How do Cymbalta and Prozac differ in treating depression and anxiety. What are the main side effects of these antidepressants. Which medication is more effective for various mental health conditions. How do the costs and insurance coverage compare between Cymbalta and Prozac.

Understanding Cymbalta and Prozac: Key Differences and Similarities

Cymbalta (duloxetine) and Prozac (fluoxetine) are two widely prescribed antidepressant medications used to treat various mental health conditions. While both drugs are effective in managing depression, they belong to different classes of antidepressants and have distinct mechanisms of action.

Cymbalta is a serotonin-norepinephrine reuptake inhibitor (SNRI), which works by increasing the levels of both serotonin and norepinephrine in the brain. On the other hand, Prozac is a selective serotonin reuptake inhibitor (SSRI) that primarily targets serotonin levels.

Key Differences Between Cymbalta and Prozac

• Drug Class: Cymbalta (SNRI) vs. Prozac (SSRI)
• Formulations: Cymbalta (capsules only) vs. Prozac (tablets, capsules, oral solution)
• Typical Dosage: Cymbalta (60 mg/day) vs. Prozac (20 mg/day)
• Age Range: Cymbalta (adults and specific conditions in children) vs. Prozac (adults and children over 7-8 years old)

Conditions Treated by Cymbalta and Prozac: Expanding the Scope

Both Cymbalta and Prozac are primarily used to treat major depressive disorder (MDD), but their approved indications extend beyond depression. Understanding the range of conditions each medication can address is crucial for patients and healthcare providers.

Cymbalta’s Approved Indications

• Major Depressive Disorder (MDD)
• Generalized Anxiety Disorder (GAD) in adults and children 7 years and older
• Diabetic Peripheral Neuropathic Pain
• Chronic Musculoskeletal Pain
• Fibromyalgia in adults and adolescents 13 years and older

Prozac’s Approved Indications

• Major Depressive Disorder (MDD)
• Obsessive-Compulsive Disorder (OCD) in adults and children 7 years and older
• Bulimia Nervosa
• Panic Disorder
• Premenstrual Dysphoric Disorder (PMDD)

Are there any off-label uses for Cymbalta and Prozac? Yes, healthcare providers may sometimes prescribe these medications for conditions not explicitly approved by the FDA. This practice, known as off-label use, is based on a doctor’s clinical judgment and available scientific evidence.

Efficacy Comparison: Cymbalta vs. Prozac in Clinical Practice

When comparing the effectiveness of Cymbalta and Prozac, it’s essential to consider both clinical studies and real-world evidence. Research has shown that both medications can be equally effective in treating depression, with some variations depending on individual patient factors.

A comprehensive study reviewing multiple clinical trials found that Cymbalta and Prozac demonstrated similar efficacy and safety profiles in patients with depression. However, the choice between the two often depends on the specific condition being treated and individual patient characteristics.

Factors Influencing Medication Choice

• Diagnosis: Prozac may be preferred for OCD, while Cymbalta might be chosen for fibromyalgia
• Patient History: Previous response to SSRIs or SNRIs
• Comorbid Conditions: Presence of anxiety, pain disorders, or other medical issues
• Side Effect Profile: Individual tolerability to potential side effects
• Drug Interactions: Consideration of other medications the patient is taking

How do healthcare providers determine which medication is more appropriate for a specific patient? Doctors consider various factors, including the patient’s diagnosis, medical history, other health conditions, and potential drug interactions. They may also take into account the patient’s preferences and previous experiences with antidepressants.

Insurance Coverage and Cost Comparison: Making Treatment Accessible

The cost of medication can significantly impact a patient’s ability to access and adhere to treatment. Both Cymbalta and Prozac are available in generic forms, which can substantially reduce out-of-pocket expenses for patients.

Cymbalta (Duloxetine) Cost Overview

• Out-of-pocket cost: Approximately $126 for 30 capsules (60 mg)
• With SingleCare discount card: As low as $15

Prozac (Fluoxetine) Cost Overview

• Out-of-pocket cost: Approximately $21 for 30 capsules (20 mg)
• With SingleCare discount card: As low as $4

Is insurance coverage typically available for Cymbalta and Prozac? Most insurance plans and Medicare Part D prescription plans cover both medications, especially in their generic forms. However, brand-name versions may have higher copays or limited coverage.

Patients are encouraged to check with their insurance providers for the most up-to-date coverage information. Additionally, prescription discount cards like SingleCare can offer significant savings, particularly for those without insurance or with high deductibles.

Side Effects: Understanding the Potential Risks

While Cymbalta and Prozac are generally well-tolerated, they can cause side effects. Being aware of these potential adverse reactions is crucial for patients and healthcare providers to manage treatment effectively.

Common Side Effects of Cymbalta

• Nausea
• Dry mouth
• Constipation
• Decreased appetite
• Fatigue
• Drowsiness
• Increased sweating

Common Side Effects of Prozac

• Nausea
• Insomnia
• Anxiety
• Decreased libido
• Headache
• Drowsiness
• Diarrhea

Are there any serious side effects associated with these medications? Both Cymbalta and Prozac can potentially cause more severe side effects, including an increased risk of suicidal thoughts in young adults, serotonin syndrome, and changes in heart rhythm. Patients should be closely monitored, especially during the initial weeks of treatment or after dosage changes.

