Wellbutrin vs. Cymbalta

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

Key Takeaways

  • Wellbutrin is a norepinephrine-dopamine reuptake inhibitor for depression, while Cymbalta is an SNRI also approved for anxiety and several chronic pain conditions.

  • Wellbutrin is less likely to cause sexual side effects or weight gain, while Cymbalta carries a higher risk of nausea and drowsiness.

  • Cymbalta typically costs less per month than Wellbutrin, and both carry an FDA boxed warning for suicidal thoughts in children and young adults.

Wellbutrin vs. Cymbalta Drug Summary

Wellbutrin

Wellbutrin (bupropion) is an aminoketone antidepressant that works by inhibiting norepinephrine and dopamine reuptake, a different mechanism than most antidepressants that target serotonin. It is FDA-approved for major depressive disorder and taken as an oral tablet, usually in divided doses through the day.

Cymbalta

Cymbalta (duloxetine) is a serotonin and norepinephrine reuptake inhibitor approved for depression, generalized anxiety disorder, and several chronic pain conditions like fibromyalgia and diabetic nerve pain. It comes as a delayed-release capsule taken once or twice daily.

Wellbutrin vs. Cymbalta Side Effects

Wellbutrin

Most common
Headache (≥10%)
Nausea (≥10%)
Dry mouth (≥10%)
Constipation (≥10%)

Cymbalta

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

Wellbutrin vs. Cymbalta Dosage

Wellbutrin

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 200 mg/day (100 mg BID) Days 1-3
Maximum dose 450 mg/day (150 mg TID) If needed
Dose changes 2 increases Every 3 days

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

Wellbutrin vs. Cymbalta Indications

Wellbutrin

Wellbutrin is FDA-approved only for major depressive disorder in adults. It is also widely used off-label for adult ADHD, as an add-on treatment for bipolar depression, and to help offset sexual side effects from SSRIs. Some clinicians prescribe it off-label for weight management as well.

  • Major depressive disorder (FDA-approved)

  • ADHD in adults and children (off-label)

  • Bipolar depression, as an add-on (off-label)

  • Antidepressant-induced sexual dysfunction (off-label)

  • Obesity or weight management (off-label)

Cymbalta

Cymbalta is FDA-approved for major depressive disorder, generalized anxiety disorder, and several chronic pain conditions. These include diabetic peripheral neuropathy, fibromyalgia, and chronic musculoskeletal pain such as osteoarthritis and low back pain. This makes it one of the few antidepressants also used to manage long-term pain.

  • Major depressive disorder (FDA-approved)

  • Generalized anxiety disorder (FDA-approved)

  • Diabetic peripheral neuropathic pain (FDA-approved)

  • Fibromyalgia (FDA-approved)

  • Chronic musculoskeletal pain (FDA-approved)

Wellbutrin vs. Cymbalta Pros and Cons

Wellbutrin

Wellbutrin stands out among antidepressants for its low rates of sexual side effects and weight gain, along with a non-sedating profile. It carries a dose-related seizure risk that limits its use in certain patients, and it is not approved for anxiety disorders.

Pros

  • Low risk of sexual side effects, unlike SSRIs/SNRIs

  • Does not typically cause weight gain

  • Non-sedating, can be energizing during the day

Cons

  • Carries a dose-related seizure risk

  • Not approved for anxiety disorders

  • Contraindicated with seizure or eating disorder history

  • Costs more than Cymbalta - roughly $500 to $900 per month without insurance

Cymbalta

Cymbalta is one of the few antidepressants also approved for chronic pain conditions like fibromyalgia and diabetic neuropathy. It tends to cause more nausea and drowsiness than Wellbutrin, and it requires caution in people with liver or kidney disease.

Pros

  • Approved for chronic pain conditions like fibromyalgia

  • Also approved for generalized anxiety disorder

  • Costs less than Wellbutrin - roughly $130 to $500 per month without insurance

Cons

  • Higher rates of nausea and drowsiness than Wellbutrin

  • Not recommended with liver disease or cirrhosis

  • Avoid with severe kidney impairment

  • Delayed-release capsule must be swallowed whole

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