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Anxiety
22 min read
Written by Klarity Editorial Team
Published: Dec 7, 2022
Medically Reviewed by Dr. Zoe Russell
Finding the right medication for depression and anxiety can be overwhelming, especially when so many treatment options are available on the market. How do you know which one is right for you? In this article, we’ll compare Cymbalta vs Effexor; two prescription drugs often prescribed to treat depression and anxiety symptoms.
While both are part of the same drug class called selective serotonin and norepinephrine reuptake inhibitors (SNRIs), each medication has its own unique doses and side effects. Understanding their similarities and differences will help you have an informed discussion with your care provider about which one is right for you.
The healthcare providers on Klarity can help you identify the best medication for you, if applicable. These licensed providers provide access to affordable online depression and anxiety treatment. Find a provider and meet with them in as little as 48 hours.
This article discusses suicide, suicidal ideation, and self-harm. If you or someone you know is experiencing suicidal thoughts or is in crisis, contact the National Suicide Prevention Lifeline, by calling or texting 988 or dialing the Lifeline’s previous phone number, 1-800-273-TALK (1-800-273-8255) in the U.S.
Cymbalta | Effexor | |
Drug Class | Selective serotonin and norepinephrine reuptake inhibitor (SNRI) | Selective serotonin and norepinephrine reuptake inhibitor (SNRI) |
Brand / Generic Status | Brand name for duloxetine | Brand name for venlafaxine |
Form(s) of the Drug | Delayed-release capsule | • Tablets • Delayed-release capsule |
Standard Dosage | Capsules: • 30mg • 60mg | Tablets: • 25 mg • 37.5 mg • 50 mg • 75 mg • 100 mg |
Conditions Treated | FDA-approved uses: • Major depressive disorder • Anxiety disorder Off-label uses: • Nerve pain | FDA-approved uses: • Major depressive disorder • Generalized anxiety disorder • Panic disorder • Social anxiety Off-label uses: • Neuropathic pain related to: • Diabetes • Hot flashes • Migraines • PTSD • OCD • ADHD Complex pain syndromes |
Cost | Generic form (duloxetine): • $4.49 to $53.65 for 30 capsules* Brand-name: • $3.99 to $50.87 for 30 capsules* Prices vary depending on insurance coverage and available coupons | Generic form (venlafaxine): • $1.10 to $22.36 for 30 tablets Brand-name: • $35.35 to $88.39 for 30 tablets Prices vary depending on insurance coverage and available coupons30 tablets |
Side-Effects | Common side effects: • Difficulty sleeping • Dry mouth • Headaches • Dizziness • Blurry vision • Constipation • Diarrhea • Nausea and vomiting • Sweating • Fatigue • Weight loss • Loss of appetite • Decreased sex drive • Difficulty orgasming or maintaining an erection Serious side effects: • Hallucinations • Excessive euphoria • Prolonged restlessness • Constant headaches or muscle cramps • Eye pain or blurred vision • Yellowing skin or eyes • Bloody urine or cough • Bloody gums or inexplicable bruising | Common side effects: • Sweating • Headache • Nausea • Diarrhea • Dry mouth • Nervousness • Fatigue • Insomnia • Difficulty orgasming • High blood pressure Serious side effects: • Increased heart rate • Low blood pressure • Increased salivation • Irregular menstrual cycle • Weakness • Teeth grinding • Difficulty urinating • Eye pain or vision problems • Serotonin syndrome |
Warnings For Use | Drug interactions: • MAOIs • Adderall • Flexeril • Tramadol • Trazodone • Aspirin • Baclofen • Clonazepam • Gabapentin • Klonopin • Lyrica • Oxycodone • Xanax | Drug interactions: • MAOIs • Adderall • Tramadol • Trazodone • Wellbutrin • Abilify • Ambien • Aspirin • Clonazepam • Gabapentin • Klonopin • Lamictal • Lyrica • Seroquel • Xanax |
Cymbalta is an SNRI known as duloxetine in its generic form. SNRIs block the reabsorption of neurotransmitters like serotonin and norepinephrine, which contribute to our overall mood and energy. When reuptake is stopped, higher levels of these neurotransmitters in our system help us feel better and more energized.