Drug Interactions: Navigating Potential Complications

Understanding drug interactions is crucial when prescribing or taking antidepressants like Cymbalta and Prozac. These interactions can affect the efficacy of the medications or increase the risk of side effects.

Significant Drug Interactions with Cymbalta

• Monoamine Oxidase Inhibitors (MAOIs)
• Triptans (used for migraine treatment)
• Other SNRIs or SSRIs
• Certain pain medications (e.g., tramadol)
• Drugs affecting blood clotting (e.g., warfarin)

Significant Drug Interactions with Prozac

• Monoamine Oxidase Inhibitors (MAOIs)
• Pimozide
• Thioridazine
• Other SSRIs or SNRIs
• Certain antipsychotics

How can patients and healthcare providers manage potential drug interactions? It’s essential for patients to provide a complete list of all medications, including over-the-counter drugs and supplements, to their healthcare provider. Doctors may need to adjust dosages, change medications, or closely monitor patients when potentially interacting drugs are used together.

Warnings and Precautions: Ensuring Safe Use of Antidepressants

Both Cymbalta and Prozac come with important warnings and precautions that patients and healthcare providers should be aware of to ensure safe and effective use of these medications.

Key Warnings for Cymbalta and Prozac

1. Suicidal Thoughts and Behaviors: Increased risk, especially in young adults and adolescents
2. Serotonin Syndrome: Risk of this potentially life-threatening condition
3. Discontinuation Syndrome: Abrupt stopping can lead to withdrawal-like symptoms
4. Liver Function: Potential for liver damage, especially with Cymbalta
5. Bleeding Risk: Increased risk of bleeding, particularly when combined with certain medications
6. Hyponatremia: Risk of low sodium levels, especially in older adults
7. Pregnancy and Breastfeeding: Potential risks to the fetus and infants

What precautions should patients take when using these medications? Patients should be monitored closely, especially during the initial weeks of treatment or after dosage changes. They should report any unusual changes in mood, behavior, or physical symptoms to their healthcare provider immediately.

Regular follow-ups and open communication with healthcare providers are essential for safe and effective use of Cymbalta and Prozac. Patients should never abruptly stop taking these medications without consulting their doctor, as this can lead to discontinuation syndrome.

Choosing Between Cymbalta and Prozac: A Personalized Approach

Selecting the most appropriate antidepressant is a complex decision that requires careful consideration of various factors. While Cymbalta and Prozac are both effective treatments for depression, the choice between them depends on individual patient characteristics and specific health conditions.

Factors to Consider When Choosing an Antidepressant

• Specific Diagnosis: Depression, anxiety, pain conditions, etc.
• Patient Age: Considerations for children, adolescents, adults, and older adults
• Medical History: Previous response to antidepressants, other health conditions
• Potential Side Effects: Individual tolerance and risk factors
• Drug Interactions: Consideration of other medications the patient is taking
• Cost and Insurance Coverage: Accessibility and affordability of treatment

How do healthcare providers determine the best treatment option for each patient? Doctors typically start with a thorough assessment of the patient’s symptoms, medical history, and current medications. They may also consider factors such as the patient’s lifestyle, preferences, and any previous experiences with antidepressants.

In some cases, a healthcare provider might recommend starting with one medication and switching to the other if the initial treatment is not effective or causes intolerable side effects. This process of finding the right antidepressant can take time and may require patience from both the patient and the healthcare provider.

Ultimately, the goal is to find a treatment that effectively manages the patient’s symptoms while minimizing side effects and interactions with other medications. Regular follow-ups and open communication between the patient and healthcare provider are crucial for optimizing treatment outcomes and ensuring patient safety.

Differences, similarities, and which is better for you

Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ

If you or a loved one experience depression, anxiety, or other conditions that affect mental health, you are not alone. More than 16 million American adults have major depressive disorder (also called MDD, or depression), and nearly 7 million adults have generalized anxiety disorder (GAD).

Cymbalta (duloxetine) and Prozac (fluoxetine) are two popular antidepressant medications prescribed for depression and several other conditions. Both prescription drugs are approved by the United States Food and Drug Administration (FDA). Medication use with Cymbalta or Prozac is often combined with psychotherapy with a psychologist or doctor of psychiatry.

Cymbalta is classified in a group of medications called SNRIs (serotonin-norepinephrine reuptake inhibitors). They work by increasing the levels of serotonin and norepinephrine in the brain.

Prozac is part of a group of drugs called SSRIs (selective serotonin reuptake inhibitors). SSRIs work by increasing levels of serotonin in the brain.

What are the main differences between Cymbalta and Prozac?

Cymbalta (duloxetine) is an SNRI medication. It is available in both brand and generic. Cymbalta is only available in capsule form. The dosage varies, but a typical dose is 60 mg per day. Cymbalta is used in adults but may be used in younger ages for certain conditions (see chart).

