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.

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: An SNRI Antidepressant

Cymbalta is classified as a serotonin-norepinephrine reuptake inhibitor (SNRI). It works by increasing the levels of both serotonin and norepinephrine in the brain. This dual action can be particularly beneficial for patients experiencing both mood and pain symptoms.

Prozac: An SSRI Antidepressant

Prozac, on the other hand, is a selective serotonin reuptake inhibitor (SSRI). It primarily increases the levels of serotonin in the brain, which plays a crucial role in regulating mood, anxiety, and other emotional responses.

Why is understanding the difference between SNRIs and SSRIs important? The choice between these two types of antidepressants can significantly impact treatment outcomes and side effect profiles for individual patients.

Conditions Treated by Cymbalta and Prozac

While both medications are primarily used to treat depression, they have been approved for various other conditions as well.

Cymbalta’s Approved Uses

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

Prozac’s Approved Uses

• Major Depressive Disorder (MDD) in adults and children 8 years and older
• Obsessive-Compulsive Disorder (OCD) in adults and children 7 years and older
• Bulimia Nervosa in adults
• Panic Disorder in adults
• Premenstrual Dysphoric Disorder (PMDD) in adults

How do these differences in approved uses affect treatment decisions? The specific condition being treated plays a crucial role in determining which medication may be more appropriate for a patient.

Efficacy Comparison: Cymbalta vs Prozac

When it comes to treating depression, both Cymbalta and Prozac have shown comparable efficacy in clinical studies. A comprehensive review of multiple studies comparing Cymbalta, Prozac, and another antidepressant called Effexor to placebo found that Cymbalta and Prozac demonstrated similar effectiveness and safety profiles in patients with depression.

However, the choice between these medications often depends on the specific condition being treated and individual patient factors. For instance:

• For depression, either Prozac or Cymbalta may be appropriate
• For OCD, Prozac is more suitable as it is specifically indicated for this condition
• For fibromyalgia, Cymbalta is the preferred choice due to its approved indication

What factors should healthcare providers consider when choosing between Cymbalta and Prozac? In addition to the specific diagnosis, a patient’s medical history, other existing medical conditions, and potential drug interactions all play crucial roles in determining the most appropriate medication.

Dosage and Administration: Cymbalta vs Prozac

Understanding the dosage and administration differences between Cymbalta and Prozac is crucial for proper treatment.

Cymbalta Dosage

Cymbalta is available only in capsule form. The typical dosage for adults is 60 mg per day, although this can vary depending on the condition being treated and individual patient factors. It’s important to note that Cymbalta should not be opened, crushed, or chewed, as this can affect its release in the body.

Prozac Dosage

Prozac offers more flexibility in its dosage forms. It is available as:

• Tablets
• Capsules
• Oral solution

The typical starting dose for adults is 20 mg once daily, but this can be adjusted based on the patient’s response and the condition being treated.

How does the flexibility in Prozac’s dosage forms benefit patients? This variety allows for easier dose adjustments and can be particularly helpful for patients who have difficulty swallowing pills or require precise dose titration.

Side Effects: Comparing Cymbalta and Prozac

While both medications can be effective in treating depression and other conditions, they come with potential side effects that patients should be aware of.

Common Side Effects of Cymbalta

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

Common Side Effects of Prozac

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

Why is it important to consider side effects when choosing between Cymbalta and Prozac? The side effect profile can significantly impact a patient’s quality of life and adherence to treatment. Some patients may find certain side effects more tolerable than others, which can influence the choice of medication.

Drug Interactions: Cymbalta and Prozac Considerations

Both Cymbalta and Prozac can interact with other medications, potentially altering their effectiveness or increasing the risk of side effects. It’s crucial for patients to inform their healthcare providers about all medications, supplements, and herbal products they are taking.

Key Drug Interactions with Cymbalta

• MAO inhibitors
• Thioridazine
• Certain antibiotics (e.g., linezolid)
• NSAIDs (may increase risk of bleeding)
• Warfarin (may increase risk of bleeding)

Key Drug Interactions with Prozac

• MAO inhibitors
• Thioridazine
• Pimozide
• Certain antipsychotics
• Other SSRIs or SNRIs

How can understanding drug interactions help prevent potential complications? By being aware of these interactions, healthcare providers can make informed decisions about medication combinations and adjust dosages if necessary to minimize risks.