Cymbalta comes as a delayed-release capsule, and your dosage varies based on your current symptoms, health history, and the recommendation of your care provider. Always take Cymbalta exactly as prescribed to avoid adverse side effects.
For people experiencing depression, you may be prescribed 30 to 60 mg a day. If you have anxiety symptoms, your dose may be 30 to 120 mg daily. Your care provider may start you on a lower dose and gradually increase the amount as you progress through your treatment plan.
Cymbalta is FDA-approved to treat major depressive disorder and anxiety disorder. It can also be prescribed for other conditions in an off-label capacity.
Cymbalta is an antidepressant that treats symptoms of anxiety and depression, including the following.
For depression:
For anxiety disorders:
Beyond treating major depression and anxiety disorder, Cymbalta can also be prescribed off-label to treat nerve pain associated with diabetes. Off-label use of medications means that while it may not be FDA-approved to treat nerve pain, it has been an effective treatment if other medicines fail.
The cost of Cymbalta varies based on your prescribed dose, the pharmacy you use, and your insurance coverage. You can expect to pay anywhere from $3.99 to $50.87 for 30 capsules of 30 mg. Talk with your care provider about taking the generic form of Cymbalta, Duloxetine, as it can be more affordable than the brand name.
Everyone’s experience taking medication differs, so you should monitor how you respond to Cymbalta as you begin taking it. The common side effects of Cymbalta include the following:
Some side effects will dissipate as your body acclimates to the medication. If you experience any of the following more serious side effects, contact emergency medical services immediately.
You should not take Cymbalta if you have narrow-angle glaucoma or if you’ve taken any of the following MAO Inhibitors within the last two weeks.
Additionally, if you experience any significant mood changes or start having thoughts of self-harm, contact your care provider immediately. They will advise you to either safely stop taking the medication or adjust your dose to alleviate unwanted side effects.
Cymbalta interacts with 576 drugs, with 103 major interactions, 450 moderate interactions, and 23 minor interactions. When cross-checked with the most frequently prescribed medications, Cymbalta has major interactions with Adderall, Flexeril, Tramadol, and Trazodone. This medication has moderate interactions with the following drugs.
You should discuss any other medications you’re taking with your care provider before trying Cymbalta to ensure it’s safe for you.
Effexor, called Venlafaxine in its generic form, is also a medication within the SNRI drug class. It works by increasing mood-enhancing chemicals in our brains to help alleviate symptoms of anxiety and depression.
Everyone experiences anxiety and depression differently, which means the dose you’ll take depends on your symptoms and your healthcare provider’s recommendation.
Effexor comes as a tablet or an extended-release capsule typically prescribed at 75 mg per day, once daily. If you experience more severe symptoms, your care provider may increase your dose to a maximum of 375 mg, but you must be titrated up in dosages
Effexor is an antidepressant approved to treat major depressive disorder, generalized anxiety disorder, panic disorder, and social anxiety. This medication has also been used off-label to treat other psychiatric conditions.
While Effexor treats the same symptoms of anxiety and depression as Cymbalta, it’s also been effective in treating symptoms of panic disorder.
Symptoms of panic disorder include the following.
Effexor can be prescribed off-label to treat neuropathic pain related to diabetes, hot flashes, migraines, fibromyalgia, PTSD, OCD, ADHD, and complex pain syndromes. The FDA doesn’t approve this medication to treat these specific conditions, but some people experience relief by using Effexor as directed by their care provider.
How much you pay for Effexor depends on the pharmacy you use, your insurance coverage, and your prescribed dose. However, you can expect to pay anywhere from $35.35 to $88.39 monthly for 30 tablets at 75 mg. If the generic form, Venlafaxine, is available, it’s often a more cost-effective option.
