Cymbalta vs. Luvox

See how Cymbalta and Luvox compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Cymbalta is an SNRI approved for depression, anxiety, and several chronic pain conditions, while Luvox is an SSRI approved specifically for OCD.

  • Both drugs carry a boxed warning for increased suicidal thoughts in young people and share nausea, headache, and somnolence as common side effects.

  • Luvox requires divided daily dosing at higher amounts and has more drug interactions, while Cymbalta is typically dosed once or twice a day.

Cymbalta vs. Luvox Drug Summary

Cymbalta

Cymbalta (duloxetine) is a serotonin and norepinephrine reuptake inhibitor (SNRI) approved for major depressive disorder, generalized anxiety disorder, and several chronic pain conditions including diabetic neuropathy and fibromyalgia. It comes as a delayed-release capsule, usually taken once a day, sometimes split into two daily doses at the highest dose.

Luvox

Luvox (fluvoxamine) is a selective serotonin reuptake inhibitor (SSRI) approved for obsessive-compulsive disorder in both adults and children ages 8 and up. It comes as an immediate-release tablet, started at a low dose and increased over time, with higher daily amounts split into two doses.

Cymbalta vs. Luvox Side Effects

Cymbalta

Most common
nausea (up to 30%)
somnolence (up to 21%)
headache (up to 18%)
dizziness (up to 17%)

Luvox

Most common
nausea (up to 40%)
somnolence (up to 27%)
headache (up to 35%)
insomnia (up to 35%)

Cymbalta vs. Luvox Dosage

Cymbalta

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 30 mg once daily Week 1
Maximum dose 60 mg once daily Week 2 onward
Dose changes 1 increase Every week

Luvox

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 25 mg once daily At the start
Maximum dose 50 mg once daily Days 1-7
Dose changes 1 increase As tolerated

Cymbalta vs. Luvox Indications

Cymbalta

Cymbalta treats major depressive disorder, generalized anxiety disorder, and several chronic pain syndromes, making it useful when a patient has overlapping mood and pain symptoms. It is not approved for OCD.

  • Major depressive disorder

  • Generalized anxiety disorder

  • Diabetic peripheral neuropathic pain

  • Fibromyalgia

  • Chronic musculoskeletal pain (osteoarthritis, low back pain)

Luvox

Luvox is FDA-approved specifically for obsessive-compulsive disorder in adults and in children as young as 8. It is also prescribed off-label for depression, social anxiety, and panic disorder, though it lacks FDA approval for these uses.

  • Obsessive-compulsive disorder (adults)

  • Obsessive-compulsive disorder (ages 8-17)

  • Off-label: major depressive disorder

  • Off-label: social anxiety disorder

  • Off-label: panic disorder

Cymbalta vs. Luvox Pros and Cons

Cymbalta

Cymbalta stands out for its dual approval in psychiatric and chronic pain conditions, letting one medication address both depression and physical pain. It requires caution in liver or severe kidney disease and tends to cost more than generic alternatives.

Pros

  • Approved for chronic pain conditions like diabetic neuropathy and fibromyalgia

  • Fixed once- or twice-daily dosing without splitting tablets

  • FDA-approved for both depression and anxiety disorders

  • No CYP1A2 interaction concerns with caffeine or theophylline

Cons

  • Must be avoided in chronic liver disease or cirrhosis

  • Must be avoided in severe kidney impairment or end-stage renal disease

  • Not approved for OCD

  • Typically costs $130 to $500 per month without insurance

Luvox

Luvox's main strength is its specific approval for OCD, including in children as young as 8, an option Cymbalta does not offer. It carries notable interactions through CYP1A2 inhibition and generally costs less since only generic versions remain available.

Pros

  • FDA-approved for OCD in children as young as 8

  • Only generic versions are sold, often lowering cost

  • Typically costs $15 to $170 per month without insurance

  • Long track record of use since 1994

Cons

  • Significant CYP1A2 interactions with caffeine, theophylline, and clozapine

  • Not FDA-approved for depression despite common off-label use

  • Requires divided dosing at higher daily amounts

  • Higher rates of insomnia and asthenia than Cymbalta

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