Drug Comparison
For educational purposes only — a decision-support tool, not a substitute for clinical judgment.
Side-by-side rubric across 96 psychiatric medications. Every rating traces to a verbatim primary-source quote — click any cell to see it.
How to read this tool ▾
Rating scale
– Favorable / lower than class baseline
± Minimal / equivocal
+ Low / uncommon
++ Moderate / common
+++ High / very common
++++ Very high / class-outlier
Frequency vs severity
F = frequency, S = severity. Each gets its own pill colored on the same traffic-light scale: green → blue → yellow → orange → red. Click any cell for incidence percentages and NNH.
Evidence tier
A Network meta-analysis / RCT / FDA label
B Cohort / registry / pooled label data
C Expert review / textbook / case series
Sourcing
Click any cell to see the verbatim source quote and citation. Missing data shows n/a.
Data depth
++ Graded — frequency + severity, primary-source traces
+ FDA label — §6 frequency only (dashed border). Click for sub-types.
Blank — not yet checked (not “absent”)
–±++++++++++ABCF = frequency · S = severity · Dashed border = FDA label only · Click cell for details
1 drug selected — Duloxetine(click to collapse)
1/4 selected
Duloxetine
Cymbalta · Duloxetine Delayed-Release · Irenka
Serotonin-Norepinephrine Reuptake Inhibitor
FDA-approved indications
- Major depressive disorder (adults)
- Generalized anxiety disorder (adults; pediatric 7+)
- Diabetic peripheral neuropathic pain (adults)
- Fibromyalgia (adults; pediatric 13+)
Off-label uses
- Stress urinary incontinence
- Chemotherapy-induced neuropathy
Half-life12 hours
Decision GuideWhen to pick each / when to consider an alternative
Duloxetine
Consider when
- Chronic pain comorbidity with depression — only SNRI FDA-approved for DPNP, fibromyalgia, and chronic MSK pain; single agent treats both
- Balanced SNRI effect from starting dose — 10:1 SERT:NET ratio provides dual reuptake inhibition at 30–60 mg without venlafaxine's dose threshold
- Pediatric anxiety or fibromyalgia — unique FDA approvals for GAD (≥7 years) and fibromyalgia (≥13 years) among SNRIs
- Functional impairment is the primary target — ranks second among antidepressants for SDS functional improvement
- +1 more
Consider an alternative when
- Active hepatic disease or chronic alcohol use — FDA hepatotoxicity warning unique among SNRIs; contraindicated in liver disease/cirrhosis
- Emotional blunting is a concern — 75% prevalence (Goodwin 2017), +29 percentage points above SSRI cluster; leading switch reason
- CYP2D6 substrates co-prescribed — moderate CYP2D6 inhibitor unique among SNRIs; desipramine AUC +122%
- On CYP1A2 inhibitor (fluvoxamine, ciprofloxacin) — AUC increase up to 460%; contraindication-level interaction
- +1 more
| Axis | Duloxetine SNRI |
|---|---|
| Boxed Warnings | |
Suicidality (boxed warning) | |
| CNS | |
Sedation / somnolence | |
Activation / insomnia | |
Emotional blunting | |
Seizure risk | |
| Metabolic | |
Weight loss | |
Metabolic (glucose / lipids) | |
| Autonomic | |
Anticholinergic burden | |
Urinary retention / hesitancy | |
Orthostatic hypotension | |
Sweating | |
Angle-closure glaucoma | |
| Cardiac | |
QTc prolongation | |
Heart rate / tachycardia | |
| GI | |
Nausea / GI (general) | |
| Hepatic | |
Liver enzymes / hepatotoxicity | |
| Electrolytes | |
Hyponatremia / SIADH | |
| Sexual | |
Sexual dysfunction | |
| Discontinuation | |
Withdrawal / discontinuation | |
| Interactions | |
Serotonin syndrome risk | |
CYP interactions / DDI profile | |
| Safety | |
Bleeding risk | |
Overdose toxicity | |
| Pregnancy | |
Teratogenicity | |
Lactation / breastfeeding safety | |