Lexapro versus cymbalta

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

Cymbalta and Lexapro are two prescription drugs most commonly used to treat both major depressive disorder (MDD) and generalized anxiety disorder (GAD). Major depressive disorder is estimated to affect approximately 16 million adults in the United States. It is characterized by a low mood for at least a two-week period. Patients may also exhibit a loss of interest in activities they normally enjoy or low energy. Some patients experience pain without any known cause.

Generalized anxiety disorder is estimated to affect 6.8 million adults in the United States. It is characterized by excessive worry about a variety of issues including money, family, health, and work. It is diagnosed once patients display this worry on more days than not for at least six months.

While Cymbalta and Lexapro are both used to treat these conditions and many others, there are some significant differences between the two medications.

What are the main differences between Cymbalta and Lexapro?

Cymbalta (duloxetine) is a prescription medication indicated in the treatment of both MDD and GAD. Cymbalta belongs to a group of antidepressants known as selective serotonin-norepinephrine reuptake inhibitors (SNRIs). In the neuron synapse, Cymbalta blocks the reuptake of both norepinephrine and serotonin. This leaves the neurotransmitters more readily available to play a positive role on mood and affect. Other SNRIs you may be familiar with are Effexor (venlafaxine) and Pristiq (desvenlafaxine).

Cymbalta is available as a 20 mg, 30 mg, and 60 mg oral capsule.

Lexapro (escitalopram) is also a prescription medication indicated in the treatment of both MDD and GAD. Lexapro belongs to the group of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). Lexapro works by blocking the reuptake of serotonin at the neuronal membrane transport pump. This action effectively leaves more free serotonin in the neuron synapse. Other SSRIs you may be familiar with include Prozac, Zoloft, Celexa, or Paxil.

Lexapro is available as an oral tablet in strengths of 5 mg, 10 mg, and 20 mg. It is also available as an oral solution in a 5 mg/5 ml concentration.

Conditions treated by Cymbalta and Lexapro

As previously mentioned, Cymbalta and Lexapro are both indicated to treat both major depressive disorder and generalized anxiety disorder. Cymbalta is approved for some unique indications related to neuropathic and musculoskeletal pain. These indications set Cymbalta apart from other antidepressant medications as it is the only one approved in pain-related diagnoses. Lexapro is sometimes used off-label for conditions such as obsessive compulsive disorder, bulimia nervosa, and binge eating.

The following chart provides a list of conditions treated by Cymbalta and Lexapro. It may not include all potential uses, and you should always consult with your healthcare professional to see if one of these drugs is right for you.

Is Cymbalta or Lexapro more effective?

A meta-analysis reviewed studies comparing duloxetine to escitalopram and other common SSRIs. The study found that in terms of the treatment of major depression, duloxetine fails to show a significant advantage in terms of treatment success over SSRIs. However, according to this review, patients are more likely to discontinue duloxetine due to adverse events. A second meta-analysis echoed these findings. It may not be possible to say if Cymbalta or Lexapro are better than the other in terms of treating depression. The increased rate of side effects with Cymbalta would be an important factor to consider when choosing a therapy.

Coverage and cost comparison of Cymbalta vs. Lexapro

Cymbalta is a prescription medication that is typically covered by both commercial and Medicare drug plans. The out-of-pocket price for Cymbalta 60 mg can be more than $300, but with a coupon from SingleCare, you could get the generic for as low as $15 at participating pharmacies.

Lexapro is also a prescription medication that is typically covered by both commercial and Medicare drug plans. The out-of-pocket price for a 30 day supply of Lexapro 10 mg can be as much as $400. SingleCare offers a coupon for generic Lexapro, which can lower the price to $10 or less.

prescription discount card

Common side effects of Cymbalta vs. Lexapro

Cymbalta and Lexapro have the potential to cause similar side effects, though some are more likely with one or the other agent. Nausea, for example, was only reported in 5% of patients taking Lexapro in clinical trials versus 23% of patients taking Cymbalta. While the nausea is not always a long-lasting side effect, it can impact a person’s quality of life. It is more likely to happen in the first few weeks of therapy, and given that these drugs generally take anywhere from two to six weeks to show an impact on depression or anxiety symptoms, nausea could be a reason for early discontinuation before the true benefit of the drug is known.

Perspiration, or sweating, occurs at a similar rate between the two drugs. This side effect may also impact a person’s daily life and self-esteem, and it could be a reason patients choose to discontinue the drug.

The following list is not intended to be a complete list of adverse events. Please consult a pharmacist, doctor, or another medical professional for a complete list of possible side effects.

