Cymbalta vs. Effexor: Similarities, Differences, & Side Effects - K Health (2024)

Medication can be incredibly helpful for people who have depression and anxiety.

And the variety of options is a great thing, because you’re more likely to find a treatment that’s compatible with other medications you may be taking as well as your lifestyle.

Cymbalta (a brand name of duloxetine) and Effexor (a brand name of venlafaxine) are two common medications for treating major depression and anxiety disorders.

While these are both serotonin and norepinephrine reuptake inhibitors (SNRIs), each drug is slightly different.

To help anyone considering the two drugs, in this article, we’ll cover the differences and similarities between Cymbalta and Effexor, including what they treat, which one is more effective, possible side effects, and potential drug interactions.

Always consult your doctor before ending or changing the use of these medications.

What Are the Differences & Similarities Between Cymbalta and Effexor?

Cymbalta and Effexor are both SNRIs, or serotonin and norepinephrine reuptake inhibitors. They work by boosting levels of serotonin and norepinephrine in the brain. These two neurotransmitters play a role in mood.

Healthcare providers prescribe Cymbalta and Effexor to treat major depression, anxiety disorders, and other psychiatric disorders.

The chart below breaks down the main similarities and differences between Cymbalta and Effexor.

CymbaltaEffexor
Drug classSerotonin-norepinephrine reuptake inhibitorsSerotonin-norepinephrine reuptake inhibitors
Generic nameDuloxetineVenlafaxine
FormOral delayed-release capsuleExtended-release tablet
Standard dosage60 milligrams (mg) once daily75 mg once daily
Half-lifeAbout 12 hoursUp to 11 hours
How the drug is metabolizedThrough the liverThrough the liver

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What Conditions Are Treated with Cymbalta and Effexor?

Cymbalta and Effexor are both prescribed to treat major depressive disorders and generalized anxiety disorders.

Each is also prescribed for a few other medical conditions, as outlined below.

(Note: “Off-label” means healthcare providers prescribe the medication for this condition, however, the medication does not have FDA approval to treat that condition.)

ConditionCymbaltaEffexor
Major depressive disorderYesYes
Generalized anxiety disorderYesYes
Panic disorderOff-labelYes
Social anxiety disorderOff-labelYes
Chronic musculoskeletal painYesOff-label
FibromyalgiaYesOff-label
Diabetic neuropathyYesOff-label
Chemotherapy-induced peripheral neuropathyOff-labelNo
Stress urinary incontinenceOff-labelNo
Obsessive-compulsive disorderNoOff-label
PTSDNoOff-label
CataplexyNoOff-label
Premenstrual dysphoric disorderNoOff-label
Hot flashes (menopausal)NoOff-label
Migraine preventionNoOff-label
Attention-deficit disorderNoOff-label
Chronic fatigue syndromeOff-labelNo

Is Cymbalta or Effexor More Effective?

Few clinical studies directly compare Cymbalta and Effexor. Additionally, everyone may respond differently to each medication.

That said, according to a systematic review of 70 studies, both Cymbalta and Effexor are more effective than placebo for the short-term treatment of major depressive disorder.

Additionally, Effexor may be more tolerable and effective for people who wish to switch from selective serotonin reuptake inhibitors (SSRIs) or tricyclic and tetracyclic antidepressants.

And, according to another study, duloxetine and venlafaxine are equally effective and tolerable for treating generalized anxiety disorders.

Cost & Coverage of Cymbalta vs. Effexor

The cost of Cymbalta and Effexor varies depending on your insurance provider or Medicare plan, pharmacy, and dosage.

A 21-day supply of 60-mg Cymbalta costs around $250, while duloxetine is about $20 for a month’s worth of the same strength pills.

Many insurance companies cover Cymbalta or the generic duloxetine so you only pay a copay. Medicare covers duloxetine.

Effexor costs about $520 for a 30-day supply of 75-mg tablets, and venlafaxine is about $12 for the same dosage and number of pills. Medicare and many insurance plans cover the generic venlafaxine.

What Are the Side Effects of Cymbalta and Effexor?

Cymbalta and Effexor share many common adverse effects. The chart below outlines these effects. Keep in mind that everyone reacts differently. You may experience very few or none of these.

Side EffectCymbaltaEffexor
NauseaYesYes
HeadacheYesYes
DrowsinessYesYes
Dry mouthYesYes
ConstipationYesYes
Increased sweatingYesYes
Decreased appetiteYesYes
FatigueYesYes
DiarrheaYesYes
InsomniaYesYes
DizzinessYesYes
Abdominal painYesYes
Abnormal visionYesYes
Heart palpitationsYesYes
Decreased sex driveYesYes

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Drug Interactions & Warnings

Both Cymbalta and Effexor, like other antidepressants, carry black box warnings, which indicate that there is increased risk of developing worsening depression, suicidal thinking and behavior, that can be markedly increased in children, adolescents, and young adults, but can happen to anyone.

