Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major…
Worth asking your prescriber how duloxetine's tolerability compares with antidepressants that had lower dropout rates in this analysis (such as escitalopram or sertraline) if side effects are making it hard to stay on.
Top of the evidence hierarchy, independently funded. how we score evidence
Caveat on this rating: Review itself was publicly funded, but several authors declared lecture or consultancy fees from pharmaceutical companies, and most included trials were industry sponsored.
In 522 trials covering 116,477 adults with major depression, duloxetine — like all 21 antidepressants studied — beat placebo for response (drug odds ratios ranged 1.37 to 2.13), but in head-to-head comparisons duloxetine was among the seven drugs with the highest dropout rates (odds ratios 1.30 to 2.32).
Worth asking
Worth asking your prescriber how duloxetine's tolerability compares with antidepressants that had lower dropout rates in this analysis (such as escitalopram or sertraline) if side effects are making it hard to stay on.
What it is FDA approved for
Read off the label. Trial duration and approval year are shown only where they were recorded — never inferred.
- Major depressive disorder (adults)
- Generalized anxiety disorder (adults and pediatric patients 7 years and older)
- Diabetic peripheral neuropathic pain (adults)
- Fibromyalgia (adults and pediatric patients 13 years and older)
- Chronic musculoskeletal pain (adults)
Source
Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis — Cipriani A, et al. (2018)
Top-tier peer-reviewed journal
Read the source: https://doi.org/10.1016/S0140-6736(17)32802-7
DOI: 10.1016/S0140-6736(17)32802-7
How this was scored
- Study design
- Meta-analysis of randomised trials
- Funding
- Independently funded
- Published in
- Top-tier peer-reviewed journal
- Sample size
- 116,477
- Preregistered
- Yes
- Conflicts disclosed
- Yes
- Independent of proponent
- Yes
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published August 19, 2026.
Questions
How strong is the evidence behind this?
Resolv rates this source "gold standard". Top of the evidence hierarchy, independently funded. It scores 100 out of 100 on our published rubric. One caveat travels with that badge: Review itself was publicly funded, but several authors declared lecture or consultancy fees from pharmaceutical companies, and most included trials were industry sponsored. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis — Cipriani A, et al. (2018). Published in: Top-tier peer-reviewed journal. DOI: 10.1016/S0140-6736(17)32802-7. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Meta-analysis of randomised trials. Funding: Independently funded. The researchers were independent of whoever benefits from the result. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is duloxetine (Cymbalta), cymbalta FDA approved?
Yes — FDA approved for Major depressive disorder (adults), Generalized anxiety disorder (adults and pediatric patients 7 years and older), Diabetic peripheral neuropathic pain (adults), Fibromyalgia (adults and pediatric patients 13 years and older), Chronic musculoskeletal pain (adults). Approval is for a specific indication, not for everything the drug is prescribed for.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.