Vortioxetine (Trintellix) is expensive as fuck, most insurance plans have it under multiple restrictions (step therapy (ST), prior auth (PA), others). They have a manufacturer discount card to take off $100 max but if your prescription benefits don't kick in until after you're deductible you will max out every year pretty quickly. I just paid $900 for a 3 month supply.

But... Anecdotally, it does have less sexual side effects than escitalopram (Lexapro), and helps about the same amount with anxiety as escitalopram (Lexapro), though maybe a little bit less effective at that.