Applicable? | Frequency |
| Nausea | Yes | 32% | Yes | 22% |
| Headache | Yes | *not reported | Yes | 21% |
| Insomnia | No | – | Yes | 19% |
| Nervousness | No | – | Yes | 13% |
| Anxiety | No | – | Yes | 12% |
| Diarrhea | Yes | 7% | Yes | 11% |
| Dizziness | Yes | 9% | Yes | 9% |
| Dry mouth | Yes | 8% | Yes | 9% |
| Constipation | Yes | 6% | Yes | 5% |
| Vomiting | Yes | 6% | Yes | 3% |
| Unusual dreams | Yes | 3% | Yes | 1% |
| Itching | Yes | 3% | Yes | 3% |
| Flatulence | Yes | 1% | Yes | 3% |
| Indigestion | Yes | * | Yes | 8% |
| Sexual dysfunction / Decreased libido | Yes | 20% females/ 14% males | Yes | 4% |
| Weight loss | No | – | Yes | 2% |
This may not be a complete list of adverse effects that can occur. Please refer to your doctor or healthcare provider to learn more.
Source: DailyMed (Trintellix), DailyMed (Prozac)
Drug interactions of Trintellix vs. Prozac
Trintellix and Prozac are both processed by CYP enzymes in the liver. Other drugs that affect these enzymes can change how Trintellix or Prozac is processed by the body. Taking either drug with a CYP2D6 inhibitor such as bupropion or quinidine can cause increased levels of Trintellix or Prozac in the body. Increased drug levels can lead to an increased risk of adverse effects.
Conversely, CYP inducers can decrease the levels of Trintellix or Prozac in the body. Drugs like carbamazepine and phenytoin can decrease the effectiveness of these antidepressants. In some cases, antidepressant doses may need to be adjusted when taking drugs that are CYP inducers.
Because Trintellix and Prozac increase the levels of serotonin in the brain, they should be used with caution with other drugs that act in the same way. Serotonergic drugs like sertraline, venlafaxine, and amitriptyline can increase the risk of serotonin syndrome when taken with Trintellix or Prozac (see Warnings of Trintellix and Prozac).
| Drug | Drug Class | Trintellix | Prozac |
| Bupropion Paroxetine Quinidine |
CYP2D6 inhibitors | Yes | Yes |
| Carbamazepine Phenytoin Rifampin |
CYP inducers | Yes | Yes |
| Phenelzine Selegiline Isocarboxazid |
Monoamine oxidase inhibitors (MAOIs) | Yes | Yes |
| Sertraline Paroxetine Duloxetine Mirtazapine Venlafaxine Amitriptyline Desipramine Tramadol Fentanyl Lithium Buspirone Trazodone St. John’s Wort |
Serotonergic drugs | Yes | Yes |
| NSAIDs Aspirin Warfarin |
Drugs that interfere with blood clotting | Yes | Yes |
*Consult a healthcare professional for other drug interactions.
Warnings of Trintellix vs. Prozac
Using antidepressants may increase the risk of suicidal thoughts in some people, especially young adults and children. It’s important to monitor these adverse effects and seek medical advice if they arise.
Taking Trintellix or Prozac with other antidepressants may cause serotonin syndrome, a serious and potentially fatal condition. Some opioids like fentanyl and tramadol can also increase the risk of serotonin syndrome. Symptoms of serotonin syndrome can include high fever, agitation, shaking, dilated pupils, and diarrhea. If you experience any of these symptoms, seek immediate medical attention.
Taking Trintellix or Prozac with blood thinners such as aspirin and warfarin can increase the risk of bleeding. Taking these drugs together may cause abnormal bleeding and stomach ulcers.
Trintellix and Prozac can cause hyponatremia, or abnormally low sodium in the blood. Hyponatremia is often associated with syndrome of inappropriate antidiuretic hormone (SIADH).
Trintellix and Prozac can increase the risk of glaucoma, or abnormally low blood pressure in the eye. Glaucoma can lead to optic nerve damage and blindness if left untreated.
Prozac can also affect heart rhythm. Taking Prozac may increase the risk of abnormal heart rhythms especially in those who have already experienced heart problems or arrhythmias.
Frequently asked questions about Trintellix vs. Prozac
What is Trintellix?
Trintellix (vortioxetine) is an antidepressant FDA-approved in 2013 for the treatment of major depressive disorder. It is usually taken as a 10 mg tablet once daily with or without food. Trintellex is currently approved for use in adults only.
What is Prozac?
Prozac is an SSRI antidepressant that is used to treat major depressive disorder. It can also be used to treat other mental health disorders such as OCD, panic disorder, and bulimia. Prozac is usually taken as a 20 mg tablet once daily for depression.
Are Trintellix and Prozac the same? / What makes Trintellix different?
No. Trintellix and Prozac are not the same. Trintellix is a newer brand-name only drug that is approved to treat depression in adults. Prozac is available as a brand-name or generic drug that can be used to treat depression in adults and children 8 years and older.
Is Trintellix or Prozac better?
Currently, there are no head-to-head clinical trials comparing Trintellix and Prozac. However, both prescription drugs are effective for alleviating the symptoms of depression. Depending on your overall condition, your doctor may prescribe one over the other.
Can I use Trintellix or Prozac while pregnant?
Trintellix or Prozac should only be used during pregnancy if the benefits outweigh the risks. Taking Trintellix or Prozac during pregnancy may increase the risk of birth defects. Talk to your doctor if you are pregnant or breastfeeding before taking these antidepressants.
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 2 weeks to start feeling the benefits of Trintellix, it can often take 4 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 common 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 symptoms of depression which can include fatigue, changes in appetite, and problems with concentration or focus. By enhancing serotonin levels and alleviating depression symptoms, Trintellix may help with focus.
