- Celexa (citalopram) vs. Cymbalta (duloxetine) quick comparison of differences
- What is Celexa? How does it work (mechanism of action)?
- What is Cymbalta? How does it work (mechanism of action)?
- What are the uses for Celexa vs. Cymbalta?
- What are the side effects of Celexa vs. Cymbalta?
- What are withdrawal symptoms of Celexa vs. Cymbalta?
- What is the dosage of Celexa vs. Cymbalta?
- What drugs interact with Celexa vs. Cymbalta?
- Are Celexa and Cymbalta safe to take if I am pregnant or breastfeeding?
Celexa (citalopram) vs. Cymbalta (duloxetine) quick comparison of differences
- Celexa (citalopram) and Cymbalta (duloxetine) are antidepressants used to treat depression and anxiety disorders.
- Celexa and Cymbalta are not the same type of antidepressant (they do not have the same mechanism of action). Celexa belongs to a drug class called selective serotonin reuptake inhibitors (SSRIs), and Cymbalta belongs to a drug class called selective serotonin and norepinephrine reuptake inhibitors (SNRIs).
- Side effects of Celexa and Cymbalta that are similar include:.
- Side effects of Celexa that are different from Cymbalta include:
- Side effects of Cymbalta that are different from Celexa include:
- Some individuals may experience withdrawal reactions upon stopping Celexa or Cymbalta.
- Symptoms of withdrawal from Celexa include:
- Symptoms of withdrawal from Cymbalta include:
What is Celexa? How does it work (mechanism of action)?
Celexa prevents the uptake of the neurotransmitter serotonin by nerve cells after it has been released, which results in more free serotonin in the brain to stimulate nerve cells. Celexa is also used off-label for treating alcoholism, binge-eating disorder, generalized anxiety disorder, panic disorder, hot flashes, and obsessive-compulsive disorder (OCD).
What is Cymbalta? How does it work (mechanism of action)?
Cymbalta (duloxetine) also is a selective serotonin and norepinephrine reuptake inhibitor (SNRI) SNRI antidepressant used for or the treatment of depression, anxiety disorders, and pain. Other SNRIs include milnacipran (Savella), venlafaxine (Effexor), and desvenlafaxine (Pristiq).
Cymbalta prevents the reuptake of the neurotransmitters serotonin and epinephrine by nerves after they have been released, thereby increasing the effect of serotonin and norepinephrine in the brain.Cymbalta is used to treat major depressive disorder (MDD), generalized anxiety disorder (GAD), diabetic peripheral neuropathic pain, fibromyalgia, and chronic musculoskeletal pain.
What are the uses for Celexa vs. Cymbalta?
Citalopram is approved for treating depression. It is also used off-label for treating:
- Binge-eating disorder
- Generalized anxiety disorder (GAD)
- Panic disorder
- Hot flashes
- Obsessive compulsive disorder (OCD)
Duloxetine is used for the treatment of:
What are the side effects of Celexa vs. Cymbalta?
Celexa side effects
The most common side effects associated with citalopram are
Overall, between 1 in 6 and 1 in 5 persons experience a side effect. Citalopram is also associated with sexual dysfunction.
Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of citalopram or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidality, or unusual changes in behavior.
Cymbalta side effects
The most common side effects of duloxetine include
Increased blood pressure can occur and should be monitored. Seizures have been reported. Sexual dysfunction (decreased sex drive and delayed orgasm and ejaculation) has been associated with duloxetine.
Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of duloxetine or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidality, or unusual changes in behavior.
What are withdrawal symptoms of Celexa vs. Cymbalta?
Celexa withdrawal symptoms
Some individuals may experience withdrawal reactions upon stopping citalopram. Symptoms of withdrawal include
- tingling sensations,
- tiredness, vivid
- dreams, and
- irritability or poor mood.
