Trintellix is a costly therapy for depression that basically offers the same anti-depressant activity as the generic forms of Prozac, Zoloft, Paxil or Celexa but at a much greater price. Nowhere in the barrage of televised advertising is there mention that the daily cost of the drug exceeds $10 versus $3-10 for one month of the generic versions of similarly acting selective serotonin reuptake inhibitors.
How well this drug works for depression remains the subject of controversy. Most people enrolled in trials suffered from moderate rather than severe depression. While study outcomes appeared statistically significant, the practical real world benefit may not be clinically relevant.
An estimated 5-10% of patients in a family doctor’s office may suffer from symptoms of depression with the number rising to as many as 15% among the elderly. Key features of depression include sadness, loss of energy, lack of interest and difficulty concentrating. But specific requirements exist before considering routine situational mood swings sufficient to warrant therapy.
If fact by some estimates a large fraction of those receiving these drugs do not fulfill the criteria necessary for the diagnosis of depression. And once treatment begins, a natural tendency exists to maintain the course indefinitely.
Side effects commonly appear including vomiting, constipation, flatulence and sexual dysfunction in men. The drug may interfere with the blood’s clotting ability and lead to prolonged bleeding. If prescribed for bipolar disorder, manic episodes may result. Some experience changes in vision or redness of the eye. Drugs in the Trintellix family increase the likelihood of suicide in children and teenagers.
In England, regulators originally rejected the drug as too expensive and lacking any merit over the readily available alternatives. Only after heavy lobbying on behalf of the drug maker did authorities partially relent. They require patients to fail on at least 2 other drugs before providing coverage for Trintellix.