- Cymbalta (duloxetine) vs. Effexor (venlafaxine), what is the difference?
- What is Cymbalta? What is Effexor? How do they work (mechanism of action)?
- What are the uses for Cymbalta vs. Effexor?
- What are the differences in the side effects of Cymbalta and Effexor?
- What are the withdrawal symptoms of Cymbalta and Effexor?
- What are the differences in the dosages of Cymbalta vs. Effexor?
- What are the drug interactions of Cymbalta vs. Effexor?
- Are Cymbalta or Effexor safe to take if I am pregnant or breastfeeding?
Cymbalta (duloxetine) vs. Effexor (venlafaxine), what is the difference?
- Cymbalta (duloxetine) and Effexor XR (venlafaxine) are selective serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressants used for treating depression and anxiety disorders.
- Cymbalta also is used for the treatment of diabetic peripheral neuropathic pain, fibromyalgia, and chronic musculoskeletal pain.
- Cymbalta and Effexor XR have similar side effects, for example:
- Side effects of Cymbalta that do not occur with Effexor XR include:
- Side effects of Effexor XR that are different from Cymbalta include:
- If you stop taking Cymbalta or Effexor XR suddenly (abruptly) you may have withdrawal symptoms, which may include:
- Cymbalta (duloxetine) is the generic name for Cymbalta. Effexor XR is the brand name available in the US. The brand Effexor is no longer available.
What is Cymbalta? What is Effexor? How do they work (mechanism of action)?
Cymbalta (duloxetine), Effexor, and Effexor XR (venlafaxine) are selective serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressants. Cymbalta and Effexor XR are both used for the treatment of pain and major depressive and anxiety disorders (for example, general anxiety, panic, and social disorders). Cymbalta also treats diabetic peripheral neuropathy, fibromyalgia, and chronic musculoskeletal pain. Other SNRIs include milnacipran (Savella) and desvenlafaxine (Pristiq).
Cymbalta prevents reuptake of the neurotransmitters serotonin and epinephrine by nerves after they have been released, thereby increasing the effect of serotonin and norepinephrine in the brain. Effexor XR works in the same way as Cymbalta; however, it prevents the reuptake of the neurotransmitters serotonin and norepinephrine.
What are the uses for Cymbalta vs. Effexor?
Cymbalta (duloxetine) uses
Cymbalta is used for the treatment of:
- Generalized anxiety disorder
- Diabetic peripheral neuropathy pain
- Chronic musculoskeletal pain
Effexor (venlafaxine) uses
Effexor is used for the treatment of depression, depression with associated symptoms of anxiety, generalized anxiety disorder, and social anxiety disorder; and for the treatment of adults with panic disorder.
What are the differences in the side effects of Cymbalta and Effexor?
Cymbalta side effects
The most common side effects of duloxetine include:
Effexor side effects
Effexor, like most antidepressants, can cause:
- Loss of appetite
- Other side effects that can occur are
- Ejaculation disorder (erectile dysfunction, impotence)
- Dry mouth
- Weight loss
Cymbalta and Effexor serious side effects
- Sexual dysfunction (decreased sex drive and delayed orgasm and ejaculation)
- An increase in blood pressure, blood pressure should be monitored.
- Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children, adolescents, and young adults with depression and other psychiatric disorders. Anyone considering the use of venlafaxine or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidality, or unusual changes in behavior.
What are the withdrawal symptoms of Cymbalta and Effexor?
Cymbalta, Effexor XR, and any other antidepressants can cause withdrawal symptoms if they are stopped suddenly (abruptly) without gradually reducing the dosage. Withdrawal symptoms may occur even if a few doses are missed. Withdrawal symptoms include:
- Changes in mood
- Changes in the sense of smell and taste
What are the differences in the dosages of Cymbalta vs. Effexor?
- The recommended dose for treating depression is 20 or 30 mg twice daily or 60 mg once daily. Patients may be started with 30 mg once daily for one week before increasing the dose to 60 mg daily because it may help patients adjust to the drug.
- The recommended dose is 60 mg daily for anxiety disorder, pain associated with diabetic neuropathy, fibromyalgia, or chronic musculoskeletal pain.
- There is no evidence that doses greater than 60 mg/day provide additional benefits. However, the maximum dose for depression or anxiety disorder is 120 mg/day.
Venlafaxine should be taken with food at doses specifically directed by a doctor since individual doses can vary greatly.
- The antidepressant effects are not maximal for 1-2 weeks. The dose of Effexor XR gradually should be reduced under the direction of a doctor to avoid withdrawal symptoms.
