Remeron vs. Cymbalta for Depression: Important Differences and Potential Risks.

Key takeaways

Mirtazapine (Remeron) and duloxetine (Cymbalta) are both used to treat major depressive disorder, but they belong to different classes of medications. Mirtazapine is a tetracyclic antidepressant, while duloxetine is an SNRI (serotonin and norepinephrine reuptake inhibitor). Mirtazapine is typically taken once daily at night and is known to cause sleepiness and weight gain. In contrast, duloxetine can be taken once or twice daily and is used to treat a wider range of conditions, including anxiety, diabetic neuropathy, fibromyalgia, and chronic pain. Duloxetine may cause side effects like nausea, headache, and dry mouth, and it can also affect your liver health, especially if you drink alcohol. Both medications can lead to withdrawal symptoms if stopped suddenly, so it's important to follow your prescriber's instructions when discontinuing them.

Mirtazapine

(Remeron)

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Duloxetine

(Cymbalta)

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Summary for Remeron

Prescription only

Mirtazapine (Remeron) is an atypical antidepressant (or more specifically, tetracyclic antidepressant). It's used to treat major depressive disorder (MDD) in adults. Mirtazapine (Remeron) is available as an oral tablet and orally disintegrating tablet (ODT) that's taken once daily, typically at night. Some common side effects of this medication include sleepiness and dry mouth. Mirtazapine (Remeron) can also raise your appetite and put you at risk for weight gain.

Indications for Remeron

Major depressive disorder (MDD) in adults

Pros and Cons for Remeron

Pros

Taken by mouth once daily
Available as a dissolvable tablet for those who can't swallow pills
Less likely to cause sexual side effects compared SSRIs
Available as a lower-cost generic

Cons

Can take up to 2 months before you feel the the full benefits
More likely than other antidepressants to cause weight gain
Can cause sleepiness
Risk of withdrawal symptoms if you suddenly stop taking it

Common Side Effects for Remeron

Sleepiness (54%)
Dry mouth (25%)
Feeling more hungry (17%)
Constipation (13%)
Weight gain (12%)
Weakness (8%)
Dizziness (7%)

Warnings for Remeron

Worsening depression, suicidal thoughts, and unusual behavior
Higher risk of infection (from low white blood cell count)
Serotonin syndrome
Withdrawal
Not for bipolar disorder
Glaucoma
Life-threatening abnormal heart rhythm (QT prolongation)
Severe allergic and skin reactions
Difficulty concentrating and extreme sleepiness
Seizures
Low blood sodium levels
Caution use in people with phenylketonuria (PKU) - orally disintegrating tablets only

Summary for Cymbalta

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 Cymbalta

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 Cymbalta

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