Source: Cymbalta (DailyMed) Lexapro (DailyMed)

Drug interactions of Cymbalta vs. Lexapro

Cymbalta and Lexapro are each metabolized by the cytochrome enzyme system in the liver. Cymbalta is a major substrate for CYP1A2, and a moderate inhibitor of CYP2D6. It is important to note that some patients may suffer from attention disorders in addition to depression and anxiety disorders. Many patients with attention disorders are treated with amphetamines. Cymbalta can increase the serum concentration of amphetamines through its inhibition of CYP2D6. Patients taking this combination should be monitored closely.

Lexapro is a major substrate of CYP2C19 and CYP3A4, and a weak inhibitor of CYP2D6.

The use of Lexapro with tricyclic antidepressants, such as amitriptyline, may increase the risk of QT prolongation and serotonin syndrome. In general, this combination should be avoided.

The following list is not intended to be a complete list of drug interactions. It is best to consult your provider or pharmacist for a complete list.

Warnings of Cymbalta and Lexapro

Cymbalta and Lexapro will not produce an immediate remission of symptoms of either depression disorder or anxiety disorder. It will take a minimum of two weeks to notice any change in most post patients, and up to four to six weeks to realize the full effect of the medication. It is important patients understand this so they do not prematurely discontinue their medication with the belief that it is not working.

Patients with MDD may experience a worsening of depression or suicidal thoughts whether or not they are taking antidepressant medications. These conditions may worsen until remission is achieved. Cymbalta and Lexapro therapy may increase suicidal ideation and thoughts among teens and young adults, especially in the early stages of treatment before any type of remission is achieved. These patients must be monitored closely if this treatment is deemed medically necessary. A therapy change may be necessary if symptoms suddenly arise or get worse.

There have been reports of liver failure, sometimes fatal, with Cymbalta. These cases may present with abdominal pain and elevated liver enzymes with or without jaundice. The consumption of alcohol may increase this risk, and therefore this combination should be avoided.

Serotonin syndrome has been reported with all SSRIs and SNRIs, including Cymbalta and  Lexapro. This is a condition related to abnormally high levels of serotonin and can result in the patient feeling agitated, dizzy, and having an increased heart rate. This can be brought on by the use of two serotonergic drugs together. It is important to refer to the manufacturer’s information on drug interactions when prescribing these drugs.

Frequently asked questions about Cymbalta vs. Lexapro

What is Cymbalta?

Cymbalta is a prescription antidepressant medication used in the treatment of major depression, generalized anxiety disorder, and various neuropathic and musculoskeletal pain disorders. Cymbalta is available as an oral capsule in 20 mg, 30 mg, and 60 mg strengths.

What is Lexapro?

Lexapro is a prescription antidepressant medication used in the treatment of major depression and generalized anxiety disorder.  Lexapro is available as an oral tablet in 5 mg, 10 mg, and 20 mg strengths. It is also available as an oral solution.

Are Cymbalta and Lexapro the same?

While both Cymbalta and Lexapro treat depression and anxiety, they are not the same. Cymbalta blocks the reuptake of both serotonin and norepinephrine in the neuronal synapse, while Lexapro blocks serotonin reuptake only. Cymbalta carries additional indications for pain disorders.

Is Cymbalta or Lexapro better?

Cymbalta and Lexapro appear to be similarly effective in treating depression. Large meta-analyses of multiple studies indicate that the higher rate of adverse events with Cymbalta may be a reason to try Lexapro first in most patients.

Can I use Cymbalta or Lexapro while pregnant?

The Food and Drug Administration (FDA) considers both Cymbalta and Lexapro pregnancy category C, meaning there have not been adequate human studies to determine safety. With Cymbalta, non-teratogenic effects have been observed in newborns following the administration of Cymbalta while pregnant. These include respiratory distress, feeding difficulty, and tremors. With Lexapro use, animal studies have shown teratogenic effects to the fetus, including cardiovascular effects, and it has been determined that it crosses the human placenta. For these reasons, the use of Cymbalta or Lexapro in pregnancy must be weighed against potential harm to the fetus.

Can I use Cymbalta or Lexapro with alcohol?

Alcohol can increase the toxic effects of both Cymbalta and Lexapro. Drinking alcohol while taking these drugs can cause significant psychomotor impairment, and for this reason, patients are advised to avoid alcohol if taking Cymbalta or Lexapro. As previously discussed, alcohol consumption while on Cymbalta increases the likelihood of hepatic failure.

Does Cymbalta help with anxiety?

Cymbalta is approved in the treatment of generalized anxiety disorder. Patients should be educated that the drug will not provide immediate remission of anxiety symptoms, and some patients may need additional medication for acute anxiety episodes.

Does Cymbalta make you happy?

Cymbalta works by increasing available norepinephrine and serotonin. These neurotransmitters play a significant role in mood or affect. Patients who take Cymbalta may report feeling “happier” or less depressed, especially after four to six weeks of treatment.

Does Cymbalta change your personality?

