How JustAnswer Works:
  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.
Ask Bill Your Own Question
Bill
Bill, LCSW, Consultant, Expert Witness
Category: Mental Health
Satisfied Customers: 3706
Experience:  35 years treating individuals, couples, families with mental health and substance abuse prob's
48585111
Type Your Mental Health Question Here...
Bill is online now
A new question is answered every 9 seconds

With my doctors knowlege I am switching from Cymbalta (due

This answer was rated:

With my doctors knowlege I am switching from Cymbalta (due to cost) to generic prozac. I keep putting it off because I fear any side effects this might cause. I had no problems with Cymbalta but can no long afford it.......I have taken prozac before years ago. Do you think the switch will be OK? How about side effects of the switch?

Bill :

Hello- Thank you for asking the question. I have over 30 years of experience working with individuals, couples and families & am happy to reply.

Bill :

I am happy to help with this.

Customer:

Ok

Bill :

I understand your concern about this change - and these are different Classes of medications for the treatment of Depression- SNRI & SSRI however, it is not uncommon for people to switch from Cymnbalta to Prozac for a variety of reasons.

Bill :

There are a number of differences between Cymbalta (duloxetine) versus Prozac (fluoxetine). The main differences between Cymbalta versus Prozac include mechanism of action, the way in which the drug works in the body, and indications for use approved by the U.S. Food and Drug Administration (FDA). Cymbalta is a potent inhibitor of both serotonin and norepinephrine reuptake in the central nervous system, while Prozac is a much more potent inhibitor of serotonin reuptake than norepinephrine. The only common indication between Cymbalta and Prozac is major depressive disorder. Cymbalta belongs to a class of antidepressants known as serotonin norepinephrine reuptake inhibitors (SNRI) and is indicated for the treatment of major depressive disorder, generalized anxiety disorder, diabetic peripheral neuropathic pain, fibromyalgia and chronic musculoskeletal pain. Prozac belongs to a different class of antidepressants known as selective serotonin reuptake inhibitors (SSRI) and is indicated for the treatment of major depressive disorder, obsessive-compulsive disorder, panic disorder and bulimia nervosa. Another difference between Cymbalta versus Prozac is approved use in the pediatric population. While Prozac is currently approved, by the FDA, for the treatment of major depressive disorder and obsessive-compulsive disorder in the pediatric population, both in children and adolescents, the safety and effectiveness of Cymbalta in the pediatric population has not been established. Another difference between Cymbalta versus Prozac is there is currently no generic equivalent available for Cymbalta, while Prozac is available in a generic form, known as fluoxetine. Cymbalta and Prozac have similar adverse reactions and warnings and precautions associated with treatment. However, Cymbalta has been associated with an increased risk of mydriasis (prolonged dilation of the pupils of the eye) and should be used cautiously in patients with controlled narrow-angle glaucoma. Patients should be advised to discuss with their health care provider if they have a past medical history of glaucoma prior to initiation of treatment with Cymbalta. Another difference between Cymbalta versus Prozac, with regard to warnings and precautions, Cymbalta treatment was observed to worsen glycemic control in some patients with diabetes during clinical trials.

Bill :

The proper course to change is to slowly wean off Cymbalta as you start and increase Prozac.

Bill :

Your Doctor should provide direction on the process that will best meet your unique needs. There should be minimal side effects if this is done properly.

Bill :

This should be done over a course of several weeks to minimize negative side effects.

Customer:

Do you mean keep taking cymbalta and prozac at the same time? Right now I am on 60 mg cymbalta and have 20 mg ov prozac here

Customer:

my doctor says they are similar and to just switch should be fne........but I am terrified of side effects.

Bill :

You have to wean off the Cymbalta slowly meaning no more than 25% PER WEEK as you ramp up the Prozac.

Bill :

As long as you wean off slowly while increasing the Prozac you should have minimal side effects.

Customer:

Ok thank you very much.

Bill :

If you start to experience side effects then this is your body telling you that you are going too fast and you need to go slower.

Customer:

I just cannot afford to purchase cymbalta and if I need to buy different mg. of it to wean off I will go broke.

Bill :

I understand-------- I think you will be fine and that your Doctor knows what will work best. As you see in the above information- Prozac is often used to aid in the withdrawal of Cymbalta.

Bill :

If you did well on Prozac before- it should be fine as you begin using again.

Customer:

Thank you Bill.............

Bill :

You are most welcome.

Bill :

All the best to you!

Bill and other Mental Health Specialists are ready to help you