Cymbalta vs. Viibryd
See how Cymbalta and Viibryd 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 Viibryd is a SPARI approved only for major depressive disorder in adults.
Cymbalta's most common side effects are nausea and somnolence, while Viibryd's most common are diarrhea and nausea, and Viibryd must be taken with food to absorb properly.
Both drugs carry a boxed warning for suicidal thoughts in young people, but Viibryd carries added warnings for serotonin syndrome and angle-closure glaucoma risk.
Cymbalta vs. Viibryd 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 like diabetic neuropathy and fibromyalgia. It comes as a delayed-release capsule taken once or twice daily and has been available since 2004.
Viibryd
Viibryd (vilazodone) is a serotonin partial agonist and reuptake inhibitor (SPARI) approved only for major depressive disorder in adults. It is an oral tablet taken once daily with food, since food is needed for proper absorption, and has been available since 2011.
Cymbalta vs. Viibryd Side Effects
Cymbalta
Viibryd
Cymbalta vs. Viibryd Dosage
Cymbalta
Viibryd
| STAGE | DOSE | WHEN |
| Starting dose | 30 mg once daily | Week 1 |
| Maximum dose | 60 mg twice daily | If needed |
| Dose changes | 2 increases | Every week |
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg once daily | Days 1-7 |
| Maximum dose | 40 mg once daily | Day 15 onward |
| Dose changes | 2 increases | Every 7 days |
Cymbalta
| STAGE | DOSE | WHEN |
| Starting dose | 30 mg once daily | Week 1 |
| Maximum dose | 60 mg twice daily | If needed |
| Dose changes | 2 increases | Every week |
Viibryd
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg once daily | Days 1-7 |
| Maximum dose | 40 mg once daily | Day 15 onward |
| Dose changes | 2 increases | Every 7 days |
Cymbalta vs. Viibryd Indications
Cymbalta
Cymbalta treats depression and anxiety, but its unique advantage is FDA approval for chronic pain conditions like diabetic neuropathy, fibromyalgia, and musculoskeletal pain. This makes it a common choice when depression coexists with chronic pain.
Major depressive disorder (MDD)
Generalized anxiety disorder (GAD)
Diabetic peripheral neuropathic pain
Viibryd
Viibryd is approved only for major depressive disorder in adults, with no additional FDA-approved uses. It is not approved for pediatric depression, and clinicians sometimes use it off-label as an alternative to standard SSRIs.
Major depressive disorder (MDD) in adults
Not approved for pediatric MDD
No additional FDA-approved indications
Cymbalta vs. Viibryd Pros and Cons
Cymbalta
Cymbalta's broad approval for pain conditions plus depression makes it useful for patients with overlapping symptoms. It has been on the market since 2004 and is available as a lower-cost generic, but it requires caution in patients with liver or severe kidney disease.
Pros
Approved for chronic pain conditions like fibromyalgia and diabetic neuropathy
Available as a lower-cost generic, roughly $130 to $500 per month without insurance
Long track record, FDA-approved since 2004
Can be dosed once or twice daily for flexibility
Cons
Contraindicated in chronic liver disease and severe kidney impairment
Higher rates of nausea and somnolence than Viibryd
Can cause dry mouth and constipation more than Viibryd
May require twice-daily dosing at higher doses
Viibryd
Viibryd's distinct mechanism, partial serotonin receptor activity, may lower the risk of sexual side effects compared to older antidepressants. It has a simple once-daily schedule, but it must be taken with food and typically costs more since no generic is widely available.
Pros
Distinct mechanism (partial 5-HT1A agonism) may lower sexual side effects
Simple once-daily dosing with no dose increase beyond day 15
Lower rates of dry mouth and constipation than Cymbalta
Not associated with the somnolence risk seen with Cymbalta
Cons
Must be taken with food; absorption drops significantly without it
No widely available generic, typically $380 to $650 per month without insurance
Only approved for depression, not anxiety or pain conditions
Additional warnings for serotonin syndrome and angle-closure glaucoma
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