Cymbalta will affect mood by increasing available norepinephrine and serotonin. For most patients, this induces a positive change in their mental health. If you notice a negative change in yourself or someone you care for while taking Cymbalta, including suicidal thoughts or ideations, seek help immediately.

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

About 13.2% of adults in the U.S. take antidepressants.

Of the many types of antidepressants available, Cymbalta and Lexapro are commonly prescribed for the treatment of major depressive disorder (MDD) and generalized anxiety disorder (GAD). 

You may be experiencing adverse reactions with your current medication and considering your other options.

Although these two drugs have a similar mechanism of action—both affect the levels of serotonin in the brain—there are some differences.

In this article, we’ll discuss the differences and similarities between Cymbalta and Lexapro, the conditions they treat, and their effectiveness.

We’ll also compare the coverage and the cost of the medication, the common side effects, and the possible drug interactions of Cymbalta and Lexapro.

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What Are the Differences & Similarities Between Cymbalta and Lexapro?

Cymbalta and Lexapro are prescription drug antidepressants used to treat major depression and generalized anxiety disorder. 

Cymbalta, the brand name for duloxetine, is a serotonin-norepinephrine reuptake inhibitor (SNRI).

This class of antidepressants works by preventing the reuptake (reabsorption) of two neurotransmitters in the brain called serotonin and norepinephrine. 

The resulting increased levels of these chemical messengers helps to relieve symptoms of major depressive disorder and generalized anxiety disorder.

The FDA has also approved Cymbalta for the treatment of some pain conditions.  

Lexapro, the brand name for escitalopram, is a selective serotonin reuptake inhibitor (SSRI).

It works by preventing the reuptake of serotonin in the brain, thereby increasing the levels of available serotonin. 

Since serotonin is a neurotransmitter responsible for mood, sleep, and other bodily functions, increased amounts in the brain help ease symptoms of major depressive disorder and generalized anxiety disorder. 

The table below provides an overview of how the two antidepressant medications compare:

Drug classSerotonin-norepinephrine reuptake inhibitors (SNRI)Selective serotonin reuptake inhibitors (SSRI)
Generic nameDuloxetineEscitalopram
Standard dosage60 milligrams (mg) once daily10 mg once daily
Dosage strengths available20 mg, 30 mg, and 60 mg5 mg, 10 mg, and 20 mg
Dosage formsOral capsuleOral tablet and oral solution
Recommended age group7 years and older (generalized anxiety disorder)  12 years and older (major depressive disorder) 

What Conditions Are Treated with Cymbalta and Lexapro?

Both Cymbalta and Lexapro are prescription medications for the treatment of major depressive disorder and generalized anxiety disorder.  

Cymbalta is also approved for treating some pain-related conditions, including fibromyalgia, diabetic peripheral neuropathic pain, and chronic musculoskeletal pain.

Cymbalta is the only antidepressant approved to treat neuropathic pain. 

Lexapro is prescribed off-label for the treatment of conditions such as panic disorder, premenstrual dysphoric disorder, and obsessive-compulsive disorder. 

When a doctor or healthcare provider prescribes a drug off-label, they prescribe it for a condition that the FDA has not approved.

Off-label prescription is not illegal, but your doctor should explain how the drug may help your condition.

Below is a summary of the conditions that Cymbalta and Lexapro are used to treat:

Major depressive disorder (MDD)YesYes
Generalized anxiety disorder (GAD)YesYes
Irritable bowel syndrome (IBS)YesYes
Chronic musculoskeletal painYesNo
Diabetic peripheral neuropathic pain (DPNP)YesNo
Panic disorderNoOff-label
Obsessive-compulsive disorder (OCD)NoOff-label
Premenstrual dysphoric disorderNoOff-label
Posttraumatic stress disorderNoOff-label
Social anxiety disorderNoOff-label
Vasomotor symptoms of menopauseNoOff-label
Chemotherapy-induced peripheral neuropathyOff-labelNo
Stress urinary incontinenceOff-labelNo

This list is not conclusive.

Consult your doctor to know which medication is suitable for you. 

Effectiveness of Cymbalta and Lexapro

A comparative study of escitalopram (Lexapro) and duloxetine (Cymbalta) found that escitalopram was superior to duloxetine for short-term treatment of depression.

The researchers also concluded that escitalopram is as effective as and more tolerable than duloxetine for long-term treatment.

Due to adverse reactions, the withdrawal rate of patients on duloxetine was 8% higher than that of patients on escitalopram. 

Another study showed similar results: Escitalopram was better tolerated and at least as effective as duloxetine for treating major depressive disorder.

This is not to say that Lexapro is better than Cymbalta for treating depression, but rather that people were more likely to discontinue Cymbalta due to common adverse reactions.

Coverage & Cost of Cymbalta and Lexapro

Medicare and commercial insurance plans usually cover at least some of the cost of both generic versions and brand-name Cymbalta and Lexapro.  