Prozac (fluoxetine) is an SSRI medication. It is available in both brand and generic. Prozac is available in tablet form, capsule form, and as an oral solution. Although the dosage varies, a typical dose is 20 mg once a day. Prozac may be used in adults for all of the indications listed in the chart below. Prozac can also be used in children over 8 years old for depression or over 7 years old for OCD.

Conditions treated by Cymbalta and Prozac

Cymbalta is indicated for major depressive disorder, diabetic peripheral neuropathic pain, and chronic musculoskeletal pain in adults. It can also be used for generalized anxiety disorder in adults as well as children ages 7 years and older and for fibromyalgia in adults and adolescents 13 years and older. Cymbalta is not approved for use in children for depression, diabetic peripheral neuropathic pain, or chronic musculoskeletal pain.

Prozac is indicated for major depression and obsessive-compulsive disorder (OCD) in children, adolescents, and adults. Prozac can also treat bulimia nervosa, premenstrual dysphoric disorder, and panic disorder. Prozac is not approved for use in children under 7 years old.

Note: Symbyax is a combination drug that contains fluoxetine, the ingredient in Prozac, along with another medication called olanzapine. Symbyax can treat depressive episodes associated with bipolar I disorder or treatment-resistant depression.

Sometimes doctors prescribe these drugs off-label for other uses than what they are indicated.

Is Cymbalta or Prozac more effective?

One study reviewed many studies comparing Cymbalta, Prozac, and another medication called Effexor, to placebo. Cymbalta and Prozac were found to be similar in efficacy and safety for patients with depression.

The diagnosis is an essential factor in deciding which medication will be more appropriate. For example, if the indication is depression, either Prozac or Cymbalta may be an appropriate option. However, if the diagnosis is OCD, Prozac is more appropriate because it is indicated to treat OCD while Cymbalta is not. And if the diagnosis is fibromyalgia, Cymbalta is more appropriate because it is indicated for fibromyalgia, while Prozac is not.

Your healthcare provider can determine which drug is more appropriate for you, taking into account your diagnosis, medical history, and other medical conditions, along with any medications you take that could interact with Cymbalta or Prozac.

Coverage and cost comparison of Cymbalta vs. Prozac

Most insurance and Medicare Part D prescription plans cover Cymbalta or Prozac—choosing the generic form will result in significant cost savings. The brand-name products have a much higher copay or may not be covered at all.

The out-of-pocket cost of Cymbalta is about $126 for 30, 60 mg generic capsules. A free SingleCare card will help you save money on generic Cymbalta, bringing the price down to as low as $15.

The out-of-pocket cost for Prozac is about $21 for #30, 20 mg generic capsules. You can save money on generic Prozac with a SingleCare card, which can bring the generic price down to approximately $4.

Contact your insurance plan for up-to-date coverage information on Cymbalta or Prozac.

Common side effects of Cymbalta vs. Prozac

The most common side effects of Cymbalta are nausea, headaches, sleepiness, appetite loss, constipation, dry mouth, and dizziness.

The most common side effects of Prozac are headache, nausea, drowsiness, insomnia, appetite loss, sexual side effects, and nervousness or anxiety.

When you fill or refill your Cymbalta or Prozac prescription, you will receive a medication guide that discusses side effects, warnings, and other important information about your medication.

This is not a full list of adverse effects. Other, serious side effects may occur. Consult your healthcare provider for a complete list of side effects.

Source: DailyMed (Cymbalta), DailyMed (Prozac)

Drug interactions of Cymbalta vs. Prozac

MAO inhibitor (MAOI, or monoamine oxidase inhibitor) medications should not be used while taking Cymbalta or Prozac, or for a period of time before or after taking Cymbalta or Prozac. The combination may increase the risk of serotonin syndrome, a life-threatening medical emergency due to excess serotonin. Triptans, which are migraine medications, such as Imitrex (sumatriptan), and other antidepressants, should not be used in combination with Cymbalta or Prozac due to the risk of serotonin syndrome. Also, the cough suppressant dextromethorphan, found in Robitussin-DM and many cough and cold products, should be avoided as it can also cause serotonin syndrome when combined with Cymbalta or Prozac.

Avoid alcohol when taking Cymbalta or Prozac.

This is not a full list of drug interactions. Consult your healthcare provider for a complete list of drug interactions. Tell your doctor about all the medications you take, including prescription, over-the-counter (OTC), and vitamins.

Warnings of Cymbalta and Prozac

Antidepressants, including Cymbalta and Prozac, have a black box warning of suicidality. A black box warning is the strongest warning required by the FDA. Children, adolescents, and young adults (up to 24 years old) taking antidepressants are at an increased risk of suicidal thoughts and behavior. Anyone who takes antidepressants should be carefully monitored.