- For people with difficulty swallowing tablets or capsules, Effexor XR capsules can be opened and the contents sprinkled onto a spoonful of applesauce or other food; however, removing the capsule contents will immediately release of the drug, so it is no longer extended release.
- The dose for treatment of depression using the immediate release formulation is 75 to 375 mg daily divided in 2 or 3 doses and given every 8 or 12 hours. The extended release dose is 37.5 mg to 225 mg once daily. Dosing is usually begun with low initial concentrations and adjusted as needed by the treating doctor.
- Generalized anxiety and panic disorder are treated with 37.5 mg to 225 mg once daily using the extended release formulation.
- Social anxiety is treated with 75 mg daily using the extended release formulation.
Latest Depression News
Daily Health News
What are the drug interactions of Cymbalta vs. Effexor?
Cymbalta drug interactions
- Duloxetine should not be used in combination with a monoamine oxidase inhibitor (MAOI) such as phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan), and selegiline (Eldepryl), or within 14 days of discontinuing the MAOI. At least 5 days should be allowed after stopping duloxetine before starting an MAOI. Combinations of SNRIs and MAOIs may lead to serious, sometimes fatal, reactions including very high body temperature, muscle rigidity, rapid fluctuations of heart rate and blood pressure, extreme agitation progressing to delirium, and coma. Similar reactions may occur if duloxetine is combined with antipsychotics, tricyclic antidepressants or other drugs that affect serotonin in the brain. Examples include tryptophan, sumatriptan (Imitrex), lithium, linezolid (Zyvox), tramadol (Ultram), and St. John’s Wort.
- Fluoxetine (Prozac, Sarafem), paroxetine (Paxil, Paxil CR, Pexeva), fluvoxamine (Luvox), and quinidine increase blood levels of duloxetine by reducing its metabolism in the liver. Such combinations may increase adverse effects of duloxetine.
- Combining duloxetine with aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), warfarin (Coumadin) or other drugs that are associated with bleeding may increase the risk of bleeding, because duloxetine itself is associated with bleeding.
- Duloxetine has an enteric coating that prevents dissolution until it reaches a segment of the gastrointestinal that has a pH higher than 5.5. In theory, drugs that raise the pH in the gastrointestinal system (for example, Prilosec) may cause duloxetine to be released early while conditions that slow gastric emptying (for example, diabetes) may cause premature breakdown of duloxetine. Nevertheless, administration of duloxetine with an antacid or famotidine (Axid) did not significantly affect the absorption of duloxetine.
- Duloxetine may reduce the breakdown of desipramine (Norpramin), leading to increased blood concentrations of desipramine and potential side effects.
Effexor drug interactions
- Venlafaxine should not be used in combination with a monoamine oxidase inhibitor (MAOI) such as phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan), and selegiline (Eldepryl), or within 14 days of discontinuing the MAOI. At least 5 days should be allowed after stopping venlafaxine before starting an MAOI. Combinations of SNRIs and MAOIs may lead to serious, sometimes fatal, reactions including very high body temperature, muscle rigidity, rapid fluctuations of heart rate and blood pressure, extreme agitation progressing to delirium, and coma. Similar reactions may occur if venlafaxine is combined with antipsychotics, tricyclic antidepressants or other drugs that affect serotonin in the brain. Examples include tryptophan, sumatriptan (Imitrex), lithium, linezolid (Zyvox), tramadol (Ultram), and St. John's Wort.
- Combining venlafaxine with aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), warfarin (Coumadin) or other drugs that are associated with bleeding may increase the risk of bleeding, because venlafaxine is associated with bleeding.
- Most medications affecting the brain such as venlafaxine have the potential to slow reflexes or impair judgment. Therefore, caution is advised especially early in the course of treatment.
- Safety has not been established in children below the age of 18 years.
Are Cymbalta or Effexor safe to take if I am pregnant or breastfeeding?
- Duloxetine is excreted into the milk of lactating women. Because the safety of duloxetine in infants is not known, breastfeeding while on duloxetine is not recommended.
Cymbalta, brand name duloxetine, and Effexor XR brand name venlafaxine (Effexor has been discontinued) are antidepressants belonging to a drug class called selective serotonin and norepinephrine reuptake inhibitors (SNRIs). Cymbalta and Effexor are used for the treatment of chronic depression, anxiety disorders (for example, general or social), and pain. Cymbalta also treats fibromyalgia, and musculoskeletal or diabetic neuropathy (nerve pain).
Similar side effects of Cymbalta and Effexor include headaches, insomnia, anxiety, nausea, and dry mouth. Both Cymbalta and Effexor can cause serious side effects like increased blood pressure, erectile dysfunction (ED, impotence) and seizures. They also may increase the risk of suicidality.