The exact cost of your medication varies depending on the brand and dosage, as well as your insurance and pharmacy.

A month’s supply of 30-milligram Cymbalta can cost almost $390, while a month of 20-milligram Lexapro can cost up to $260.

You may be able to save money using coupon codes with participating pharmacies.

Common Side Effects of Cymbalta and Lexapro

Cymbalta and Lexapro share similar side effects, although some are more pronounced using one drug than the other.

The table below covers the possible side effects, though this list is not exhaustive.

Most symptoms do not last past the first few weeks of starting either medication.

If you experience any of these symptoms, speak with your doctor.

They can help you manage them and, depending on how severe they are, may suggest switching to another antidepressant.

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Drug Interactions & Warnings 

Cymbalta and Lexapro can have unpleasant reactions with other drugs.

Before starting either medication, inform your doctor of the other medicines you’re using, including vitamins and supplements.

Cymbalta and Lexapro should not be used within 14 days of using any monoamine oxidase inhibitors (MAOIs).

This class of antidepressants includes:

  • Isocarboxazid (Marplan)
  • Phenelzine (Nardil)
  • Selegiline (Emsam)
  • Tranylcypromine (Parnate)
  • Linezolid (Zyvox)
  • Intravenous methylene blue

Cymbalta and Lexapro also interact with other serotonergic medications such as:

  • Tricyclic antidepressants
  • Triptans
  • Lithium
  • Fentanyl
  • Buspirone
  • Tramadol
  • Tryptophan
  • St. John’s wort
  • Amphetamine

Lastly, using Cymbalta and Lexapro with aspirin, non-steroidal anti-inflammatory drugs (NSAIDs), warfarin, and other anticoagulants increases bleeding risk, including life-threatening hemorrhages.

Cymbalta or Lexapro also have side effects of their own.

People taking either medication for major depressive disorder or other psychiatric disorders are at risk for increased suicidal thoughts and behavior.

If you have any concerning thoughts, seek care immediately.

How K Health Can Help 

Your choice of an antidepressant can affect the quality of your life. You need to consult a doctor to know which treatment plan will be best for you.

Think you might need a prescription for Cymbalta (duloxetine) or a prescription for Lexapro (escitalopram)?

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, Cymbalta or Lexapro?

Studies show that duloxetine (Cymbalta) and escitalopram (Lexapro) are equally effective at treating major depressive disorder long term. However, a randomized controlled trial reported that escitalopram was better tolerated. Your doctor can discuss all of the pros and cons with you when prescribing the right antidepressant for you.

Is Cymbalta a good replacement for Lexapro?

Since Cymbalta and Lexapro have similar efficacy in the treatment of depression, it can be a suitable replacement. One concern is that Cymbalta tends to be less tolerated, so people may be more likely to discontinue the medication. Also, Lexapro is prescribed off-label for some conditions that Cymbalta cannot be used for. Your doctor or healthcare provider can provide you with more information about whether it is a good choice for you.

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.

K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.

  • Antidepressant Use Among Adults: United States, 2015–2018. (2020).

  • A Comparative Study of the Efficacy of Acute and Continuation Treatment With Escitalopram Versus Duloxetine in Patients With Major Depressive Disorder. (2007).

  • Cymbalta Prices, Coupons and Patient Assistance Programs. (n.d.).

  • Double-Blind Comparison of Escitalopram and Duloxetine in the Acute Treatment of Major Depressive Disorder. (2007).

  • Lexapro Prices, Coupons and Patient Assistance Programs. (n.d.).

  • The Use of Antidepressants in the Treatment of Irritable Bowel Syndrome and Other Functional GI Disorders. (n.d.).

90,000 Cymbalta vs. Prozac: Differences, Similarities, and Which is Best for You - Drug Vs. Friend

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Drug Vs. Friend

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

If you or your loved one is experiencing depression, anxiety or other mental health conditions, 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 antidepressants prescribed for depression and several other conditions. Both prescription drugs are approved by the US Food and Drug Administration (FDA). The use of drugs with cymbalta or Prozac is often combined with psychotherapy by a psychologist or psychiatrist. nine0005

Cymbalta belongs to a group of medicines called SNRIs (serotonin-norepinephrine reuptake inhibitors). They work by increasing the levels of serotonin and norepinephrine in the brain.

Prozac belongs to a group of drugs called SSRIs (Selective Serotonin Reuptake Inhibitors). SSRIs work by increasing serotonin levels in the brain.

What are the main differences between Cymbalta and Prozac?

Cymbalta (duloxetine) is an SNRI medication. It is available in both branded and generic. Cymbalta is only available in capsule form. Dosage varies, but a typical dose is 60 mg per day. Cymbalta is used in adults, but under certain conditions it can be used at a younger age (see Table).

