Prozac vs. Cymbalta

See how Prozac and Cymbalta compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Prozac is an SSRI approved for depression, OCD, bulimia, and panic disorder, while Cymbalta is an SNRI also approved for chronic pain conditions like fibromyalgia and diabetic neuropathy.

  • Cymbalta causes more nausea, dizziness, and headache, while Prozac is more likely to cause insomnia and anxiety.

  • Prozac offers a unique once-weekly maintenance dose after stabilization, while Cymbalta must be taken daily and avoided in liver or severe kidney disease.

Prozac vs. Cymbalta Drug Summary

Prozac

Prozac (fluoxetine) is a selective serotonin reuptake inhibitor (SSRI) used to treat depression, OCD, bulimia, and panic disorder. It comes as a capsule, tablet, or liquid, and can be taken daily or, after stabilization, once weekly.

Cymbalta

Cymbalta (duloxetine) is a serotonin and norepinephrine reuptake inhibitor (SNRI) used for depression, generalized anxiety, and several chronic pain conditions. It comes only as a delayed-release capsule, taken once or twice daily.

Prozac vs. Cymbalta Side Effects

Prozac

Most common
nausea (up to 21%)
somnolence (up to 12%)
insomnia (up to 33%)
anxiety/nervousness (up to 15%)

Cymbalta

Most common
nausea (up to 30%)
somnolence (up to 21%)
headache (up to 18%)
dizziness (up to 17%)

Prozac vs. Cymbalta Dosage

Prozac

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 20 mg once daily At the start
Maximum dose 90 mg once weekly If needed
Dose changes 2 increases As tolerated

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

Prozac vs. Cymbalta Indications

Prozac

Prozac treats major depressive disorder, OCD, bulimia nervosa, and panic disorder, and can be combined with olanzapine for treatment-resistant or bipolar depression. It is also used off-label for premenstrual dysphoric disorder and binge eating disorder.

  • Major depressive disorder

  • Obsessive-compulsive disorder (OCD)

  • Bulimia nervosa

  • Panic disorder

  • Bipolar I depression (with olanzapine)

Cymbalta

Cymbalta treats major depressive disorder and generalized anxiety disorder, and is also FDA-approved for chronic pain conditions like diabetic neuropathy, fibromyalgia, and musculoskeletal pain. This dual approval makes it a common choice when depression or anxiety occurs alongside chronic pain.

  • Major depressive disorder

  • Generalized anxiety disorder

  • Diabetic peripheral neuropathic pain

  • Fibromyalgia

  • Chronic musculoskeletal pain

Prozac vs. Cymbalta Pros and Cons

Prozac

Prozac has decades of clinical use and a flexible once-weekly maintenance option once symptoms stabilize. Its long half-life means missed doses are less disruptive, but it also takes longer to clear the body if side effects occur.

Pros

  • Once-weekly maintenance dosing option after stabilization

  • Available as capsule, tablet, and oral solution

  • FDA-approved for OCD and bulimia, not just depression

Cons

  • Not approved for generalized anxiety disorder alone

  • Long half-life delays clearance if switching medications

  • Requires a longer washout before starting an MAOI

Cymbalta

Cymbalta's dual action on serotonin and norepinephrine makes it useful for both mood disorders and chronic pain. It requires more caution in people with liver disease or significant kidney impairment.

Pros

  • Also approved for diabetic nerve pain and fibromyalgia

  • Approved for generalized anxiety disorder as monotherapy

  • Can be taken once or twice daily depending on dose

Cons

  • Only available as a delayed-release capsule

  • Should be avoided in liver disease or severe kidney impairment

  • Monthly cost roughly $130 to $500, higher than generic Prozac

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