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Dr-A-Greene, Psychologist
Category: Mental Health
Satisfied Customers: 309
Experience:  Clinical and Forensic Psychologist
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I have been on 150 mg of zoloft for 13 years working in a

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I have been on 150 mg of zoloft for 13 years working in a high stressful job. Still had occasional heart pounding, but nothing I couldn't handle. Didn't stop me from doing anything or going anywhere. Never missed a day of work for anxiety....Recently changed my medication to Cymbalta 30 mg. I started to notice my mood decreasing, added baclofem. Had anxiety/panic attack at work and have been off work for 8 weeks. Increased cymbalta to 60 mg and now as of today to 90 mg. I have asked my nurse practictioner if this cymbalta works in the same form as the zoloft. Can you explain the difference. Hopefully the 90 mg of cymbalta will help...Right Now I am taking ativan at home but am having severe heart pounding which also pulses in my head very badly
Submitted: 5 years ago.
Category: Mental Health
Expert:  Dr-A-Greene replied 5 years ago.

Zoloft is an SSRI (Selective Serotonin Reuptake Inhibitor), meaning that it makes the serotonin you have more available in the brain. More serotonin = increased mood and less depression.

Cymbalta is an SNRI (Serotonin and Norepinephrine Reuptake Inhibitor). Thus, it affects both serotonin and norepinephrine. Norepinephrine (or noradrenaline, as it is sometimes called) is a neurotransmitter like serotonin (delivers messages in the brain), but it is also a hormone that produces energy in times of stress (think "fight or flight"). So, people with depression that makes them tired or apathetic often respond well to an SNRI because it gives them that shot of energy they need to get going. People with pre-existing anxiety? - Not so much

The only reason I can think of that the Cymbalta was given is because of the muscle tension you were describing. It's often used for pain management and stress in fibromyalgia and the like. However, for anxiety with depression, a straight up SSRI might be better (Prozac, Celexa, Paxil, Zoloft, Lexapro)... Also, the heart pounding might be anxiety, but it could possibly be due to the Cymbalta too, so you might want to give you NP a call.

Does this answer your question?

Customer: replied 5 years ago.
you are saying that cymbalta is not necessarily a drug specifically for anxiety. Like I said we increased to 90 mg,but I don't want to wait three to four weeks to find out its not working, and then have to switch back to the zoloft, as I realize it takes time to get in to your system. The ativan I am taking right now makes me feel more like myself but once it wears off, the heartpounding is back in full force. The zoloft kept it to a minimum. Thanks so much for your help. I will call my NP tomorrow.
Expert:  Dr-A-Greene replied 5 years ago.

You are correct - Cymbalta is not specifically for anxiety. There are other drugs that might work better and have less side effects. Best of luck to you & take care!

Dr. G.

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