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

Most common
Nausea (up to 30%)
Somnolence (up to 21%)
Headache (up to 18%)
Dizziness (up to 17%)

Sertraline

Most common
Nausea (up to 26%)
Insomnia (up to 21%)
Diarrhea (up to 20%)
Ejaculation failure (up to 14%)

Cymbalta vs. Sertraline Dosage

Cymbalta

Dosage
Dosage Table
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

Dosage
Dosage Table
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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