Cymbalta withdrawal symptoms
Some individuals may experience withdrawal reactions upon stopping duloxetine. Symptoms of withdrawal include:
- irritability, and
The dose of Celexa and Cymbalta should be gradually reduced when therapy is discontinued to prevent symptoms of withdrawal.
What is the dosage of Celexa vs. Cymbalta?
- The usual starting dose is 20 mg in the morning or evening. The dose may be increased to 40 mg daily after one week.
- A dose of 60 mg has not been shown to be more effective than 40 mg.
- As with all antidepressants, it may take several weeks of treatment before maximum effects are seen. Doses are often slowly adjusted upwards to find the most effective dose.
The recommended dose for treating depression is 20 or 30 mg twice daily or 60 mg once daily. Patients may be started with 30 mg once daily for one week before the dose is advanced to 60 mg daily.
- The recommended dose for anxiety disorder, pain associated with diabetic neuropathy, fibromyalgia, or chronic musculoskeletal pain is 60 mg daily. Starting at 30 mg daily for one week before increasing to 60 mg daily may help patients adjust to the drug. There is no evidence that doses greater than 60 mg/day provide additional benefits. However, the maximum dose for depression or anxiety disorder is 120 mg/day.
What drugs interact with Celexa vs. Cymbalta?
Celexa drug interactions
- All SSRIs, including citalopram, should not be taken with any of the mono-amine oxidase (MAO) inhibitor-class of antidepressants, for example, isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), selegiline (Eldepryl), and procarbazine (Matulane). Such combinations may lead to confusion, high blood pressure, tremor, and hyperactivity. If treatment is to be changed from citalopram to an MAOI or vice-versa, there should be a 14 day period without either drug before the alternative drug is started.
- Tryptophan, a common dietary supplement, can cause headaches, nausea, sweating, and dizziness when taken with any SSRI.
- Linezolid and intravenous methylene blue are also MAO inhibitors and should not be combined with citalopram.
- Use of an SSRI with aspirin, nonsteroidal anti-inflammatory drugs or other drugs that affect bleeding may increase the likelihood of upper gastrointestinal bleeding.
Cymbalta drug interactions
- Duloxetine should not be used in combination with a monoamine oxidase inhibitor (MAOI) such as phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan), and selegiline (Eldepryl), or within 14 days of discontinuing the MAOI. At least 5 days should be allowed after stopping duloxetine before starting an MAOI. Combinations of SNRIs and MAOIs may lead to serious, sometimes fatal, reactions including very high body temperature, muscle rigidity, rapid fluctuations of heart rate and blood pressure, extreme agitation progressing to delirium, and coma. Similar reactions may occur if duloxetine is combined with antipsychotics, tricyclic antidepressants or other drugs that affect serotonin in the brain. Examples include tryptophan, sumatriptan (Imitrex), lithium, linezolid (Zyvox), tramadol (Ultram), and St. John’s Wort.
- Fluoxetine (Prozac, Serafem), paroxetine (Paxil, Paxil CR, Pexeva), fluvoxamine (Luvox), and quinidine increase blood levels of duloxetine by reducing its metabolism in the liver. Such combinations may increase adverse effects of duloxetine.
- Combining duloxetine with aspirin, nonsteroidal antiinflammatory drugs (NSAIDs), warfarin (Coumadin) or other drugs that are associated with bleeding may increase the risk of bleeding, because duloxetine itself is associated with bleeding.
- Duloxetine has an enteric coating that prevents dissolution until it reaches a segment of the gastrointestinal that has a pH higher than 5.5. In theory, drugs that raise the pH in the gastrointestinal system (for example, Prilosec) may cause duloxetine to be released early while conditions that slow gastric empyting (for example, diabetes) may cause premature breakdown of duloxetine. Nevertheless, administration of duloxetine with an antacid or famotidine (Axid) did not significantly affect the absorption of duloxetine.
- Duloxetine may reduce the breakdown of desipramine (Norpramine), leading to increased blood concentrations of desipramine and potential side effects.
