| Major Depressive Disorder
Trintellix vs Effexor XR
Side-by-side clinical, coverage, and cost comparison for major depressive disorder.Deep comparison between: Trintellix vs Effexor with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsEffexor has a higher rate of injection site reactions vs Trintellix based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Effexor but not Trintellix, including UnitedHealthcare
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Category
Trintellix
Effexor
At A Glance
Oral
Once daily
Antidepressant
Oral
Daily
SNRI
Indications
- Major Depressive Disorder
- Major Depressive Disorder
- Generalized Anxiety Disorder
- Phobia, Social
- Panic Disorder
Dosing
Major Depressive Disorder Starting dose 10 mg once daily without regard to meals; increase to 20 mg/day as tolerated. May decrease to 5 mg/day for patients who do not tolerate higher doses. Maximum 20 mg/day (10 mg/day in CYP2D6 poor metabolizers). Taper from 15-20 mg/day to 10 mg/day for one week before discontinuation if possible.
Major Depressive Disorder Starting dose 37.5-75 mg/day; target 75 mg/day; max 225 mg/day; administered once daily with food.
Generalized Anxiety Disorder Starting dose 37.5-75 mg/day; target 75 mg/day; max 225 mg/day; administered once daily with food.
Phobia, Social Recommended dose 75 mg/day; administered once daily with food; no evidence that higher doses confer additional benefit.
Panic Disorder Starting dose 37.5 mg/day for 7 days, then 75 mg/day; max 225 mg/day; administered once daily with food.
Contraindications
- Hypersensitivity to vortioxetine or any component of the formulation
- Use of MAOIs intended to treat psychiatric disorders concurrently or within 21 days of stopping TRINTELLIX
- Use within 14 days of stopping an MAOI intended to treat psychiatric disorders
- Initiation in patients being treated with linezolid or intravenous methylene blue
- Known hypersensitivity to venlafaxine hydrochloride, desvenlafaxine succinate, or any excipients in the formulation
- Concomitant use with MAOIs (including linezolid and intravenous methylene blue), or within 14 days of stopping an MAOI antidepressant, due to risk of serotonin syndrome
Adverse Reactions
Most common (>=5% and twice placebo) Nausea (21-32%), constipation (3-6%), vomiting (3-6%), diarrhea (7-10%), dry mouth (6-8%), dizziness (6-9%)
Serious Serotonin syndrome, increased bleeding risk, activation of mania/hypomania, angle closure glaucoma, hyponatremia, hypersensitivity reactions including anaphylaxis and angioedema
Postmarketing Hyperprolactinemia, acute pancreatitis, seizure, aggression, agitation, anger, hostility, irritability, anosmia, hyposmia, weight gain, rash, generalized rash, hyperhidrosis
Most common (>=5%) Nausea, somnolence, dry mouth, sweating, abnormal ejaculation, anorexia, constipation, impotence, decreased libido
Serious Serotonin syndrome, elevated blood pressure, increased risk of bleeding, angle-closure glaucoma, activation of mania/hypomania, discontinuation syndrome, seizure, hyponatremia, interstitial lung disease, eosinophilic pneumonia
Postmarketing Anaphylaxis, angioedema, QT prolongation, ventricular fibrillation, ventricular tachycardia (including torsade de pointes), takotsubo cardiomyopathy, Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiforme, neuroleptic malignant syndrome, rhabdomyolysis, hyponatremia, SIADH
Pharmacology
Vortioxetine's antidepressant effect is thought to be related to enhancement of serotonergic activity in the CNS through inhibition of serotonin reuptake, along with 5-HT3 receptor antagonism and 5-HT1A receptor agonism.
Venlafaxine is an SNRI whose antidepressant and anxiolytic effects are thought to be related to potentiation of serotonin and norepinephrine in the CNS through inhibition of their reuptake; it also weakly inhibits dopamine reuptake and has no significant affinity for muscarinic, H1-histaminergic, or alpha1-adrenergic receptors.
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Most Common Insurance
Anthem BCBS
Trintellix
- Covered on 5 commercial plans
- PA (3/12) · Step Therapy (3/12) · Qty limit (11/12)
Effexor
- Covered on 5 commercial plans
- PA (0/12) · Step Therapy (0/12) · Qty limit (12/12)
UnitedHealthcare
Trintellix
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (4/8) · Qty limit (5/8)
Effexor
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Trintellix
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (3/3) · Qty limit (2/3)
Effexor
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
$10/fillfill
Trintellix Savings CardCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
Final cost depends on formulary coverage
No savings programs available for Effexor.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.