Cymbalta vs. Sertraline
See how Cymbalta and Sertraline compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Cymbalta is an SNRI approved for depression, anxiety, and chronic pain conditions like fibromyalgia and diabetic nerve pain, while sertraline is an SSRI approved for depression, OCD, panic disorder, PTSD, and social anxiety disorder.
Both drugs list nausea as their most common side effect, but Cymbalta is more likely to cause drowsiness while sertraline is more likely to cause insomnia and sexual side effects.
Generic sertraline typically costs far less per month than Cymbalta, which can matter for people paying out of pocket.
Cymbalta vs. Sertraline Drug Summary
Cymbalta
Cymbalta (duloxetine) is a serotonin and norepinephrine reuptake inhibitor, or SNRI, used to treat major depressive disorder, generalized anxiety disorder, and several chronic pain conditions including diabetic nerve pain and fibromyalgia. It comes as a delayed-release capsule, usually taken once a day, sometimes split into two daily doses for pain conditions.
Sertraline
Sertraline is a selective serotonin reuptake inhibitor, or SSRI, used to treat major depressive disorder along with several anxiety-related conditions, including OCD, panic disorder, PTSD, and social anxiety disorder. It comes as a tablet, capsule, or oral liquid, taken once daily.
Cymbalta vs. Sertraline Side Effects
Cymbalta
Sertraline
Cymbalta vs. Sertraline Dosage
Cymbalta
Sertraline
| STAGE | DOSE | WHEN |
| Starting dose | 30 mg once daily | Week 1 |
| Maximum dose | 60 mg twice daily | If needed |
| Dose changes | 2 increases | Every week |
| STAGE | DOSE | WHEN |
| Starting dose | 50 mg once daily | At the start |
| Maximum dose | 200 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
Cymbalta
| STAGE | DOSE | WHEN |
| Starting dose | 30 mg once daily | Week 1 |
| Maximum dose | 60 mg twice daily | If needed |
| Dose changes | 2 increases | Every week |
Sertraline
| STAGE | DOSE | WHEN |
| Starting dose | 50 mg once daily | At the start |
| Maximum dose | 200 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
Cymbalta vs. Sertraline Indications
Cymbalta
Cymbalta is approved for major depressive disorder and generalized anxiety disorder, and it also carries FDA approval for several chronic pain conditions. That dual mood-and-pain profile is unusual among antidepressants.
Major depressive disorder (MDD)
Generalized anxiety disorder (GAD)
Diabetic peripheral neuropathic pain
Fibromyalgia
Chronic musculoskeletal pain (osteoarthritis, low back pain)
Sertraline
Sertraline is approved for major depressive disorder along with a wide range of anxiety-related conditions. It is one of the most prescribed antidepressants in the United States, with decades of use across multiple diagnoses.
Major depressive disorder (MDD)
Obsessive-compulsive disorder (OCD)
Panic disorder
Post-traumatic stress disorder (PTSD)
Social anxiety disorder
Cymbalta vs. Sertraline Pros and Cons
Cymbalta
Cymbalta's SNRI action targets both mood and physical pain, giving it approvals no SSRI carries. It requires closer monitoring in people with liver or kidney disease and generally costs more than generic options.
Pros
FDA-approved for chronic pain, not just mood disorders
One capsule may treat both pain and depression symptoms
Available as a lower-cost generic (duloxetine)
Cons
Must be avoided in liver disease or cirrhosis
Not recommended with severe kidney impairment
Stopping suddenly can cause pronounced withdrawal symptoms
Sertraline
Sertraline has one of the longest safety track records of any SSRI and covers more psychiatric indications than Cymbalta. It carries no chronic pain approval, and sexual side effects are a common trade-off for many patients.
Pros
Approved for OCD, panic disorder, PTSD, and social anxiety disorder
More than three decades of real-world safety data
Fewer restrictions in liver or kidney disease than Cymbalta
Cons
Not approved for any chronic pain condition
Sexual side effects, including ejaculation failure, are common in men
Requires more titration steps to reach an effective dose
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