Latest Depression News
Are Celexa and Cymbalta safe to take if I am pregnant or breastfeeding?
- Exposure of neonates to citalopram in the third trimester may cause complications.
- Citalopram is excreted in breast milk. Breastfeeding by a citalopram treated woman may cause adverse effects in the infant.
- Duloxetine is excreted into the milk of lactating women. Because the safety of duloxetine in infants is not known, breastfeeding while on duloxetine is not recommended.
Celexa (citalopram) and Cymbalta (duloxetine) are drugs used to treat depression. Celexa belongs to the antidepressant drug class called selective serotonin reuptake inhibitors (SSRIs), and Cymbalta belongs to the selective serotonin and norepinephrine reuptake inhibitor (SSNRI) drug class. The main difference between the two drugs is that Celexa prevents the reuptake of one neurotransmitter, and Cymbalta prevents the reuptake of two.
Celexa is approved for the treatment of depression. Non-FDA approved uses for Celexa include hot flashes, obsessive compulsive disorder (OCD), panic disorder, general anxiety disorder (GAD), bing-eating disorder, and alcoholism.
Common side effects of Celexa and Cymbalta include insomnia, dry mouth, and nausea. Side effects unique to Celexa include headache, tremor, and vomiting. Side effects unique to Cymbalta include constipation, diarrhea, fatigue, high blood pressure, sexual dysfunction, and seizures.
Multimedia: Slideshows, Images & Quizzes
Depression Quiz: Signs & Symptoms
Many people do not recognize the symptoms and warning signs of depression and depressive disorders in children and adults. With...
Panic Attacks (Panic Disorder) Quiz: Test Your Mental Health IQ
Could you suffer a panic attack? Take this Panic Attacks Quiz to learn causes, symptoms, and treatments for panic disorder. Use...
Diabetic Neuropathy Quiz: Test Your Medical IQ
Diabetic neuropathy is serious. Take this quiz to get the facts....
Binge Eating Disorder Quiz: Test Your Medical IQ
Do you binge eat? Take this quick quiz to learn what binge eating is and what makes people do it....
Alcohol Quiz: Alcoholism & Health Effects
Take the Alcohol (Alcoholism) Quiz to learn how your alcohol is processed by your body and your brain....
Picture of Dermatofibroma
A common type of benign skin tumor that is small, slow-growing, typically firm, red-to-brown and most often on the legs. See a...
Picture of Fibromyalgia
A syndrome characterized by chronic pain, stiffness, and tenderness of muscles, tendons, and joints without detectable...
Fibromyalgia Symptoms, Diagnosis & Treatment
What is fibromyalgia? Fibromyalgia is a chronic condition that causes pain and stiffness of the tendons, muscles, and joints....
Learn to Spot Depression: Symptoms, Warning Signs, Medication
What is depression? Get information on symptoms, signs, tests, and treatments for many types of depression including major...
Depression Tips: Exercise, Diet, Stress Reduction, and More in Pictures
The right exercise, diet, and activities -- even playing with a pet --can help you recover from depression. Learn simple...
Fibromyalgia Pain Relief With Stretching and Strength Exercises in Pictures
Living with fibromyalgia is painful. By making simple exercise modifications, you can boost your energy, decrease pain and...
Depression Myths: Overwork, Recklessness and More in Pictures
Explore the myths and facts about depression. See how folk remedies and half-truths still prevent many from getting treatment for...
Alcohol Abuse: 12 Health Risks of Chronic Heavy Drinking
Read about the health risks of chronic heavy or binge drinking. Anemia, cancer, gout, cardiovascular disease and many more...
Anxiety Disorder Pictures: Symptoms, Panic Attacks, and More with Pictures
Learn about generalized anxiety disorder (GAD). See if your worries are normal or something more by learning about symptoms,...
Physical Symptoms of Depression in Pictures
Depression can cause physical problems such as insomnia, chest pain, fatigue, headaches, and more. Learn the signs of depression...