Insurance Coverage and Cost Comparison

The cost of medication can be a significant factor in treatment decisions. Both Cymbalta and Prozac are available in generic forms, which can offer substantial cost savings compared to brand-name versions.

Cymbalta (Duloxetine) Cost

The out-of-pocket cost for generic Cymbalta (duloxetine) is approximately $126 for 30 capsules of 60 mg. However, using a discount card like SingleCare can reduce this cost to as low as $15.

Prozac (Fluoxetine) Cost

Generic Prozac (fluoxetine) is generally more affordable, with an out-of-pocket cost of about $21 for 30 capsules of 20 mg. With a SingleCare discount card, this price can be reduced to approximately $4.

Why is considering the cost of medication important in treatment decisions? The affordability of a medication can significantly impact a patient’s ability to adhere to their prescribed treatment regimen. Lower-cost options may improve long-term treatment compliance.

Special Considerations and Warnings

Both Cymbalta and Prozac come with important warnings and precautions that patients and healthcare providers should be aware of.

Cymbalta Warnings

• Increased risk of suicidal thoughts and behaviors, especially in young adults
• Potential for liver damage
• Risk of serotonin syndrome when combined with other serotonergic drugs
• Potential for increased blood pressure
• Risk of withdrawal symptoms if discontinued abruptly

Prozac Warnings

• Increased risk of suicidal thoughts and behaviors, particularly in children and young adults
• Potential for serotonin syndrome
• Risk of abnormal bleeding, especially when combined with NSAIDs or blood thinners
• Potential for hyponatremia (low sodium levels)
• Risk of activation of mania in patients with bipolar disorder

How do these warnings impact the decision-making process for prescribing these medications? Healthcare providers must carefully weigh the potential benefits against the risks for each individual patient, considering their medical history and specific circumstances.

In conclusion, while Cymbalta and Prozac are both effective antidepressants, they have distinct characteristics that make them more suitable for different conditions and patient profiles. The choice between these medications should be made in consultation with a healthcare provider, taking into account the specific diagnosis, potential side effects, drug interactions, cost considerations, and individual patient factors. Regular follow-ups and open communication with healthcare providers are essential to ensure the best possible outcomes when using these medications.

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

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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 Effexor: Differences, Similarities and What’s Best for You – Drug Vs.

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Drug Overview and Key Differences | Conditions of treatment | Efficiency | Insurance coverage and cost comparison | Side effects | Drug Interactions | Warnings | Frequently Asked Questions

Cymbalta (duloxetine) and Effexor (venlafaxine) are brand name drugs used to treat mental illnesses such as depression and anxiety. They are commonly prescribed as antidepressants to relieve symptoms of major depressive disorder. Symptoms of major depressive disorder may include persistent sadness and a severe loss of interest in daily activities.

Cymbalta and Effexor belong to a class of drugs called serotonin and norepinephrine reuptake inhibitors (SNRIs). They work by increasing the availability of serotonin and norepinephrine in the brain. These chemicals, or neurotransmitters, are believed to play a role in causing mental disorders.

For the purposes of this comparison, the name Effexor may also refer to Effexor XR, the only Effexor brand currently available on the market.

What are the main differences between Cymbalta and Effexor?

Cymbalta

Cymbalta is the brand name for duloxetine. It is available as delayed-release oral capsules in 20mg, 30mg, or 60mg strengths. It is usually taken by mouth as one capsule once a day depending on the condition being treated. The maximum daily dose is 120 mg, although there is no evidence that doses greater than 60 mg provide a significant increase in benefit.

Cymbalta has a half-life of about 12 hours. It is metabolized and excreted through the liver and kidneys. It should be avoided in severe liver or kidney disease.

Effexor

Effexor is the brand name for venlafaxine. However, the brand name Effexor is only available as Effexor XR or venlafaxine extended release tablets. The immediate release effexor has been discontinued because it needs to be injected multiple times throughout the day and causes more nausea than the extended release version.