You should always take Effexor exactly as prescribed to avoid adverse reactions. Common side effects include the following, which will often improve over time.
Taking Effexor can also result in problems with orgasming or ejaculatory delay and high blood pressure. It’s important to speak with your healthcare provider if these side effects persist. Additionally, consult your healthcare provider immediately if you experience any of the following.
If you take Effexor, there’s an increased risk of Serotonin Syndrome. Serotonin Syndrome occurs when there’s too much serotonin in your system, resulting in mild symptoms like shivering or diarrhea to severe symptoms like muscle rigidity. Serotonin Syndrome can be fatal, so speak to your care provider right away if you have these symptoms.
You may be at an increased risk for bleeding, especially if you take Effexor with other anti-inflammatory medications like aspirin or ibuprofen. If you experience excessive bleeding from your gums, nose, or gastrointestinal bleeding, contact your healthcare provider immediately or seek emergency care.
Effexor interacts with 662 drugs, with 143 major interactions, 515 moderate interactions, and four minor interactions. Of the most frequently checked medications, Effexor has major interactions with Adderall, Tramadol, Trazodone, and Wellbutrin. Moderate interactions occur with the following drugs.
Speak with your mental health provider before taking Effexor or stopping its use to ensure your safety.
Besides their common use to treat anxiety and depression, Cymbalta and Effexor have been proven effective in managing various other medical conditions.
Cymbalta has been approved for the management of chronic musculoskeletal pain and fibromyalgia, in addition to treating nerve damage associated with diabetes, known as diabetic peripheral neuropathy.
Effexor can be utilized to treat social anxiety disorder and panic disorder. It might also be prescribed for obsessive compulsive disorder (OCD) as part of a comprehensive treatment plan from a medical provider.
It’s essential to note that the effectiveness of Cymbalta and Effexor can vary greatly depending on the specific condition being treated. Therefore, getting an evaluation by a healthcare provider is crucial to determine if either medication is suitable for a particular condition other than anxiety or depression.
Getting anxiety and depression treatment doesn’t have to involve navigating neverending wait times, taking off work, or long commutes.
At Klarity, we connect you with trained mental health providers online so that you can get treatment from the comfort of your own home when it’s convenient for you. Your provider will review your medical history and current symptoms to determine whether Cymbalta or Effexor is right for you.
Start your journey to better mental health, and schedule an appointment today.
Some people gain weight when taking Cymbalta long-term. However, with a healthy diet and exercise, most people can return to their regular weight. On the other hand, weight gain is associated less with f Effexor, and it can even aid in weight loss
Both Cymbalta and Effexor (SNRIs in general) are more energizing than sedating, and tend to cause insomnia over drowsiness. Once you understand how your body responds to the medication, your care provider may give you the clear to take your medication at a different time.
Your mental healthcare provider may recommend switching from Cymbalta to Effexor, especially if Cymbalta doesn’t seem to be working after a period of time. Always follow your provider’s instructions to switch from one medication to another safely. You may have to taper off Cymbalta before starting Effexor.
Cymbalta and Effexor (SNRIs in general) are more energizing than sedating, and tend to cause insomnia over drowsiness. Once you understand how your body responds to the medication, your care provider may give you the clear to take your medication at a different time.
Cymbalta and Effexor do have brain fog or confusion as possible side effects. If you experience persistent brain fog, contact your care provider immediately.
Alcohol can alter the effects of Cymbalta and Effexor, resulting in serious adverse effects. You should not drink alcohol when taking either of these medications unless your healthcare provider tells you it’s okay.
Drinking caffeine with Cymbalta can increase your risk of developing Serotonin Syndrome. Caffeine can also impact the effectiveness of Effexor, so you should speak with your care provider before drinking caffeinated beverages with either medication.
Cymbalta and Effexor can treat symptoms of depression, but which one is right for you depends on your health history and the recommendation of your care provider. Some may respond better to Effexor as a short-term relief option for depression symptoms, whereas others may find Cymbalta to be a better choice.
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