Other warnings:

• Serotonin syndrome is a life-threatening emergency caused by too much serotonin. Patients taking Cymbalta or Prozac should be monitored for serotonin syndrome signs and symptoms, such as hallucinations, seizures, heart rhythm or blood pressure changes (such as high blood pressure), and agitation. Seek emergency medical treatment if any of these symptoms occur. Taking other drugs that increase serotonin levels (triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, dextromethorphan, amphetamines, St. John’s Wort, and MAOIs) increase the risk of serotonin syndrome.
• When discontinuing Cymbalta or Prozac, withdrawal symptoms such as agitation may occur. Your healthcare provider can advise you on the best way to discontinue Cymbalta or Prozac, with a slow taper schedule. Never stop Cymbalta or Prozac abruptly.
• Use with caution in patients who have seizures or who have bipolar disorder.
• Hyponatremia (low sodium) due to the syndrome of inappropriate antidiuretic hormone secretion (SIADH) may occur and can be severe. Symptoms may include headache, difficulty concentrating, memory impairment, confusion, weakness, and unsteadiness, which may lead to falls. Seek emergency treatment and stop Cymbalta or Prozac if symptoms occur.
• Avoid SSRIs in patients with untreated anatomically narrow angles (angle-closure glaucoma).
• SSRIs may increase bleeding risk—this risk increases with concomitant use of aspirin, NSAIDs, or warfarin.
• Do not drive or operate machinery until you know how Cymbalta or Prozac affects you.
• Use with caution in patients with kidney problems.
• Cymbalta or Prozac may alter blood sugar levels in patients with diabetes. This requires monitoring and may require dosage adjustment to diabetes medications.
• Cymbalta or Prozac may cause weight changes. Cymbalta may cause weight gain or loss, while Prozac may cause weight loss. Monitor weight during treatment with Cymbalta or Prozac.
• Cymbalta or Prozac should only be used in pregnancy if the benefit to the mother is greater than the risk to the baby. Stopping the medication may cause a relapse of depression or anxiety. However, neonates exposed to an SNRI (like Cymbalta) or an SSRI (like Prozac) in the third trimester have developed complications requiring prolonged hospitalization, respiratory support, and tube feeding. If you already take Cymbalta or Prozac and find out you are pregnant, contact your healthcare provider immediately for guidance.
• Cymbalta and Prozac are on the Beers’ List (drugs that may be inappropriate in older adults). Consult your healthcare provider to see if Cymbalta or Prozac is safe for you.

Other Cymbalta warnings:

• Cymbalta capsules should be swallowed whole and can be taken with or without food. Do not chew, crush, or open the capsule.
• There have been cases of liver problems in people who take Cymbalta—these can be fatal. Consult your doctor immediately and stop taking Cymbalta if you develop signs of jaundice or liver problems. People who have liver problems and/or drink a substantial amount of alcohol should not take Cymbalta.
• Cymbalta can cause orthostatic hypotension (a drop in blood pressure when you stand up), falls, and/or fainting. Falls can lead to fractures or hospitalizations.
• Severe skin reactions may occur. They can be due to conditions called erythema multiforme or Stevens-Johnson syndrome. Stop taking Cymbalta and notify your doctor right away for guidance if you develop blisters, peeling rash, or skin lesions. If symptoms are severe, seek emergency medical treatment.
• Cymbalta may cause urinary problems. Notify your doctor if you have problems urinating.
• Monitor blood pressure while taking Cymbalta.
• Do not take Cymbalta if you have chronic liver disease or cirrhosis.
• Do not take Cymbalta if you have severe kidney disease.

Other Prozac warnings:

• In rare cases, there have been reports of rash and allergic reactions/systemic anaphylaxis reactions, which have been fatal. If you experience a rash or allergic symptoms, stop taking Prozac, and seek immediate medical treatment.
• Prozac may cause QT prolongation and ventricular arrhythmia, which can be life-threatening. Certain patients are at higher risk due to medical conditions or other medications. Ask your healthcare provider if Prozac is safe for you.

Frequently asked questions about Cymbalta vs. Prozac

What is Cymbalta?

Cymbalta, also known by its generic name duloxetine, is an SNRI, or serotonin-norepinephrine reuptake inhibitor. Cymbalta, which is available in both brand and generic form, treats depression, anxiety, fibromyalgia, pain from diabetic peripheral neuropathy, and chronic musculoskeletal pain.

What is Prozac?

Prozac, also known by its generic name, fluoxetine, is an SSRI or selective serotonin reuptake inhibitor. Prozac treats depression, obsessive-compulsive disorder, bulimia nervosa, premenstrual dysphoric disorder, and panic disorder. Prozac is available in both brand and generic form.

Are Cymbalta and Prozac the same?

Cymbalta and Prozac are similar, but not the same. Cymbalta is an SNRI or serotonin-norepinephrine reuptake inhibitor. Some other SNRIs include Effexor (venlafaxine) and Pristiq (desvenlafaxine).

Prozac is an SSRI. Other SSRI drugs you may have heard of include Celexa (citalopram), Lexapro (escitalopram), Luvox (fluvoxamine), Paxil (paroxetine), and Zoloft (sertraline).

Is Cymbalta or Prozac better?

Studies show that Cymbalta and Prozac are similar in terms of safety and efficacy.

The best medication for you can only be determined by your healthcare provider who can consider your diagnosis, symptoms, medical conditions, and history, along with any other medications you take that could potentially interact with Cymbalta or Prozac.

Can I use Cymbalta or Prozac while pregnant?

Neonates exposed to certain antidepressants, including Cymbalta or Prozac, in the third trimester of pregnancy have developed severe complications. These complications include lengthy hospitalizations, tube feeding, and breathing support.