Prozac (fluoxetine) is an SSRI medication. It is available in both branded and generic. Prozac comes in the form of tablets, capsules, and oral solution. Although dosage varies, a typical dose is 20 mg once a day. Prozac can be used in adults for all of the indications listed in the table below. Prozac can also be used in children older than 8 years for depression or older than 7 years for OCD. nine0041 What is the common name? Duloxetine Fluoxetine What form(s) does the drug come in? Capsules Tablet, capsule, oral solution; also available in combination with olanzapine as Symbyax What is the standard dosage? Example: 60 mg once daily (dosage varies). Example: 20 mg once daily (dosage varies). nine0041 How long does a typical treatment take? Varies Varies Who usually takes this medicine? Adults, children and adolescents 7 years of age or older with generalized anxiety disorder or 13 years of age and older with fibromyalgia Adults, children and adolescents with depression (over 8 years) or OCD (over 7 years)

Diseases 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 and children 7 years of age and older, and fibromyalgia in adults and adolescents 13 years of age and older. Cymbalta is not approved for use in children with depression, diabetic peripheral neuropathic pain, or chronic musculoskeletal pain. nine0005

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 of age.

Symbiax is a combination drug containing fluoxetine, an ingredient in Prozac, and another medicine called olanzapine. Symbiax may treat depressive episodes associated with bipolar I disorder or treatment-resistant depression. nine0041 Yes Not for the purpose of Fibromyalgia Yes Not for the appointment Chronic skeletal pain NOT for the appointment of Off label yes Bulimia No yes Panic disorder Off label Yes premenstrual dysphoric disorder not for the purpose of yes in combination with Olanzapine (like Simbiax) for the treatment of bipolar disorders 9003, no, yes Management of anxiety disorders yes yes

Cymbalta or Prozac more effective? nine0025

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

Diagnosis is an important factor in deciding which remedy is more appropriate. For example, if depression is the indication, Prozac or Cymbalta may be a suitable option. However, if the diagnosis is OCD, Prozac is more appropriate because it is indicated for the treatment of OCD, while Cymbalt is not. And if the diagnosis is fibromyalgia, Cymbalta is more appropriate because it is indicated for fibromyalgia, and Prozac is not. nine0005

Your doctor can determine which drug is best for you based on your diagnosis, medical history and other medical conditions, and any medications you may be taking that may interact with Cymbalta or Prozac.

Cymbalta and Prozac coverage and cost comparison

Most Medicare Part D and prescription plans cover Cymbalta or Prozac - choosing the generic form will result in significant cost savings. Branded items have a much higher surcharge or may not be covered at all. nine0005

Cymbalta out of pocket costs about $126 for 30 60mg capsules. A free SingleCare card helps you save money on the versatile Cymbalta by dropping the price down to $15.

Prozac's out-of-pocket cost is about $21 for a 30-milligram generic capsule. You can save on generic Prozac with the SingleCare card, which can bring the cost of a generic to about $4.

Contact your health plan for the latest information about Cymbalta or Prozac coverage. nine0005

900-20 $ 15 + 9-20

Common side effects of Cymbalta versus Prozac

The most common side effects of Cymbalta are nausea, headaches, drowsiness, loss of appetite, constipation, dry mouth and dizziness. nine0005

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

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

This is not a complete list of side effects. Other serious side effects may occur. Check with your healthcare provider for a complete list of side effects. nine0005

Cymbalta Prozac
Usually covered by insurance Yes (general) Yes (general)
Usually covered by Medicare Part D? Yes (general) Yes (general)
Quantity0038 30, 20 mg capsules
Typical surcharge of Medicare 0–20 dollars 0–20 dollars
Cost Singlecare $ 15 + $ 15 +
Cymbalta Prozak
Side effect applicable? Frequency Applicable? Frequency
Headaches yes 14% yes 21% 41 Yes 2. 3% Yes 21%
Drumeness / Dreaminess Yes Yes
Formation Yes 12%
Construction Yes Yes 5%
Dry In the mouth 13% Yes Yes Yes Yes Yes Yes0038 10%
Ejaculation disorder / Sexual dysfunction Yes 2-4% Yes % not reported
and 9% 9% 9% 9% 9% 9% 9% 9% 9% 9% 9% 9% 9% 9% 9%
Dizziness Yes 9% Yes 9%
Loss of appetite 7% Eleven% 9%
Nervousness / anxiety Yes 3% Yes 13%

Source: DailyMed (Cymbalta), DailyMed (Prose)

COMMICIAL OF TSIBALES (MAOI or monoamine oxidase inhibitor) should not be used while taking Cymbalta or Prozac or for a certain 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. In addition, the cough remedy 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. nine0005

Avoid drinking alcohol while taking Cymbalta or Prozac.

