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Zoloft or Cymbalta?

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  • Zoloft or Cymbalta?

    I am 15 weeks pregnant and thinking about starting an antidepressant. I've taken Cymbalta in the past and did really well on it, so it's my strong preference to take it again rather than risk something new. But it seems Zoloft is more frequently recommended for pregnancy and breastfeeding. Can you tell me what the difference is regarding safety? Do we know Zoloft to be much safer than Cymbalta, or is it unclear?

  • #2
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    ​In pregnancy Cymbalta (duloxetine) is rated a P3-unknown-risk to fetus cannot be ruled out. Duloxetine is an antidepressant drug that belongs to the class of serotonin-norepinephrine-reuptake inhibitors (SNRIs). For women suffering from depression, pregnancy can be a time for recurrences and relapses and many need to continue on medications throughout the pregnancy. Since duloxetine is a fairly new drug (approved by the FDA in 2004), there are no adequate and well-controlled studies in pregnant women; therefore, duloxetine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. In a study by Boyce, 31 year old pregnant women delivered term, healthy baby. Cord/maternal serum concentration ratio was 0.12 suggesting limited transfer of the drug across the placenta.

    Zoloft (sertraline) is a P3-unknown-risk to fetus cannot be ruled out. Sertraline is an antidepressant drug belonging to the group of selective serotonin reuptake inhibitors (SSRIs). Studies show that the use of this drug in pregnancy does not increase the risk of congenital malformations. This drug has been linked to the development of neonatal abstinence syndrome. It is recommended that infants born to mothers who were on any SSRI during their pregnancy be followed closely for at least 48 hours.

    Originally posted by admin View Post

    We have extensive study on the use of Zoloft(sertraline) in pregnant and breastfeeding women and the overall outcome on the infant is just fine. It is the most commonly used antidepressant in pregnant and breastfeeding women in the world. While it does produce a slight withdrawal in newborn infants (which is normally uneventful), tapering the dose or quitting the last month of pregnancy would certainly remove the risk of withdrawal in your infant (normal rate is around 30% show some withdrawal symptoms).

    Be advised, that the complications of untreated depression are horrific in pregnancy and in a breastfeeding mothers. Keeping yourself healthy (mentally) during this period is very important. Follow your doctors advice and treat your depression and anxiety. Its the best thing for you and your infant.

    Tom Hale Ph.D.
    Director, InfantRisk Center

    I would suggest if the Cymbalta works for you, then you could try it, there is more data on the Zoloft but you need to use what works best for you. I would also suggest reading the articles "Antidepressant Use During Pregnancy and Breastfeeding" and "Depression in Pregnancy and Breastfeeding" on the infantrisk.com site.

    I hope this helps.

    Sandra Lovato R.N.
    InfantRisk Center
    806-352-2519

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    • #3
      I was on cymbalta and paxil for my nerve pain but it made me very moody so I had to get off it.

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