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
Cymbalta
Prozac vs. Cymbalta Dosage
Prozac
Cymbalta
| 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 |
| 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
| 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
| 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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