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.
|Drug class||Serotonin-norepinephrine reuptake inhibitors||Serotonin-norepinephrine reuptake inhibitors|
|Form||Oral delayed-release capsule||Extended-release tablet|
|Standard dosage||60 milligrams (mg) once daily||75 mg once daily|
|Half-life||About 12 hours||Up to 11 hours|
|How the drug is metabolized||Through the liver||Through the liver|
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.)
|Major depressive disorder||Yes||Yes|
|Generalized anxiety disorder||Yes||Yes|
|Social anxiety disorder||Off-label||Yes|
|Chronic musculoskeletal pain||Yes||Off-label|
|Chemotherapy-induced peripheral neuropathy||Off-label||No|
|Stress urinary incontinence||Off-label||No|
|Premenstrual dysphoric disorder||No||Off-label|
|Hot flashes (menopausal)||No||Off-label|
|Chronic fatigue syndrome||Off-label||No|
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.
|Decreased sex drive||Yes||Yes|
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 a prescription 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 our free 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
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.
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A Non-Inferiority Comparison of Duloxetine and Venlafaxine in the Treatment of Adult Patients with Generalized Anxiety Disorder. (2008).
A Systematic Review of Duloxetine and Venlafaxine in Major Depression, Including Unpublished Data. (2011).
Taking Depression Seriously: Understanding Medications. (2019).
Treatment Patterns Associated With Duloxetine and Venlafaxine Use for Major Depressive Disorder. (2011).
Venlafaxine Prices, Coupons and Patient Assistance Programs. (n.d.).