Cymbalta Vs. Zoloft

Antidepressants are prescribed for depression and other conditions, and although the exact reason they work is unknown, they do alter levels of neurotransmitters, chemicals in the brain. Neurotransmitters are necessary for communication between neurons; they are also thought to play a role in mood and behavior. Two options for antidepressants include Cymbalta, or duloxetine; and Zoloft, or sertraline. Although both of these drugs treat depression, they have some differences that are worth noting.

Person with a pill in hand. (Image: etorres69/iStock/Getty Images)

Mechanism

Drugs.com points out that both Cymbalta and Zoloft are reuptake inhibitors, though they affect different neurotransmitters. Zoloft prevents the reuptake of the neurotransmitter serotonin, while Cymbalta interferes in the reuptake of the neurotransmitters serotonin and norepinephrine. In other words, both drugs work to make certain neurotransmitters more available to your nervous system.

Uses

Zoloft and Cymbalta can treat multiple conditions, some of which are approved by the Food and Drug Adminstration and some of which are off-label. For example, Zoloft is approved for use in major depression; premenstrual dysphoric disorder; social anxiety disorder; obsessive-compulsive disorder; panic disorder and post-traumatic depression. Some off-label uses include autism, Tourette syndrome, fibromyalgia, migraines, dementia, obesity, diabetic neuropathy, premature ejaculation, anorexia, bulimia, personality disorders, hot flashes and generalized anxiety disorder.

Cymbalta has been approved to treat depression, generalized anxiety disorder, fibromyalgia, and pain from diabetic neuropathy . Off-label include treating other types of chronic pain and stress incontinence.

Restrictions

Not everyone can use Cymbalta or Zoloft. Drugs.com explains that patients with certain conditions may need to undergo testing or receive a dose adjustment in order for them to take these drugs safely. For example, restrictions for Zoloft and Cymbalta use exist for patients with liver or kidney disease, epilepsy, bipolar disorder, or those with a history of drug abuse or suicidal thoughts. Patients with glaucoma or bleeding disorders may also have to undergo testing before starting Cymbalta.

Dosing

Both Zoloft and Cymbalta have specific instructions on proper use. For example, patients should take these drugs at the same time each day. If taking the liquid form of Zoloft, Drugs.com notes that the proper mixing includes combining the dose with 4 oz. of orange juice, water, lemonade, ginger ale or lemon-lime soda only. With Cymbalta, patients should not break the delayed-release capsule, because that can cause too much of the drug to be released.

Warnings

Drugs.com warns that patients taking Cymbalta or Zoloft cannot take a MAO inhibitor, another type of antidepressant, at the same time; if already on an MAO inhibitors, patients must wait 14 days before starting either Zoloft or Cymbalta. When patients start either medication, they may experience suicidal thoughts. Both Cymbalta and Zoloft are classified as a pregnancy category C drug by the Food and Drug Administration, meaning that a pregnant woman may not be able to take them during the last trimester of her pregnancy.

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