Effexor vs. Cymbalta
See how Effexor and Cymbalta compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Effexor and Cymbalta are both SNRIs used for depression and anxiety, but Cymbalta also has FDA approval for several chronic pain conditions that Effexor does not.
Effexor is FDA-approved for social anxiety disorder and panic disorder, while Cymbalta is approved for fibromyalgia and diabetic nerve pain instead.
Both drugs carry a boxed warning for suicidal thoughts in young people and require gradual dose changes to avoid withdrawal symptoms.
Effexor vs. Cymbalta Drug Summary
Effexor
Effexor (venlafaxine) is a serotonin-norepinephrine reuptake inhibitor (SNRI) approved for major depressive disorder, generalized anxiety disorder, social anxiety disorder, and panic disorder. It is usually taken as an extended-release capsule once daily, with the dose increased gradually. An immediate-release tablet also exists but needs multiple daily doses.
Cymbalta
Cymbalta (duloxetine) is an SNRI approved for major depressive disorder, generalized anxiety disorder, and several chronic pain conditions, including diabetic nerve pain and fibromyalgia. It is taken as a delayed-release capsule, once or twice daily depending on the dose. Treatment starts low and is increased after the first week.
Effexor vs. Cymbalta Side Effects
Effexor
Cymbalta
Effexor vs. Cymbalta Dosage
Effexor
Cymbalta
| STAGE | DOSE | WHEN |
| Starting dose | 37.5 mg once daily | Days 1-7 |
| Maximum dose | 225 mg once daily | If needed |
| Dose changes | 3 increases | Every 7 days |
| 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 |
Effexor
| STAGE | DOSE | WHEN |
| Starting dose | 37.5 mg once daily | Days 1-7 |
| Maximum dose | 225 mg once daily | If needed |
| Dose changes | 3 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 |
Effexor vs. Cymbalta Indications
Effexor
Effexor treats major depressive disorder along with three anxiety-related conditions: generalized anxiety disorder, social anxiety disorder, and panic disorder. Doctors sometimes prescribe it off-label for nerve pain or menopausal hot flashes, though those uses are not FDA-approved.
Major depressive disorder (MDD)
Generalized anxiety disorder (GAD)
Social anxiety disorder (SAD)
Panic disorder, with or without agoraphobia
Off-label: nerve pain and menopausal hot flashes
Cymbalta
Cymbalta treats major depressive disorder and generalized anxiety disorder, plus several chronic pain conditions: diabetic nerve pain, fibromyalgia, and chronic musculoskeletal pain. It is one of the few SNRIs FDA-approved specifically for pain management alongside psychiatric use.
Major depressive disorder (MDD)
Generalized anxiety disorder (GAD)
Diabetic peripheral neuropathic pain
Fibromyalgia
Chronic musculoskeletal pain (osteoarthritis, low back pain)
Effexor vs. Cymbalta Pros and Cons
Effexor
Effexor has a long track record dating back to 1997 and is available as an inexpensive generic. It covers a broader range of FDA-approved anxiety disorders than Cymbalta, but it has no approved use for chronic pain.
Pros
Approved for social anxiety disorder and panic disorder
Available as generic for as little as $10 to $45 a month
Long safety track record since 1997
Cons
Not approved for fibromyalgia or any chronic pain condition
Can raise blood pressure at higher doses
Requires slow taper to avoid withdrawal symptoms
Cymbalta
Cymbalta stands out for its FDA approval in chronic pain conditions like fibromyalgia and diabetic neuropathy, not just psychiatric use. It requires more caution in people with liver or kidney problems and typically costs more than generic Effexor.
Pros
Approved for fibromyalgia and chronic musculoskeletal pain
Approved for diabetic peripheral neuropathy
Broader range of FDA-approved pain indications than Effexor
Cons
Must avoid with liver disease or cirrhosis
Must avoid with severe kidney impairment
Typically costs $130 to $500 a month, more than generic Effexor
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