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

Most common
nausea (up to 37%)
somnolence (up to 23%)
dry mouth (up to 22%)
dizziness (up to 19%)

Cymbalta

Most common
nausea (up to 30%)
somnolence (up to 21%)
dry mouth (up to 15%)
dizziness (up to 17%)

Effexor vs. Cymbalta Dosage

Effexor

Dosage
Dosage Table
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

Dosage
Dosage Table
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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