Fibromyalgia Treatments and Tips to Ease Pain and Other Symptoms
What is fibromyalgia? Learn about fibromyalgia symptoms such as trigger points (also called tender points), learn what causes...
Healthy Aging: Sneaky Depression Triggers in Pictures
There are many causes and triggers of depression. From too little vitamin B12 to too much time alone, look at these surprising...
Eating Disorders: Anorexia, Bulimia, Binge Eating
Learn about different types of eating disorders. Discover the warning signs of binge eating disorder, anorexia and bulimia. Read...
Depression Therapy: Myths, Facts, and More in Pictures
False ideas scare many depression suffers away from therapy and the quick relief and help these pros can provide. Let our experts...
Diabetic Peripheral Neuropathy: Improve Diabetes Nerve Pain
Read about diabetic peripheral neuropathy and exercises to manage nerve pain. Learn how to cope with the symptoms of diabetic...
Visual Guide to Binge Eating Disorder
Learn about signs, symptoms, treatment, and recovery for this eating disorder. Get to know how binge eating affects emotional and...
Foods That Help Fight Depression
Food cannot prevent depression, but a healthy diet may boost your mood. Foods like salmon, carrots, Brazil nuts and even...
Related Disease Conditions
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one...
Fibromyalgia is a chronic pain condition characterized by symptoms such as fatigue, sleep disturbances, and tender points. Stress...
Peripheral Neuropathy (Causes, Symptoms, Treatment Medications)
Peripheral neuropathy is a problem with the functioning of the nerves outside of the spinal cord. Symptoms may include numbness,...
Panic attacks are sudden feelings of terror that strike without warning. These episodes can occur at any time, even during sleep....
Alcoholism is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as...
Natural Remedies for Hot Flashes
Hot flashes are experienced by many women, especially at night. However, not all women undergoing menopause experience hot...
Binge Eating Disorder
Characteristics of binge eating disorder include eating more quickly than usual, eating until uncomfortably full, eating a lot of...
Pain Management: Musculoskeletal Pain
Natural menopause is the permanent ending of menstruation that is not brought on by any type of medical treatment. For women...
Neuropathic pain is a chronic condition that leads to ongoing pain symptoms. Patients can be predisposed to developing...
Depression in Children
Childhood depression can interfere with social activities, interests, schoolwork and family life. Symptoms and signs include...
Depression in teenagers may be caused by many factors. Symptoms of teen depression include apathy, irresponsible behavior,...
Depression in the Elderly
Depression in the elderly is very common. That doesn't mean, though, it's normal. Treatment may involve antidepressants,...
Anxiety is a feeling of apprehension and fear characterized by symptoms such as trouble concentrating, headaches, sleep problems,...
Diabetic Neuropathy (Symptoms, Causes, Diagnosis, Treatment)
Diabetic neuropathy a condition in which nerve damage has occurred as a complication of diabetes. The pain from the nerve...
Diabetes Treatment (Type 1 and Type 2 Medications and Diet)
The major goal in treating diabetes is controlling elevated blood sugar without causing abnormally low levels of blood sugar....
Hot Flashes (Causes, Symptoms & Medication Treatment in Men and Women)
Hot flashes (or flushing) is the most common symptom experienced by a woman prior to and during the early stages of menopause,...
Pain Management: Neuropathic Pain
Neuropathic pain is chronic pain resulting from injury to the nervous system. The injury can be to the central nervous system...
Compulsive Overeating vs. Binge Eating Disorder
Compulsive overeating is eating more than needed. Binge eating disorder involves recurrent episodes of compulsive eating, even...
Rheumatoid Arthritis vs. Fibromyalgia
Though rheumatoid arthritis (RA) and fibromyalgia have similar symptoms, RA is an autoimmune disease and fibromyalgia is a...
Treatment & Diagnosis
Medications & Supplements
Health Solutions From Our Sponsors
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.