Dose Equivalency Between Sertraline and Vortioxetine
There is no established dose equivalency between 100mg of Zoloft (sertraline) and Trintellix (vortioxetine) because these medications have fundamentally different mechanisms of action and cannot be directly compared on a milligram-to-milligram basis.
Why Direct Comparison Is Not Possible
Sertraline and vortioxetine are not equivalent medications that can be dose-matched:
- Sertraline is a selective serotonin reuptake inhibitor (SSRI) with a straightforward mechanism—it blocks serotonin reuptake 1
- Vortioxetine is a multimodal agent with multiple mechanisms including serotonin reuptake inhibition, 5-HT3 receptor antagonism, and effects on multiple other serotonergic receptors, leading to enhanced release of serotonin, norepinephrine, and acetylcholine 2, 3
Therapeutic Dosing Ranges
Sertraline (Zoloft)
- Initial dose: 25-50 mg daily 1
- Therapeutic range: 50-200 mg daily 1
- Your dose of 100mg falls in the mid-therapeutic range
Vortioxetine (Trintellix)
Clinical Switching Approach
If switching from sertraline 100mg to vortioxetine, start with vortioxetine 10mg daily and titrate to 20mg based on response 4, 5. This is not based on dose equivalency but rather on vortioxetine's standard therapeutic dosing:
- Begin vortioxetine at 10 mg once daily regardless of prior SSRI dose 4, 5
- Increase to 20 mg daily after 1 week if tolerated and needed for optimal response 4
- Most patients with inadequate SSRI response show improvement on vortioxetine 10-20 mg daily 4
Important Considerations
Efficacy comparison: Both medications demonstrate antidepressant efficacy, but vortioxetine may offer advantages in cognitive function and emotional blunting that sertraline does not provide 4, 2. Studies show 47-50% remission rates with vortioxetine in patients who had partial response to SSRIs 4.
Side effect profile: The most common adverse events with vortioxetine are nausea (similar to sertraline), vomiting, constipation, headache, and dizziness 4, 2. Vortioxetine demonstrates significantly lower rates of sexual dysfunction compared to sertraline and other SSRIs 5.