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

Drug Drug class Cymbalta yes yes

Cymbalta and Prozac Warnings

Antidepressants, including Cymbalta and Prozac, carry a black box warning of suicidality. The black box warning is the most severe warning required by the FDA. Children, adolescents, and young adults (under 24) who take antidepressants are at increased risk for suicidal thoughts and behavior. Anyone taking antidepressants should be closely monitored. nine0005

Other warnings:

  • Serotonin syndrome is a life-threatening situation caused by too much serotonin. Patients taking Cymbalta or Prozac should be monitored for signs and symptoms of serotonin syndrome, such as hallucinations, seizures, changes in heart rate or blood pressure (eg, high blood pressure), and agitation. If any of these symptoms occur, seek emergency medical attention. 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. nine0752
  • Discontinuation of Cymbalta or Prozac may cause withdrawal symptoms such as agitation. Your healthcare provider may be able to advise you on the best way to stop taking Cymbalta or Prozac by gradually tapering off your dose. Never stop taking cymbalta or Prozac abruptly.
  • Use with caution in patients with seizures or bipolar disorder.
  • Hyponatremia (low sodium levels) may occur due to syndrome of inappropriate secretion of antidiuretic hormone (SIADH), which can be severe. Symptoms may include headache, difficulty concentrating, memory impairment, confusion, weakness, and unsteadiness, which may lead to a fall. Seek emergency care and stop taking cymbalta or Prozac if symptoms occur. nine0752
  • Avoid SSRIs in patients with untreated anatomically narrow angles (angle-closure glaucoma).
  • SSRIs may increase the risk of bleeding - this risk is increased by concurrent 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 adjustments in the dosage of diabetes medications. nine0752
  • Cymbalta or Prozac may cause weight changes. Cymbalta may cause weight gain or loss, while Prozac may cause weight loss. Watch your weight during treatment with cymbal or Prozac.
  • Cymbalta or Prozac should be used during pregnancy only if the benefit to the mother outweighs the risk to the baby. Stopping the medication may cause a relapse of depression or anxiety. However, neonates treated with SNRIs (eg, Cymbalt) or SSRIs (eg, Prozac) in the third trimester developed complications requiring prolonged hospitalization, respiratory support, and tube feeding. If you are already taking Cymbalta or Prozac and find that you are pregnant, contact your doctor immediately for advice. nine0752
  • Cymbalta and Prozac are on the Beer List (drugs that may not be suitable for older people). Check with your healthcare provider to see if cymbalta or Prozac is safe for you.

Other Cymbalta warnings:

  • Cymbalta capsules should be swallowed whole and may be taken with or without food. Do not chew, crush, or open the capsule.
  • People taking Cymbalta have had cases of liver disease - these can be fatal. Call your doctor right away and stop taking Cymbalta if you develop signs of jaundice or liver problems. People who have liver problems and/or who consume significant amounts of alcohol should not take Cymbalta. nine0752
  • Cymbalta may cause orthostatic hypotension (drop in blood pressure when standing up), falling and/or fainting. Falls can lead to fractures or hospitalization.
  • Severe skin reactions possible. They can be caused by conditions called erythema multiforme or Stevens-Johnson syndrome. Stop taking Cymbalta and tell your doctor right away if you develop blisters, a scaly rash, or skin lesions. If symptoms are severe, seek emergency medical attention. nine0752
  • Cymbalta may cause urinary problems. Tell your doctor if you have urinary problems.
  • Monitor your 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:

  • Rarely, rashes and allergic/systemic anaphylaxis reactions have been reported and have been fatal. If you develop a rash or allergic symptoms, stop taking Prozac and seek medical attention immediately. nine0752
  • Prozac may cause QT prolongation and ventricular arrhythmia, which can be life threatening. Some patients are at higher risk due to medical conditions or other medications. Ask your doctor if Prozac is safe for you.

Frequently Asked Questions about Cymbalta vs. Prozac

What is a cymbal?

Cymbalta, also known collectively as duloxetine, is a serotonin and norepinephrine reuptake inhibitor. Cymbalta, which is available in both branded and generic forms, treats depression, anxiety, fibromyalgia, diabetic peripheral neuropathy pain, and chronic musculoskeletal pain. nine0005

What is Prozac?

Prozac, also known collectively as 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 branded and generic forms.

Are Cymbalta and Prozac the same thing?

Cymbalta and Prozac are similar but not the same. Cymbalta is a serotonin-norepinephrine reuptake inhibitor or a serotonin-norepinephrine reuptake inhibitor. Some other SNRIs include Effexor (venlafaxine) and Pristiq (desvenlafaxine). nine0005

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

Cymbalta or Prozac is better?