If you or your loved ones are taking either of these medications or any antidepressant, please watch out for the following warning signs that will require immediate medical attention:

  • Unusual changes in behavior
  • Worsening symptoms of depression including hopelessness, feeling of worthlessness)
  • Increase in conversations about death
  • Thoughts or talk of self-harm

If any of the above symptoms occur, please seek immediate medical attention.

Cymbalta and Effexor can interact with some other medications, which could make the SNRI less effective or increase the risk of harmful side effects.

That’s why it’s important to tell your doctor about any medicines that you take, including prescriptions, over-the-counter (OTC) drugs, herbal supplements, and vitamins.

That way they can help you determine the best and safest treatment for you.

Cymbalta and Effexor should not be used with:

  • Other serotonergic drugs: Taking Cymbalta or Effexor when you also take selective serotonin reuptake inhibitors (SSRIs, like fluoxetine (Prozac) or paroxetine (Paxil)), other serotonin norepinephrine reuptake inhibitors (SNRIs like Desvenlafaxine (Pristiq) and Levomilnacipran (Fetzima)), or tricyclic antidepressants (TCAs, like amitriptyline or nortriptyline). The combination of medications may increase the risk of serotonin syndrome. This is when the brain has dangerously high levels of serotonin, and lead to symptoms such as confusion, headaches, and—in more severe cases—hallucinations, seizures, or a coma.
  • Monoamine oxidase inhibitors: Using MAOIs like phenelzine (Nardil) or isocarboxazid (Marplan) can also increase the risk of serotonin syndrome. Do not use Cymbalta and Effexor within 14 days of discontinuing an MAOI either.
  • Nonsteroidal anti-inflammatory drugs: NSAIDs include Aspirin (Bayer, Excedrin), ibuprofen (Motrin, Advil), and naproxen (Aleve). When combined with Cymbalta or Effexor, these can increase the risk of bleeding.
  • Anticoagulants or blood thinners: These also increase the risk of bleeding.

Lastly, anyone with severe kidney or liver problems should avoid Cymbalta, as there is a potential risk of further damage to these organs. However, Effexor may be safe to take in lower doses for those with kidney or liver issues.

How K Health Can Help

Think you might need aprescription for Effexor (Venlafaxine) or a prescription for Cymbalta (Duloxetine)?

K Health has clinicians standing by 24/7 to evaluate your symptoms and determine which prescription is right for you.

Get started with ourfree assessment, which will tell you in minutes if treatment could be a good fit. If yes, we’ll connect you right to a clinician who can prescribe medication and have it shipped right to your door.

Frequently Asked Questions

Is Cymbalta better than Effexor?

The best medication for depression or anxiety depends on the individual and the condition being treated. Both Cymbalta and Effexor are FDA-approved for treating major depressive disorders, and generalized anxiety disorders.. Cymbalta is also FDA-approved for some chronic pain disorders (like fibromyalgia and diabetic peripheral neuropathy). Both prescription medications also come with potential side effects and interact with other drugs. Speak to your healthcare provider about which antidepressant is the right fit for you.

Are Cymbalta and Effexor the same?

Cymbalta and Effexor are not the same. However, both are part of a class of drugs known as SNRIs or serotonin and norepinephrine reuptake inhibitors. They increase the availability of serotonin and norepinephrine in the brain. These neurotransmitters impact mood and can influence psychiatric conditions. Both Cymbalta and Effexor can be used to treat major depression and anxiety disorders, and Cymbalta is also prescribed for some chronic pain disorders and muscular conditions. Talk to your doctor about which medication is best for you.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.

Cymbalta vs. Effexor: Similarities, Differences, & Side Effects - K Health (2024)

FAQs

Which is safer, Cymbalta or Effexor? ›

Cymbalta is associated with a risk of liver damage, and Effexor carries a risk of developing interstitial lung diseases. Common side effects from taking Cymbalta may include: Nausea. Fatigue.

What is the most common side effect of Effexor? ›

Nausea. Nausea was the most common side effect of Effexor reported in clinical trials. About one-third of people taking Effexor reported nausea. The higher your Effexor dosage, the more likely nausea is.

