Duloxetine vs. Wellbutrin XL for Depression: Important Differences and Potential Risks.

Duloxetine

(Cymbalta)

Bupropion

Summary for Duloxetine

Prescription only

Duloxetine (Cymbalta) helps treat depression and anxiety. It can also help with some types of chronic pain, such as nerve pain from diabetes. Duloxetine (Cymbalta) is a type of antidepressant called an SNRI, or serotonin and norepinephrine reuptake inhibitor. Most people take it by mouth once a day, but some with depression might take it twice a day. Side effects include nausea, headache, and dry mouth. When it's time to stop taking the medication, the prescriber will slowly lower your dose to help prevent withdrawal symptoms.

Indications for Duloxetine

Depression in adults
Generalized anxiety disorder in people ages 7 years and older
Diabetic neuropathy (nerve pain caused by high blood sugar) in adults
Fibromyalgia in people ages 13 years and older
Chronic pain in the muscles, bones, joints, or tendons in adults

Pros and Cons for Duloxetine

Pros

Taken once a day for most people
Can take at any time of day
A first-choice option for depression
An option for some types of chronic pain, like nerve pain from diabetes

Cons

Can take several weeks before you feel its full effects
Might not be a good option for people who drink heavily or have liver or kidney problems
Can cause nausea or dry mouth
Can interact with many medications, including other antidepressants and certain pain relievers

Common Side Effects for Duloxetine

Nausea (23%)
Headache (14%)
Dry mouth (13%)
Drowsiness (10%)
Feeling tired (9%)
Trouble sleeping (9%)
Dizziness (9%)
Constipation (9%)
Diarrhea (9%)
Low appetite (7%)
A lot of sweating (6%)
Stomach pain (5%)

Warnings for Duloxetine

Suicidal thoughts or behavior
Liver damage
Changes in blood pressure and risk of falls
Serotonin syndrome
Higher risk of bleeding
Severe skin reaction
Withdrawal symptoms
Low sodium levels
Sexual problems
Not for use alone for bipolar disorder because of the risk of mania
Angle-closure glaucoma in certain people

Summary for Wellbutrin XL

Prescription only

Bupropion is taken by mouth to treat depression and seasonal affective disorder (SAD). It's available as short-acting tablets that are taken two or three times a day, as well as long-acting versions that are taken once daily. Bupropion has fewer sexual side effects compared to other antidepressants, but it's not a good choice for people with a history of seizures, eating disorders, or drink alcohol regularly.

Indications for Wellbutrin XL

Depression
Seasonal affective disorder (SAD) - only bupropion HCl extended-release (Wellbutrin XL)

Pros and Cons for Wellbutrin XL

Pros

Works well for depression and can be used alone or in combination with other antidepressants
Causes fewer sexual side effects than some other antidepressants
Available in a lower-cost generic form
Less likely to cause weight gain compared to other antidepressants
Good option for people who haven't had success with traditional antidepressants like selective serotonin reuptake inhibitors (SSRIs)

Cons

Can take several weeks to feel the full effects
Not the best option if you have a history of seizures or eating disorders like as anorexia or bulimia
Might need to limit or avoid using alcohol during treatment
Can cause trouble sleeping if you take it later in the day