Lexapro vs. Cymbalta
See how Lexapro and Cymbalta compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Lexapro is an SSRI approved for depression and anxiety, while Cymbalta is an SNRI also approved for chronic pain conditions like fibromyalgia and diabetic nerve pain.
Cymbalta requires a week-long titration up to 30 mg before its maintenance dose, while Lexapro starts right at a 10 mg maintenance dose.
Nausea and somnolence are common with both drugs, but Cymbalta's reported rates for these and other side effects run higher than Lexapro's.
Lexapro vs. Cymbalta Drug Summary
Lexapro
Lexapro (escitalopram) is a selective serotonin reuptake inhibitor (SSRI) approved to treat major depressive disorder and generalized anxiety disorder in adults, and depression in adolescents 12 to 17. It is taken as a single daily tablet or oral solution, usually starting at 10 mg.
Cymbalta
Cymbalta (duloxetine) is a serotonin and norepinephrine reuptake inhibitor (SNRI) approved for depression, generalized anxiety disorder, and several chronic pain conditions including diabetic nerve pain and fibromyalgia. It is taken as a delayed-release capsule, starting at 30 mg for one week before increasing, with pain doses sometimes split twice daily.
Lexapro vs. Cymbalta Side Effects
Lexapro
Cymbalta
Lexapro vs. Cymbalta Dosage
Lexapro
Cymbalta
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg once daily | Week 1 |
| Maximum dose | 20 mg once daily | Week 2 onward |
| Dose changes | 1 increase | Every week |
| 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 |
Lexapro
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg once daily | Week 1 |
| Maximum dose | 20 mg once daily | Week 2 onward |
| Dose changes | 1 increase | Every week |
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 |
Lexapro vs. Cymbalta Indications
Lexapro
Lexapro is FDA-approved to treat major depressive disorder in adults and adolescents ages 12 to 17, as well as generalized anxiety disorder in adults. It is not approved for depression in children under 12 or for anxiety in pediatric patients.
Major depressive disorder in adults and teens 12-17
Generalized anxiety disorder in adults
Not approved for pediatric anxiety
Available as tablet or oral solution
Cymbalta
Cymbalta is FDA-approved for major depressive disorder and generalized anxiety disorder, plus three pain-related conditions: diabetic peripheral neuropathy, fibromyalgia, and chronic musculoskeletal pain. This makes it one of the few SNRIs approved for both psychiatric and chronic pain use.
Major depressive disorder
Generalized anxiety disorder
Diabetic peripheral neuropathic pain
Fibromyalgia
Lexapro vs. Cymbalta Pros and Cons
Lexapro
Lexapro's clinical profile centers on psychiatric use only, with a side effect pattern that tends to be milder than Cymbalta's in trials. Generic escitalopram is widely available, which often makes it an affordable pick for insured and uninsured patients alike.
Pros
Approved for depression and anxiety, not marketed for pain
Lower reported rates of nausea and somnolence than Cymbalta
Generic escitalopram is widely available
Cons
Not approved for any chronic pain condition
Sexual side effects like ejaculation disorder are common
Contraindicated with MAOIs and pimozide
Cymbalta
Cymbalta's dual approval for mood and pain conditions makes it a common choice for patients managing both, though its side effect rates run higher across the board. Its titration schedule and organ-related precautions call for more monitoring than a simpler SSRI.
Pros
Approved for chronic pain conditions like diabetic neuropathy and fibromyalgia
Twice-daily high-dose option available for pain control
Broader label covering five separate FDA-approved conditions
Cons
Higher reported rates of nausea, somnolence, headache, and dizziness
Must be avoided in liver disease, cirrhosis, or severe kidney impairment
More complex titration schedule with multiple dose steps
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