If you are already taking Cymbalta or Prozac and find out that you are pregnant, consult your healthcare provider. If you are breastfeeding, consult your OB-GYN as well.

Can I use Cymbalta or Prozac with alcohol?

No. Cymbalta or Prozac should not be combined with alcohol. The combination increases the risk of respiratory depression—slowed breathing, not getting enough oxygen—and can increase sedation and drowsiness and impair alertness.

What antidepressant is better than Prozac?

All antidepressants have gone through extensive testing to show both safety and efficacy. While Prozac can be very effective, it does not work for everyone, because people respond differently to different medications. If you are taking Prozac and feel it is not working after taking it for six to eight weeks, consult your healthcare provider for medical advice.

How is Cymbalta different from other antidepressants?

SNRI medications like Cymbalta work on both serotonin and norepinephrine in the brain, while SSRI medications like Prozac work on serotonin. Cymbalta is also indicated to treat certain types of pain, like fibromyalgia, musculoskeletal pain, and diabetic neuropathic pain, in addition to depression and anxiety.

Who should not take Cymbalta?

People who take antidepressants in the monoamine oxidase inhibitor (MAOI) class of drugs should not take Cymbalta. Other medications interact with Cymbalta (see chart above). Ask your healthcare provider about serotonin syndrome, and if the medicines you take are safe in combination with Cymbalta.

Also, Cymbalta should not be used in children for depression, diabetic peripheral neuropathic pain, or chronic musculoskeletal pain.

Related Reading:

• Cymbalta vs. Zoloft
• Cymbalta vs. Lexapro
• Celexa vs. Prozac
• Lexapro vs. Prozac

Zoloft vs. Cymbalta: Similarities, Differences, & Side Effects

Cymbalta (duloxetine) is an antidepressant medication that falls under the medication category of selective serotonin-norepinephrine reuptake inhibitors (SNRIs). 

Zoloft (sertraline) is also an antidepressant medication but is a selective serotonin reuptake inhibitor (SSRI), which functions differently from SNRIs.  

While both medications are widely popular for treating mental health conditions such as depression (major depressive disorder), they have similarities and differences. 

In this article, we’ll compare Zoloft and Cymbalta by going over the conditions they’re used to treat, cost differences, potential side effects, and what you need to know to take Zoloft or Cymbalta safely.

What Are the Similarities & Differences Between Zoloft and Cymbalta?

Both medications are used to treat a variety of symptoms and mental health conditions. One of the biggest differences between Zoloft and Cymbalta is the medication class they’re in. 

Selective serotonin reuptake inhibitors (SSRIs) such as Zoloft work to increase the amount of serotonin in the brain and body to improve mood, stress, sleep, and metabolism. 

Selective serotonin-norepinephrine reuptake inhibitors (SNRIs) such as Cymbalta work to increase the amount of norepinephrine and serotonin in the brain and body to improve mood, stress, and pain symptoms.  

Here are some other comparisons of Cymbalta and Zoloft.

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What Conditions Are Treated with Zoloft and Cymbalta?

Zoloft and Cymbalta both treat various neurological and psychological disorders. The table below compares the conditions each medication treats.

One important difference between Zoloft and Cymbalta is that Cymbalta, an SNRI, is sometimes used to treat nerve pain symptoms. 

Research is yet to discover the particular mechanism behind how Cymbalta helps with pain, and studies are still exploring how Cymbalta affects patients with osteoarthritis, fibromyalgia, and other neuropathic pain. 

Zoloft has been on the market longer, as it was approved by the Federal Drug Administration (FDA) in 1990. Cymbalta was approved in 2004. 

This means that Zoloft has had more time to be extensively tested for a variety of symptoms and disorders. It is also one of just four medications approved by the FDA to use for children with obsessive-compulsive disorder (OCD). 

*  Off-label means it can be used for the condition but is not an official indication

Which Is More Effective, Zoloft or Cymbalta?

Each drug has been tested vigorously for a variety of health conditions and psychological disorders. Depending on which health concern you have, one may have more benefits over the other, and your healthcare provider will talk to you about which one may be best.

Some studies have directly compared Zoloft (sertraline) and Cymbalta (duloxetine) for patients with clinical depression. 

One study compared 63 patients who took either sertraline or duloxetine to treat Major Depressive Disorder (MDD). It found that the medications were overall similar for treatment efficacy, but each worked better for certain symptoms. 

Zoloft was more effective for symptoms relating to anxiety, agitation, and excessive fears of having an illness. But Cymbalta was more effective for treating physical symptoms slowed movement/thinking, and sexual problems.

Depending on your medical history, other current medications, and specific symptoms, either Zoloft or Cymbalta may be a better choice for you. Your healthcare provider will be able to work with you to determine which medication will be most effective for your needs.

Cost & Coverage of Zoloft vs. Cymbalta

Costs for prescriptions vary by state and city. The available insurance coverage for Zoloft and Cymbalta also differs depending on the area you live in.

Both Zoloft and Cymbalta are typically covered by commercial and Medicare/Medicaid healthcare plans, but costs can vary if you do not have prescription coverage or have to pay a copayment for prescriptions.

Like any other medication, the brand name is typically more costly than the generic brand.