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

The best medicine for you can only be determined by your healthcare professional, who may take into account your diagnosis, symptoms, medical conditions and history, as well as any other medicines you may be taking that could potentially interact with Cymbalta or Prozac. nine0005

Can I use Cymbalta or Prozac while pregnant?

Newborns treated with certain antidepressants, including Cymbalta or Prozac, during the third trimester of pregnancy developed severe complications. These complications include prolonged hospital stays, tube feeding, and respiratory support.

If you are already taking Cymbalta or Prozac and find you are pregnant, talk to your doctor. If you are breastfeeding, please also consult your OB/GYN. nine0005

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 - slow breathing, lack of oxygen - and may increase sedation, drowsiness and reduce alertness.

Which antidepressant is better than Prozac?

All antidepressants have been extensively tested to show they are safe and effective. While Prozac can be very effective, it doesn't work for everyone because people react differently to different medications. If you are taking Prozac and feel like it is not working after six to eight weeks, check with your doctor for medical advice. nine0005

How is Cymbalta different from other antidepressants?

SSRIs such as Cymbalta act on both serotonin and norepinephrine in the brain, while SSRIs such as Prozac act on serotonin. Cymbalta is also indicated for the treatment of certain types of pain such as fibromyalgia, musculoskeletal pain, and diabetic neuropathic pain, in addition to depression and anxiety.

Who should not take Cymbalta?

People who are taking monoamine oxidase inhibitor (MAOI) antidepressants should not take Cymbalta. Other drugs interact with Cymbalta (see table above). Ask your healthcare provider about serotonin syndrome and if the medications you are taking are safe to take with Cymbalta. nine0001 Medicine

Cymbalta is available in delayed-release capsules and is in a class of drugs called serotonin and norepinephrine reuptake inhibitors, or SNRIs. Eli Lilly and Company manufactures drugs. Duloxetine is the active ingredient in the drug.

The US Food and Drug Administration first approved an antidepressant in 2004. The popularity of the drug grew rapidly. In 2009 alone, doctors wrote 14.6 million prescriptions, according to The New York Times. nine0005

Indy Star reports annual sales of the drug at $4.99 billion. The patent for the drug expired in 2013, opening the door to several generic manufacturers.

On September 30, 2018, the Securities and Exchange Commission's quarterly report reported that Cymbalta generated $523.5 million worldwide in nine months for the drug maker in 2018, including $39.3 million in the United States.

Depending on the dose rate, the drug can cost anywhere between $242.73 and $472.66 for a 30-day supply. nine0005

Uses, Dosages and Strengths

The FDA originally approved Cymbalta for major depressive disorder and generalized anxiety disorder. The agency has since approved a drug for diabetic peripheral neuropathic pain, fibromyalgia, and chronic musculoskeletal pain in adults. The drug is not approved for use in children and adolescents.

Eli Lilly also tried to approve a drug for stress incontinence. But the FDA assumed it couldn't grant approval based on the company's data, so the drugmaker withdrew its application in 2005, according to a company press release. nine0005

The company then began researching duloxetine to treat children with fibromyalgia. On August 14, 2018, ClinicalTrials.gov updated the Phase III Clinical Trials. Eli Lilly researcher Dr. Himanshu P. Upadhyaya and colleagues presented the results of the study at the 2018 World Pain Congress in Boston. They concluded that duloxetine may be ineffective in the treatment of juvenile primary fibromyalgia syndrome compared with placebo.

Depending on the indication for treatment and the age of the patient, doctors may prescribe different strengths. The drug is available in delayed-release capsules of 20, 30 and 60 mg.

Major depressive disorder:
40 to 60 mg per day. The maximum dose is 120 mg per day.
Generalized Anxiety Disorder:
60 mg per day. The maximum dose is 120 mg per day.
Diabetic peripheral neuropathic pain:
60 mg per day. The maximum dose is 60 mg per day.
30 mg per day. The maximum dose is 60 mg per day.
Chronic musculoskeletal pain:
30 mg per day. The maximum dose is 60 mg per day.

Patients should swallow the capsules whole with or without food. If patients miss a dose, they should take the missed dose as soon as possible, but they should not take two doses at the same time. nine0005

How duloxetine works

Researchers believe duloxetine works by increasing serotonin and norepinephrine activity in the central nervous system, according to the drug's label.

The National Institutes of Health states that duloxetine increases levels of neurotransmitters in the brain, preventing them from being reabsorbed by the body, and this contributes to its antidepressant action.

Depression, chronic pain, and anxiety have interrelated symptoms, according to researcher Cheryl Wright and fellow researchers at Oregon Health and Science University's School of Nursing. Researchers believe that duloxetine treats generalized pain disorder, diabetic peripheral neuropathic pain, and fibromyalgia in the same way that it treats depression and anxiety. nine0005

Researchers know the drug does not repair the nerve damage that leads to diabetic peripheral neuropathy, but clinical trials have shown that the drug can relieve pain and other sensations associated with the condition, according to Eli Lilly.

