Cymbalta (generic name duloxetine) and Celexa (generic name citalopram) are medications approved by the Food and Drug Administration to treat generalized anxiety disorder and depression. Cymbalta is also used to treat diabetic nerve pain and fibromyalgia.
Modes of Action
Cymbalta is in the selective serotonin norepinephrine reuptake inhibitor--SSNRI--class of antidepressants. It is believed, though not entirely known for sure, that Cymbalta works by balancing serotonin and norepinephrine, two naturally occurring chemicals in the brain.
Celexa, on the other hand, is a derivative selective serotonin reuptake inhibitor--SSRI--and though linked to serotonergic activity, it has no effect on neurotransmitters as Cymbalta does.
Celexa dosing is typically started at 20 mg and may be increased to a maximum daily dose of 60 mg.
Cymbalta is typically administered in a total dose of 40 mg/day--given as 20 mg twice daily--to 60 mg/day, given either once daily or as 30 mg twice daily. To allow for patients to adjust to the medication, it may be administered slowly, starting at 30 mg daily and then gradually increased to 60 mg. There are no reports that higher doses are effective.
Similar Side Effects
Both Celexa and Cymbalta have FDA black-box warnings for the risks of suicidal thinking among pediatric and adolescent users.
They also both have similar reported side effects, including nausea, loss of appetite, sleep disturbances, fever, headache, tremor, dizziness, dry mouth and decreased libido.
Cymbalta Side Effects
In addition, Cymbalta patients may also experience stomach pain, loss of appetite, dark urine, clay-colored stools, yellowing of the skin or eyes, painful or difficult urination, easy bruising or bleeding, nosebleeds, stiff muscles, vomiting, diarrhea, sweating, overactive reflexes, trouble concentrating, memory problems, confusion, hallucinations, weakness, feeling unsteady, loss of coordination, fainting, seizure, shallow breathing or breathing that stops. Less common side effects were drowsiness, spinning sensation, constipation, flatulence, joint and muscle pain, and weight changes.
Celexa Side Effects
Celexa users also have reported increased sweating, diarrhea, dyspepsia, somnolence, anxiety, agitation, dysmenorrhea, yawning, impotence, upper respiratory tract infection, rhinitis, sinusitis, fatigue and hypotension.