The average cost for 30 days of brand-name 50mg Zoloft capsules is around $140. If you choose a generic brand of sertraline, a 30-day treatment may only cost $13.

The average cost for 30 days of brand-name 60mg Cymbalta capsules is around $390. If you choose a generic brand of duloxetine, a 30-day treatment is only around $20. 

What are the Side Effects of Zoloft and Cymbalta?

Zoloft and Cymbalta each have common side effects. See the table below for the most common side effects of each medication. This list does not include all of the possible side effects. 

If you are considering taking Zoloft or Cymbalta, be sure to ask your healthcare provider about any potential side effects.

Zoloft and other SSRIs can also sometimes cause weight gain. While the mechanisms behind the weight gain is not fully understood by experts, it may have something to do with changes in metabolism or appetite.

There is also data that shows some patients experience weight loss when they initially start Cymbalta.

Talk to your healthcare provider before stopping any antidepressant. 

If you stop taking Zoloft, Cymbalta, or another antidepressant without slowly reducing your dosage, you might experience uncomfortable symptoms or even antidepressant discontinuation syndrome. 

Symptoms of this syndrome include nausea, vomiting, headaches, and other flu-like symptoms. To be safe, notify your healthcare provider if you begin to experience any of these symptoms.

You can take some over-the-counter medications to improve some symptoms, and they typically subside after a couple of weeks.

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Drug Interactions and Warnings

Starting a new antidepressant has the potential to increase the risk of suicidal thoughts and depressive symptoms. If you experience any suicidal thoughts or are considering suicide, go to the nearest medical facility for immediate care. 

You can also call the National Suicide Prevention Lifeline (Lifeline) at 988, or text the Crisis Text Line (text HELLO to 741741). These services are free, confidential, and available 24/7.

Both SSRIs like Zoloft and SNRIs like Cymbalta are known to have negative interactions with the following treatments and medications:

• Treatments for seizure disorders
• Treatments for psychosis and schizophrenia
• Antiplatelet medications
• Lithium
• Triptans for migraines
• Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen
• Tricyclic antidepressants (TCAs)
• Monoamine oxidase inhibitors (MAOIs)

Certain drug interactions can result in dangerous and even fatal consequences.

Be sure to discuss your medical history and current medications with your healthcare providerbefore beginning any new treatment or medication.

Pregnancy and Breastfeeding

If you become pregnant while taking Zoloft or Cymbalta, notify your healthcare provider immediately.

Some SSRIs and SNRIs can cause negative effects on pregnancy or cause birth defects. 

People who are breastfeeding should discuss their medication options with their healthcare provider. 

Many times SNRIs like Cymbalta are not recommended while breastfeeding, but some SSRIs like Zoloft are approved for use while breastfeeding. 

Serotonin Syndrome

Both Zoloft and Cymbalta affect serotonin levels in the brain and body.

If too much serotonin is present, serotonin syndrome may occur. Serotonin syndrome is more likely to happen when you take other medications that increase serotonin in the body.

Examples include taking multiple antidepressants at the same time or using supplements such as  St. John’s Wort. 

Serotonin syndrome is considered a medical emergency and you should seek immediate emergency care if you display the following symptoms:

• Hallucinations
• Uncontrolled muscle spasms
• Unusual agitation or restlessness
• Nausea and vomiting
• Black, bloody stool
• Fever
• Rapid heart rate
• Severe dizziness
• Loss of coordination

How K Health Can Help

Think you might need a prescription for Zoloft (Sertraline) or a prescription for Cymbalta (Duloxetine)?

K Health has clinicians standing by 24/7 to evaluate your symptoms and determine which prescription is right for you.

Get started with our free assessment, which will tell you in minutes if treatment could be a good fit. If yes, we’ll connect you right to a clinician who can prescribe medication and have it shipped right to your door.

Frequently Asked Questions

Which is better for depression, Zoloft or Cymbalta?

When treating depression and depressive disorders, each medication has its specific benefits. Some studies have shown that Zoloft was more effective for symptoms relating to anxiety, agitation, and excessive fear of having an illness. But Cymbalta was more effective for treating physical symptoms, slowed movement/thinking, and sexual problems. The better medication option for the treatment of depression depends on the individual.

Can you switch from Zoloft to Cymbalta?

If you find that you are unhappy with the medication you’re currently taking, speak with your healthcare provider to learn about alternatives. Switching from an SNRI to an SSRI (or from an SSRI to an SNRI) must be carefully considered, as these drugs can interact with other medications and treatments.

What is stronger, Zoloft or Cymbalta?

Neither drug is stronger than the other, and they each have their own ways of affecting the brain and body. If you are looking to treat specific symptoms while experiencing clinical depression, one medication may be recommended over the other.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Antidepressant Lilly Simbalta – « How to take antidepressants correctly and reduce the intensity of side effects ➡️ Those who know these secrets have a lower risk of interrupting treatment | Efficiency and withdrawal syndrome | Duloxetine or Cymbalta, is there a difference? »

Today I want to talk about such a drug as Simbalta, aka duloxetine. It is an SSRI antidepressant. In simple words, antidepressants of this group affect not only serotonin as antidepressants of the SSRI group, but also norepinephrine. Below I will talk about my experience with Cymbalta.