Effexor XR is available in 37.5 mg, 75 mg and 150 mg oral capsules. The dosage may vary depending on the condition being treated. However, Effexor XR is usually taken once a day with a target daily dose of 75 mg and a maximum daily dose of 225 mg.

Like Cymbalta, Effexor is metabolized in the liver and has a half-life of up to 11 hours. It can be used for liver or kidney problems at lower doses.

Conditions treated by Cymbalta and Effexor

Cymbalta approved by the FDA for the treatment of major depressive disorder (MDD) ) and generalized anxiety disorder (GAD). It can also be used to treat fibromyalgia and diabetic neuropathy pain, as well as general muscle, tendon, ligament and bone pain. Cymbalta may occasionally be used off-label for other anxiety disorders.

Effexor XR is FDA approved for the treatment of major depressive disorder (MDD), generalized anxiety disorder (GAD), social anxiety disorder (SAD), and panic disorder (PD). It is also sometimes used off-label to treat obsessive-compulsive disorder (OCD), premenstrual dysphoric disorder (PMDD), and pain.

9014 8 yes

Are Cymbalta or Effexor more effective?

The effectiveness of Cymbalta or Effexor depends on the condition being treated. Very few studies have directly compared Cymbalta and Effexor. However, compared to placebo, Cymbalta and Effexor are more effective for conditions such as major depression.

One study combined several clinical trials and found venlafaxine to be a better short-term treatment option for major depression than duloxetine. Venlafaxine, the active ingredient in effexor, may also be preferred for those who do not respond well to initial treatment with selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants (TCAs). However, the study found that there were no significant differences in response and response rates between duloxetine and venlafaxine.

Another systematic review compared venlafaxine with duloxetine and other antidepressants such as paroxetine, fluoxetine and fluvoxamine. Compared to other options, venlafaxine was found to be one of the more effective antidepressants. However, both venlafaxine and duloxetine have been ranked among the least tolerated antidepressants in terms of side effects.

Consult with a mental health professional to determine the best treatment option for you.

Coverage and cost comparison of Cymbalta and Effexor

Cymbalta is a brand-name prescription drug used for depression. The generic duloxetine is usually covered by Medicare and insurance plans. With a 30-day supply, the average retail price can exceed $470. With the SingleCare Cymbalta coupon, the generic version starts at $15 at participating pharmacies.

Effexor XR tablets are available by prescription. Generic Effexor XR tablets are often covered by Medicare and insurance plans. At an average price of around $145, the Effexor XR is cheaper than the Cymbalta. However, using SingleCare’s Effexor XR Coupon can lower the cost even further. Ask a pharmacist for a generic and get it for about $15.

90 148 US$15+

Common side effects Cymbalta vs.

Effexor

The most common side effects of Cymbalta include nausea, headache, dry mouth, drowsiness or drowsiness, constipation and fatigue. Cymbalta may also cause diarrhea, decreased appetite, increased sweating, and abdominal pain, among other side effects.

The most common side effects of Effexor are nausea, headache, dry mouth, weakness and drowsiness. Effexor can also cause insomnia, constipation, dizziness, diarrhea, and decreased appetite.

Both Cymbalta and Effexor can also cause a decrease in sexual desire (libido). However, Effexor has been shown to cause more sexual dysfunction problems than Cymbalta.

The table below lists other common side effects of Cymbalta and Effexor.

90 148 yes

9014 8 1%

90 148 yes

*not reported 9011 4 Frequency not based on face-to-face trial data. This may not be a complete list of side effects that may occur. Please contact your doctor or health care provider for more information.
Source: DailyMed (Cymbalta), DailyMed (Effexor)

Cymbalta and Effexor drug interactions

Cymbalta and Effexor should not be used with monoamine oxidase inhibitors (MAOIs) such as selegiline and phenelzine. Cymbalta or Effexor should not be used within 14 days of stopping an MAOI. Otherwise, the risk of serotonin syndrome, a serious condition that may require emergency medical attention, increases.

There may also be a risk of serotonin syndrome when taking Cymbalta or Effexor together with another serotonergic drug. Serotonergic drugs include selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs). Caution should be exercised when using serotonergic drugs with Cymbalta or Effexor.