“While an additional non-industry-sponsored investigation is warranted, evidence to date suggests that in individuals with fibromyalgia, duloxetine has been largely a safe and, in some, a promising intervention for chronic chronic disease. pain ". nine0005

Adjusting neurotransmitter levels may also relieve fibromyalgia pain without affecting mood, write Wright and colleagues in Peer Review of Clinical Immunology.

“While additional non-industrial investigation is warranted, the evidence to date suggests that in patients with fibromyalgia, duloxetine has been a largely safe and, in some, a promising intervention for the treatment of chronic pain,” the researchers write. "As with the introduction of any new pharmacological agent, each patient deserves careful monitoring to assess the effectiveness of the drug and its side effects." nine0005

Side effects

Five percent or more of people who took Cymbalta during clinical trials reported common side effects at least twice as often as those who took placebo. According to the drug label, the most common side effects were nausea, dry mouth, drowsiness, constipation, loss of appetite, and increased sweating.

Although rare, serious side effects can include life-threatening conditions, and the FDA has issued several warnings about side effects such as liver disease and low blood pressure. The drug carries a black box warning of suicidal thoughts and behavior in children, adolescents and young adults. nine0005

Patients should talk to their doctor as soon as they notice any change in their condition. Many side effects will show up in time, but the doctor may need to adjust the dosage of the medicine.

Never stop taking duloxetine suddenly or without first talking to your doctor, even if you experience side effects. Stopping medication abruptly can cause withdrawal symptoms, including dizziness, headache, nausea, diarrhea, tingling sensation, irritability, vomiting, insomnia, restlessness, increased sweating, and fatigue. nine0005

The drug insert advises physicians to reduce the dose gradually rather than stopping treatment abruptly. Some people who say they have suffered side effects have filed lawsuits against Eli Lilly.

food, alcohol and drug interactions

Medications that can interact with Cymbalta range from over-the-counter pain relievers to prescription blood pressure medications, according to Everyday Health. There is a long list of possible interactions on the drug label. nine0005

Taking duloxetine with certain other drugs can affect serotonin levels, blood pressure, and body temperature. This can lead to a life-threatening condition called serotonin syndrome.

Symptoms of serotonin syndrome may include agitation, confusion, diarrhea, and dilated pupils. Other signs are high blood pressure, heavy sweating, and a fast heartbeat. The condition can also cause muscles to become stiff or twitchy. nine0005

Do you know? Smoking reduces the concentration of cymbalta in the blood by 30 percent.

Mixing Cymbalta with grapefruit or grapefruit juice may increase the risk of side effects or overdose. The sour fruit affects the metabolism of the drug and may lead to its accumulation in the patient.

Light alcohol consumption does not increase the effect of duloxetine. But drinking alcohol can lead to stress or liver damage.

Drugs and substances that may interact with Cymbalta include:

  • MAO inhibitors (Nardil, Parnate, others)
  • SSRIs (Celexa, Fluvoxamine, Lexapro, Prozac, Paxil, Symbiax, Zoloft)
  • Triptans (Amerge, Aksert, Frava, Imitrex, Masalt, Replaks, Zomig)
  • Other SNRIs (Pristiq, Fetzima, Ixel, Savella, Elamol, Tofacin, Effexor)
  • Tricyclic antidepressants (Anafranil, Ascendin, Norpramine, Sinequan)
  • Amino ketones (Wellbutrin)
  • Fluoroquinolone antibiotics (Cipro, Levaquin, Avelox)
  • St. John's wort
  • NSAIDs such as ibuprofen
  • Aspirin
  • Warfarin
  • Drugs affecting gastric acidity
  • Caffeine

This is not a complete list of all food-drug interactions. Patients should talk to their doctors about any medications or supplements they are taking, as well as alcohol use and diet, to make sure they are not subject to potential interactions. nine0005

Before taking Cymbalta

Some complications can be prevented if patients talk honestly with their doctors before starting treatment. It will also provide patients with the most effective treatment that the drug can deliver.

The National Alliance on Mental Illness encourages people to discuss the following with their physicians:

  • Most distressing symptoms
  • Thoughts about hurting yourself
  • Previous medications taken for their condition
  • How effective were other drugs or did they cause any side effects?
  • Other mental or physical conditions, including bipolar disorder, kidney or liver disease
  • Other medicines the patient is taking, including over-the-counter drugs and supplements
  • Allergy to any drugs
  • Other mental health treatment such as electrocution or substance abuse treatment
  • Current or planned pregnancy or breastfeeding
  • Use of alcohol or drugs

Misleading Ads

Eli Lilly has been repeatedly reprimanded by the FDA for running misleading ads that exaggerate the benefits of Cymbalta while downplaying the risks.

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