Packaging .

The preparation is sold in a cardboard box with a neutral design. The front side shows the name of the drug, the active substance and the number of tablets in the package. I now have two boxes of 14 capsules left. Prior to this, at the beginning of the course of treatment, I bought the drug in 28 capsules per package. It costs twice as much.

It should be borne in mind that 14 capsules are not enough even to understand whether an antidepressant works or not. It is better to buy a large package. The box contains a blister with capsules.

This format is quite a significant minus. When taking antidepressants, you initially need to go to the drug with a micro dose. In this case, you should start taking 30 milligrams, or even 15. But not 60 milligrams at once. At such high dosages, the approach to the drug turns out to be quite tough.

On sale, as far as I know, there are capsules with a volume of 30 milligrams, but I have never come across them all the time. It is impossible to divide the capsule, although there is still one way. I’ll tell you more in the “experience” section.

Active ingredient.

The active ingredient of the drug is duloxetine. I want to note that duloxetine is a relatively new antidepressant. In general, all antidepressants of the SSRI and SNRI groups are the latest developments of scientists.

Cymbalta side effects.

When buying a drug inside, you can find instructions for use, which will include side effects. I want to say the following, some are afraid of taking drugs and believe that since there are side effects in the instructions, then they will certainly happen. It is not true. Many side effects of the company are listed simply to avoid litigation. In general, the presence of large peppery side effects in the first place indicates that the drug is well studied. It is worse when the instructions say that there will be no side effects, but they eventually appear.

Application experience.

I had a standard dosage of simbalta. One dose of the drug in the morning, the course is at least half a year, ideally a year. It is possible to take antidepressants for life, including simbalts. I didn’t need something like that. I went on the drug with 30 milligrams a day. I took a capsule and poured everything on a dry surface. Then I took the capsules from the room where I first poured out all the contents. I divided the “powder” of simbalty into two equal parts and filled it into capsules from omez. It turned out two capsules of 15 milligrams. You can use any capsules, not necessarily omez. It’s just the cheapest and it’s not a pity to throw it away. Thus, I was able to enter the drug with a relatively small dosage.

In the first two weeks of taking antidepressants of this group (SSRIs and SSRIs), the condition noticeably worsens. If before that there was depression, anxiety and other conditions, then they intensify. This is absolutely normal. I once read a review where someone complained that you see the drug is ineffective and generally only made it worse. I don’t understand how people write things like this. Surely the doctor did not warn them about the peculiarities of the action of antidepressants.

In the first two weeks of taking, not only the condition worsens, but also side effects appear. If you need to go to the required dosage for more than two weeks, then the side effects will be much longer. On average, everything goes away in 10-14 days after establishing the desired dosage. No one evaluates the effect of using an antidepressant earlier than after a month of using the drug. It is necessary to drink daily strictly at the same time. You can not drink the drug anyhow, since there will not be a single concentration in the blood. You need to drink antidepressants for at least half a year, even if all the symptoms of depression have disappeared much earlier. It’s all the gold standard of care. Sometimes the effect comes too late. For example, when I drank cipralex, I got the effect only after a month and a half from the start of the intake.

I had side effects when I started taking simbalia. They won’t get stuck because it’s all individual. All side effects went away after I got to 60 milligrams a day. About a week after reaching this dosage, the side effects began to decrease and completely disappeared. In order for the side effects to be less pronounced, it is necessary to start taking it with a lower dosage. All this must be agreed with the doctor. In principle, any good doctor talks about it.

Depression began to disappear after about three weeks from the start of taking simbalta. Every day the condition began to improve until all the symptoms were completely gone. I had depression caused by taking one drug. Simply put, depression was a consequence of treatment with another drug and, in fact, was a side effect. Pl past this was anxiety and panic attacks. In general, everything went away after a few months from the start of treatment. I took the drug for about six months. I also tried duoloxenta, but still returned to simbalta.

To prevent insomnia, the drug should be taken in the morning. It is better not to do this at night. Nevertheless, simbalta affects norepinephrine and this must be taken into account. Anxiety is removed in about 2-3 months, respectively, and panic attacks pass. Also a huge plus is that simbalta relieves pain. Many people prescribe it for pain, not depression. Tolerability was generally good. I’ve had worse antidepressants with a bunch of side effects.

Summing up, I can say that Cymbalta is a good and effective antidepressant. Side effects occur in the first weeks of treatment. When compared with other antidepressants that I drank, I can say that the side effects of simbalta are not the most harmless, but it happened worse. The drug works relatively quickly, which is a plus for me. Treats depression and gives energy. In addition, the drug effectively relieves pain. It is prescribed even for diabetes. There was no negative effect on weight. In fact, I did not see the difference between pure duloxetine and simbalta. The drug was satisfied.

The drug should be taken in consultation with the attending physician. Here I share my experience with Cymbalta, and this review is not a recommendation for treatment.

Cymbalta vs generic Cymbalta (duloxetine)

Disclaimer

If you have any medical questions or concerns, contact your physician. Articles in the Health Guide are based on peer-reviewed research and information from medical societies and government agencies. However, they are not a substitute for professional medical advice, diagnosis or treatment.