Drugs such as paroxetine or fluoxetine may interfere with the metabolism of Cymbalta and increase its blood levels. This may lead to an increased risk of serious side effects when taking Cymbalta.

Cymbalta and Effexor should be used with caution or avoided with non-steroidal anti-inflammatory drugs (NSAIDs) and anticoagulants. Using these drugs together may increase your risk of bleeding.

9014 8 Selective serotonin reuptake inhibitors (SSRIs)

Talk to your doctor about other possible drug interactions.

Cymbalta and Effexor Warnings

Liver failure has been reported with Cymbalta. Those with a history of alcohol abuse or liver dysfunction should avoid taking Cymbalta. Cymbalta should be discontinued in those who develop signs of liver failure such as jaundice.

The use of Cymbalta or Effexor is associated with the risk of developing serotonin syndrome, which occurs when there is an excess of serotonin in the brain. Symptoms of serotonin syndrome may include palpitations, high blood pressure, sweating, tremors, and fever.

Cymbalta and Effexor may cause an increase in blood pressure. Patients with a history of high blood pressure should be monitored during treatment with Cymbalta or Effexor.

Cymbalta and Effexor should be used with caution in those with a history of bipolar disorder or seizures. These antidepressants can cause mania, hypomania, or seizures in some people.

Consult your physician for other possible warnings and precautions while using Cymbalta and Effexor.

Frequently asked questions about Cymbalta and Effexor

What is cymbalta?

Cymbalta is the brand name for duloxetine. It is used to treat major depression and anxiety disorders. It is also used to treat pain in diabetic neuropathy and fibromyalgia. Cymbalta is available in extended release capsules in doses of 20, 30, or 60 mg.

What is Effexor?

Effexor is the brand name for venlafaxine. It is used to treat major depressive disorder, generalized anxiety disorder, social anxiety disorder, and panic disorder. Regular Effexor has been discontinued; however, Effexor XR tablets are available in 37.5 mg, 75 mg, and 150 mg.

Are Cymbalta and Effexor the same thing?

Cymbalta and Effexor are serotonin and norepinephrine reuptake inhibitors (SNRIs). But they are not the same medicine. In addition to treating major depression and anxiety, Cymbalta is also FDA approved for treating certain types of nerve pain. On the other hand, Effexor is FDA approved for the treatment of panic attacks and social anxiety.

Cymbalta or Effexor is better?

The best antidepressant depends on the condition being treated and other medications the person may be taking. Venlafaxine may be a more effective short-term treatment option for depression. However, it may have a lower tolerance than Cymbalta in terms of side effects such as sexual dysfunction.

Can I use Cymbalta or Effexor while pregnant?

No conclusive studies have shown that Cymbalta or Effexor can be safe during pregnancy. An antidepressant should only be used during pregnancy if the benefit outweighs the potential risk. In some cases, it may be necessary to use Cymbalta or Effexor to control symptoms of depression during pregnancy. Talk to your doctor before using Cymbalta or Effexor during pregnancy.

Can I use Cymbalta or Effexor with alcohol?

Moderate drinking is probably safe when taking Cymbalta or Effexor. However, drinking alcohol at the beginning of treatment with Cymbalta or Effexor may lead to increased dizziness or drowsiness. It may be recommended to stop drinking alcohol for a few days after starting treatment.

Does Effexor affect memory?

There is no evidence that Effexor directly affects memory. Effexor XR is known to cause hyponatremia, or low blood sodium levels, especially if diuretics are also taken. Signs and symptoms of hyponatremia include headache, confusion, and memory impairment. Your doctor may recommend that you stop taking Effexor XR until the hyponatremia resolves.

What is a good alternative to Cymbalta?

Cymbalta is a selective serotonin and norepinephrine reuptake inhibitor (SNRI). Other SNRIs include Effexor (venlafaxine), Pristiq (desvenlafaxine), and Savella (milnacipran). Discuss your options for antidepressant treatment with your doctor.

How bad is Effexor withdrawal?

The dose of Effexor should be gradually reduced to prevent severe withdrawal symptoms. Abruptly stopping Effexor may result in symptoms such as nausea, dizziness, vomiting, nightmares, irritability and headaches.