Does Cymbalta work better than Zoloft? (3+ differences)
By
Ivan Kahwa
Author bio
Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.
Mr Ivan Kahwa’s Highlights:
Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.
Professional Experience:
Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.
With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.
With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.
Education:
2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.
2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.
2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.
Publications:
▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7
▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60
▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.
https://ethnobotanyjournal.org/index.php/era/article/view/4683
▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.
https://doi.org/10.53388/TMRIM202307004
▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.
https://doi.org/10.1186/s43094-021-00296-2
▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.
https://doi.org/10.5799/jmid.951600
Published book Chapter
▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.
https://doi.org/10.1016/B978-0-323-91942-5.00012-4
Submitted manuscripts Under Review:
▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience
▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine
▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology
Submitted book chapters under review
1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.
2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press
You can view my works on the following professional sites:
Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa
Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en
ORCID: https://orcid.org/0000-0002-6440-3437
Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159
This article will explore whether Cymbalta works better than Zoloft. It will compare their therapeutic benefits, efficacies, mechanisms of action, and side effects.
Finally, the article will provide tips on how to choose between both medications.
Does Cymbalta work better than Zoloft?
Cymbalta may work better than Zoloft for certain conditions. These conditions include neuropathic pain in fibromyalgia, peripheral diabetic neuropathies, and osteoarthritis. However, for other conditions like PTSD, OCD, and bulimia nervosa, Zoloft may be more beneficial [1,2].
It’s important to note that people respond differently to medications, and Cymbalta may not work better than Zoloft for everyone. Therefore, consulting with a healthcare professional is crucial in determining the most suitable antidepressant for your specific needs.
They will assess your medical history, consider any comorbidities, concurrent medications, and responses, and prescribe the most appropriate drug accordingly.
How do Cymbalta and Zoloft differ from one another?
The differences between Zoloft and Cymbalta are mentioned below:
Mechanisms of action
Cymbalta primarily works by increasing both serotonin and norepinephrine in the brain by inhibiting their reuptake. This dual action on serotonin and norepinephrine differentiates it from many other antidepressants that increase serotonin alone [1].
In contrast, Zoloft is a selective serotonin reuptake inhibitor (SSRI) that primarily raises serotonin levels in the brain, which may improve mood [2].
Due to the differences in their mechanisms, there are differences in their effectiveness for specific diseases or conditions. For example, duloxetine’s action on norepinephrine makes it effective in treating neuropathic pain.
Due to Zoloft’s selective action on serotonin, it is mainly indicated for mental health disorders.
Therapeutic benefits
The FDA-approved uses for Cymbalta and Zoloft are demonstrated below [1,2]:
| Cymbalta | Zoloft |
| Major depressive disorder | Major depressive disorder |
| Generalized anxiety disorder | Social anxiety disorder |
| Fibromyalgia | Post-traumatic stress disorder |
| Diabetic peripheral neuropathy | Obsessive-compulsive disorder |
| Chronic musculoskeletal pain | Premenstrual dysphoric disorder |
| Panic disorder |
Off-label uses of Zoloft include binge eating disorder, premature ejaculation, body dysmorphic disorder, generalized anxiety disorder, and bulimia nervosa.
Duloxetine, on the other hand, can be used off-label to manage chemotherapy-related peripheral neuropathy and stress urinary incontinence.
Effectiveness
When comparing the efficacy of Cymbalta and Zoloft for the treatment of depression and anxiety, there are some differences in the reported improvements in symptoms.
For depression symptoms, Cymbalta appears to show a higher percentage of improvement. In one month, Cymbalta demonstrated a 64% improvement, while Zoloft showed a 29% improvement. After two months, Cymbalta showed an 87% improvement, compared to a 66% improvement with Zoloft.
At three months, the improvement reported with Cymbalta was 86%, while Zoloft reported an 82% improvement [3].
For anxiety symptoms, at one month, Cymbalta showed a 33% improvement, whereas Zoloft demonstrated a 22% improvement. After two months, Cymbalta had a 47% improvement compared to a 21% improvement with Zoloft [3].
At three months, Cymbalta reported a 64% improvement, while Zoloft showed a 28% improvement. These percentages suggest that Cymbalta may provide slightly greater improvement in both depression and anxiety symptoms compared to Zoloft, based on the provided data [3].
However, it’s essential to remember that individual response and effectiveness can vary, and other factors such as side effects and tolerability should also be considered when choosing a medication. It is always best to consult with a healthcare professional for personalized advice and guidance.
Side effects
Here’s a comparison of the side effects caused by Cymbalta and Zoloft [1,2]:
| Cymbalta | Zoloft |
| Vomiting | Nausea |
| Insomnia | Insomnia |
| Loss of appetite | Loss of appetite |
| Vision problems | Anxiety |
| Increased bleeding due to inhibition of platelet aggregation | Increased bleeding due to inhibition of platelet aggregation |
| Sleepiness | Dizziness |
| Weight gain | Fatigue |
| Postural hypotension | Postural hypotension |
| Weight loss | Syncope |
| Diarrhea | Diarrhea |
| Liver problems, which may cause easy bruising and dark urine | Photosensitivity |
| Tremors | Tardive dyskinesia |
How to choose between Cymbalta and Zoloft?
When choosing between Cymbalta and Zoloft, it is important to consider several factors, including contraindications, indications, and individual responses to the medications.
Cymbalta is contraindicated in patients with uncontrolled narrow-angle glaucoma because it may increase intraocular pressure. Moreover, people with liver or kidney problems should avoid taking Cymbalta.
Zoloft, on the other hand, is contraindicated in patients taking sulfiram or pimozide. If, during the last 14 days, you have administered a monoamine oxidase inhibitor (MAOI), you should completely avoid both medications.
Furthermore, for most people, Cymbalta is often preferred for the treatment of generalized anxiety disorder, fibromyalgia, diabetic peripheral neuropathic pain, and chronic musculoskeletal pain.
On the other hand, Zoloft is often preferred for the treatment of depression, social anxiety disorder (SAD), obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and panic disorder.
However, it is crucial to consult with a doctor who can assess your needs and medical history before making a decision about which medication is more suitable. Only a doctor can determine which drug is more appropriate based on an individual’s unique circumstances.
Based on my knowledge, Cymbalta may be more effective than Zoloft in certain conditions, and vice versa. Moreover, while they share certain common side effects and contraindications, they also have certain different and specific ones.
Additionally, I believe that the decision regarding the use of either Cymbalta or Zoloft as antidepressants should depend on one’s medical and medication histories. In my perspective, only a doctor can determine which drug may work better for your condition.
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References
1.-
Dhaliwal JS, Spurling BC, Molla M. Duloxetine. [Updated 2023 May 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549806/
2.-
Singh HK, Saadabadi A. Sertraline. [Updated 2023 Feb 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547689/
3.-
Karaiskos D, Tzavellas E, Spengos K, Vassilopoulou S, Paparrigopoulos T. Duloxetine versus citalopram and sertraline in the treatment of poststroke depression, anxiety, and fatigue. J Neuropsychiatry Clin Neurosci. 2012 Summer;24(3):349-53. doi: 10.1176/appi.neuropsych.11110325. PMID: 23037649.
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