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What is duloxetine?

Duloxetine (brand name Cymbalta) is a medicine that belongs to a class of drugs known as serotonin-norepinephrine reuptake inhibitors (SNRIs). It is often prescribed for depression and general anxiety disorder. It is also prescribed for conditions such as diabetic nerve pain, fibromyalgia, and chronic musculoskeletal pain such as back pain or chronic muscle pain.

Vitals

• Duloxetine (brand name Cymbalta) is an antidepressant known as a serotonin-norepinephrine reuptake inhibitor (SNRI).
• It is prescribed for depression, anxiety, and chronic pain (such as those caused by diabetes, fibromyalgia, nerve damage, or muscle and joint problems).
• Duloxetine should not be used in people with kidney or liver disease.
• Duloxetine should be used with caution in people with certain psychiatric disorders such as bipolar disorder.

In the brain, to communicate with each other, nerve cells release chemicals called neurotransmitters. Neurotransmitters are released in the spaces between cells. They are then slowly reabsorbed back into cells for future use. Duloxetine blocks the reabsorption of two neurotransmitters: serotonin and norepinephrine. This means that the chemicals stay in the spaces between the nerves longer and can transmit signals to the nerves for longer.

Duloxetine was approved by the FDA in 2004. In 2017 (the latest year for which statistics are available), over 16.5 million prescriptions for duloxetine were filled, making it the 46th most commonly prescribed drug in the United States (Kane, n.d).

What is duloxetine used for?

Duloxetine is FDA approved for these conditions (DailyMed, no data):

• Major depressive disorder
• Generalized Anxiety Disorder
• Diabetic Peripheral Neuropathy
• Fibromyalgia
• Chronic Musculoskeletal Pain

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Dosage of duloxetine

Duloxetine is available in delayed-release capsules in doses of 20 mg, 30 mg and 40 mg. Your healthcare provider may prescribe 20 to 60 mg per day, divided into one to three doses.

The target dose is usually 60 mg.

Although a daily dose of 120 mg has been shown to be effective for anxiety and depression, there is no evidence that it provides additional benefits over 60 mg (DailyMed, 2019).

Stopping duloxetine

Do not stop duloxetine suddenly. You may have uncomfortable symptoms, including dizziness, vomiting, agitation, sweating, confusion, numbness, tingling, or an electric shock sensation (Drugs.com, n.d.). This is called duloxetine withdrawal.

Always talk to your doctor before stopping your prescription drugs.

Side effects of duloxetine

Duloxetine is generally well tolerated, but like many medicines, it can cause side effects.

A review of eight placebo-controlled studies showed that the most common side effects were nausea, dry mouth and constipation (Hudson, 2005).

Other common side effects of duloxetine include headache, drowsiness, fatigue, abdominal pain, weight loss, weakness, insomnia, dizziness, libido changes, sweating, decreased appetite, tremors, diarrhea, and erectile dysfunction (Dhaliwal, 2020).

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Serious side effects include suicidality, serotonin syndrome, hepatotoxicity, mania, syncope (syncope), and SIADH (a condition in which the body retains too much water) (Dhaliwal, 2020). If you experience any of these effects, seek medical attention immediately.

This list does not include all possible side effects, there may be others. For more information, contact your pharmacist or health care provider.

Duloxetine Warnings

The FDA has issued a black box warning for duloxetine and other antidepressants, reporting that they increase the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term trials. Patients of any age taking antidepressants should tell their healthcare provider if their symptoms worsen or they experience suicidal thoughts or behavior (DailyMed, 2019).

Do not take duloxetine within five days before or 14 days after you have used an MAOI (monoamine oxidase inhibitor) such as isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, or tranylcypromine. This could have caused a dangerous drug interaction (Drugs.com, n/a).

Duloxetine should not be used in people with the following conditions (DailyMed, NA):

• Decreased kidney function, kidney disease, or liver disease.
• Heavy drinking. Taking duloxetine while drinking large amounts of alcohol has been associated with severe liver damage.
• Previous allergic reaction to duloxetine

Duloxetine should be used with caution in people with:

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• Angle-closure glaucoma: This condition occurs in people with untreated anatomically narrow visual angles who have taken antidepressants.
• Concomitant use of other drugs that affect the central nervous system.
• History of mania or bipolar disorder. Duloxetine can cause manic episodes in some people (DailyMed, 2019).
• Pregnancy. Duloxetine is FDA category C for pregnant women, meaning it is dangerous to the fetus. cannot be ruled out (Dhaliwal, 2020). If you are pregnant, check with your doctor before taking duloxetine.

SSRIs and SSRIs, including duloxetine, may increase the risk of abnormal bleeding and bruising. If you take duloxetine at the same time as aspirin, NSAIDs such as ibuprofen, warfarin, or other anticoagulants, this risk may be increased (DailyMed, no data).

Duloxetine may raise your blood pressure. Your health care provider should take your blood pressure before you start taking duloxetine and monitor it periodically thereafter (DailyMed, no data).

Recommendations

1. DailyMed – DULOXETINE – duloxetine hydrochloride in sustained release capsules.