Zoloft vs. Cymbalta

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

Key Takeaways

  • Zoloft is an SSRI approved for depression, OCD, panic disorder, PTSD, social anxiety disorder, and PMDD, while Cymbalta is an SNRI also approved for generalized anxiety disorder and chronic pain conditions.

  • Both carry an FDA boxed warning for increased suicidal thinking in people under 25, and both commonly cause nausea and headache early in treatment.

  • Cymbalta reaches its full maintenance dose within two weeks, while Zoloft may take several weeks of titration to reach higher doses up to 200 mg.

Zoloft vs. Cymbalta Drug Summary

Zoloft

Zoloft (sertraline) is a selective serotonin reuptake inhibitor, or SSRI, first approved by the FDA in 1991. It treats major depressive disorder, OCD, panic disorder, PTSD, social anxiety disorder, and PMDD. It comes as a tablet or oral liquid taken once a day, usually starting at 25 mg to 50 mg.

Cymbalta

Cymbalta (duloxetine) is a serotonin and norepinephrine reuptake inhibitor, or SNRI, approved by the FDA in 2004. It treats major depressive disorder, generalized anxiety disorder, diabetic nerve pain, and fibromyalgia. It comes as a delayed-release capsule taken once or twice a day.

Zoloft vs. Cymbalta Side Effects

Zoloft

Most common
nausea (up to 26%)
diarrhea (up to 20%)
insomnia (up to 20%)
dry mouth (up to 14%)

Cymbalta

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

Zoloft vs. Cymbalta Dosage

Zoloft

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 25-50 mg once daily At the start
Maximum dose Up to 200 mg once daily 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

Zoloft vs. Cymbalta Indications

Zoloft

Zoloft is FDA-approved to treat several mental health conditions beyond depression, including anxiety and trauma-related disorders. It is not approved for generalized anxiety disorder or any chronic pain condition, though doctors sometimes use it off-label for other anxiety issues.

  • Major depressive disorder (MDD)

  • Obsessive-compulsive disorder (OCD)

  • Panic disorder

  • Post-traumatic stress disorder (PTSD)

  • Social anxiety disorder

Cymbalta

Cymbalta is FDA-approved for both psychiatric and chronic pain conditions, making it one of the few antidepressants also used for nerve pain and fibromyalgia. It is not approved for other anxiety disorders such as panic disorder or PTSD.

  • Major depressive disorder (MDD)

  • Generalized anxiety disorder (GAD)

  • Diabetic peripheral neuropathic pain

  • Fibromyalgia

  • Chronic musculoskeletal pain

Zoloft vs. Cymbalta Pros and Cons

Zoloft

Zoloft has one of the longest track records among SSRIs and covers a wider range of anxiety-related conditions than Cymbalta. Generic sertraline has been available since 2006, making it one of the most affordable antidepressants on the market.

Pros

  • Approved for OCD, panic disorder, PTSD, social anxiety, and PMDD

  • Available as a liquid for people who cannot swallow pills

  • Generic sertraline often costs $20 to $75 a month without insurance

  • No specific liver or kidney dose restrictions in labeling

Cons

  • Not approved for any chronic pain or nerve pain condition

  • Diarrhea is a more common complaint than with Cymbalta

  • Not approved for generalized anxiety disorder

Cymbalta

Cymbalta covers chronic pain conditions that Zoloft is not approved to treat, giving it use beyond mental health care. It reaches its full maintenance dose faster than Zoloft, but it comes with more restrictions for people with liver or kidney disease.

Pros

  • Approved for generalized anxiety disorder unlike Zoloft

  • Also treats diabetic nerve pain, fibromyalgia, and chronic pain

  • Reaches target maintenance dose within two weeks

  • Fewer GI complaints like diarrhea compared with Zoloft

Cons

  • Must be swallowed whole; capsule cannot be crushed or opened

  • Should be avoided in liver disease or severe kidney impairment

  • Typically costs $130 to $500 a month without insurance

Common Symptoms and Related Diseases You Can Explore

Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.