How do duloxetine and venlafaxine differ? ›

Duloxetine and venlafaxine XR have similar mechanisms of action, but duloxetine has a more balanced affinity for both serotonin and norepinephrine transporters, whereas venlafaxine has a higher affinity for serotonin than norepinephrine transporters [15, 16].

What is a natural equivalent to Cymbalta? ›

Natural Alternatives to Cymbalta
  • Omega-3 fatty acids. Omega-3 fatty acids are known for heart health benefits and the ability to support mental health. ...
  • Vitamin D. Known as the sunshine vitamin, Vitamin D can boost mood, which might make it a potential alternative to Cymbalta for depression. ...
  • L-theanine. ...
  • Lifestyle changes.
Nov 30, 2023

What is the downside of Cymbalta? ›

Downsides

Drowsiness, insomnia, nausea, headache, dry mouth, constipation, and dizziness.

What is the safest antidepressant on the market? ›

5 most tolerated antidepressants
  • Celexa (citalopram)
  • Lexapro (escitalopram)
  • Prozac (fluoxetine)
  • Trintellix (vortioxetine)
  • Zoloft (sertraline)

Why was Effexor banned? ›

The reason for banning this particular antidepressant drug is . that it is one of the most dificult antidepressant drugs to withdraw from. Despite the severe withdrawal symptoms, there is no mention of this in the patient information leaflet provided with the drug.

Is Effexor hard on your heart? ›

In summary, venlafaxine poisoning is associated with an unexpectedly high prevalence of cardiovascular adverse events. Tachycardia and QTc prolongation are dose-dependent effects which may be linked to development of arrhythmia in certain patients and require further evaluation.

What are the long term issues with Effexor? ›

Yes, long-term side effects of Effexor XR are possible. Examples include weight gain, weight loss, and eye problems such as closed-angle glaucoma. It's possible that taking Effexor XR for a longer period of time may raise your risk for long-term side effects.

Is Cymbalta energizing or sedating? ›

Duloxetine oral capsule can cause sleepiness or may affect your ability to make decisions, think clearly, or react quickly. You shouldn't drive, use heavy machinery, or do other dangerous activities until you know how it affects you. It can also cause other side effects.

Is Effexor energizing or sedating? ›

Depending on your symptoms, Effexor can be either an activating or sedating medication. It will help to sedate unwanted nervous ticks, like shaking and tension, but activate energy and increase your desire to engage in the activities you like to do.

What is the closest drug to Effexor? ›

Effexor (venlafaxine) is an SNRI. Other SNRIs for depression include Pristiq (desvenlafaxine), Fetzima (levomilnacipran), and Cymbalta (duloxetine).

What is safer than Cymbalta? ›

Lexapro. For patients who worry about the long-term side effects of Cymbalta, Lexapro might be the right alternative drug. Its generic name is escitalopram, and it is a selective serotonin reuptake inhibitor (SSRI).

What herbs Cannot be taken with Cymbalta? ›

Do not take the herbal remedy St John's wort while you're being treated with duloxetine, as this will increase your risk of side effects. There's not enough information to say that other herbal remedies and supplements are always safe to take with duloxetine.

What supplements should I avoid while taking Cymbalta? ›

Herbal Supplements

Like St. John's Wort when mixed with Cymbalta can lead to a greater risk of serotonin syndrome or less effective Cymbalta, also when Kava is mixed with Cymbalta it can lead to a rise in liver toxicity, So let your doctor know all herbal products you are taking.

Which SNRI has the least amount of side effects? ›

Which SSRI antidepressants have the least side effects?
  • Celexa. Overall, Celexa seems to be one of the best-tolerated SSRIs for many people. ...
  • Lexapro. Lexapro is closely related to Celexa. ...
  • Prozac. Prozac causes less weight gain than other SSRIs. ...
  • Zoloft.
Mar 15, 2023

Is Effexor a high risk medication? ›

Increased risk of suicidal thoughts and actions: EFFEXOR XR may increase suicidal thoughts and actions in some children, adolescents, and young adults, especially within the first few months of treatment or when the dose is changed.

Is Cymbalta a high risk medication? ›

One such condition caused by Cymbalta, though rare, is serotonin syndrome, which occurs when the drug forces the body to build up abnormally high levels of serotonin. Serotonin syndrome can cause dangerous changes in blood pressure and heart rate, loss of muscle control, and even seizures.

Who should avoid Cymbalta? ›

To make sure it's safe for you, tell your doctor if you:
  • have ever had an allergic reaction to duloxetine or any other medicine.
  • have kidney or liver problems.
  • have a heart problem.
  • are taking or have taken other medicines for depression within the last 14 days.

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