Side effects that occur with Cymbalta that do not occur with Effexor include constipation, diarrhea, and fatigue. Effexor may cause side effects like sleepiness, loss of appetite, weight loss, and sweating. If Cymbalta or Effexor are stopped abruptly they may cause withdrawal symptoms like irritability, insomnia, anxiety, nervousness, dizziness, nausea, vomiting, and diarrhea.
The brand name Effexor is no longer available in the US; however, Effexor XR is.
Multimedia: Slideshows, Images & Quizzes
Anxiety Disorder Pictures: Symptoms, Panic Attacks, and More with Pictures
Learn about generalized anxiety disorder (GAD). See if your worries are normal or something more by learning about symptoms,...
Pain Management: Surprising Causes of Pain
What’s causing your pain? Learn the common causes of lower back pain, as well as pain in the knee, stomach, kidney, shoulder,...
Depression Myths: Overwork, Recklessness and More in Pictures
Folk remedies and half-truths still prevent many from getting treatment for depression. WebMD's pictures show unusual symptoms in...
Learn to Spot Depression: Symptoms, Warning Signs, Medication
What is depression? Get information on symptoms, signs, tests, and treatments for many types of depression including major...
Fibromyalgia Symptoms, Diagnosis & Treatment
What is fibromyalgia? Fibromyalgia is a chronic condition that causes pain and stiffness of the tendons, muscles, and joints....
Diabetic Peripheral Neuropathy: Improve Diabetes Nerve Pain
Read about diabetic peripheral neuropathy and exercises to manage nerve pain. Learn how to cope with the symptoms of diabetic...
Pain Management: 15 Easy Ways to Reduce Chronic Pain
Chronic pain can be a symptom of many conditions, including arthritis, headaches, and others. Comprehensive pain management...
17 Everyday Ways to Ease Depression
The right exercise, diet, and activities -- even playing with a pet --can help you recover from depression. Learn simple...
Depression Therapy: Myths, Facts, and More in Pictures
False ideas scare many depression suffers away from therapy and the quick relief and help these pros can provide. Let our experts...
Diabetic Neuropathy Quiz: Test Your Medical IQ
Diabetic neuropathy is serious. Take this quiz to get the facts.
Depression Quiz: Signs & Symptoms
Many people do not recognize the symptoms and warning signs of depression and depressive disorders in children and adults. With...
Fibromyalgia Quiz: What Is Fibromyalgia?
Fibromyalgia could be the reason for your constant, deep bodily pain. Learn more about this painful condition with the...
Panic Attacks (Panic Disorder) Quiz: Test Your Mental Health IQ
Could you suffer a panic attack? Take this Panic Attacks Quiz to learn causes, symptoms, and treatments for panic disorder. Use...
Pain Quiz: Test Your IQ of Pain
Is pain all in the brain? Take the Pain Quiz to learn everything you've ever wanted to know about the unpleasant sensation we...
Diabetes Management Tips and Preventing Complications
Learn 10 simple ways to better manage your diabetes. See tips for controlling blood sugar, diet and exercise and other helpful...
12 Tips for Success with Antidepressants
Antidepressants like selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) are medication...
Picture of Fibromyalgia
A syndrome characterized by chronic pain, stiffness, and tenderness of muscles, tendons, and joints without detectable...
Healthy Aging: Sneaky Depression Triggers in Pictures
There are many causes and triggers of depression. From too little vitamin B12 to too much time alone, look at these surprising...
Fibromyalgia Pain Relief With Stretching and Strength Exercises in Pictures
Living with fibromyalgia is painful. By making simple exercise modifications, you can boost your energy, decrease pain and...
Foods That Help Fight Depression
Food cannot prevent depression, but a healthy diet may boost your mood. Foods like salmon, carrots, Brazil nuts and even...
Physical Symptoms of Depression in Pictures
Depression can cause physical problems such as insomnia, chest pain, fatigue, headaches, and more. Learn the signs of depression...
Fibromyalgia Treatments and Tips to Ease Pain and Other Symptoms
What is fibromyalgia? Learn about fibromyalgia symptoms such as trigger points (also called tender points), learn what causes...
Related Disease Conditions
Diabetes Symptoms in Men
Diabetes mellitus is a disease in which a person's blood sugar (blood glucose) is either too high (hyperglycemia) or too low (hypoglycemia) due to problems with insulin regulation in the body. There are two main types of diabetes mellitus, type 1 and type 2. Type 1 diabetes usually occurs during childhood, while type 2 diabetes usually occurs during adulthood, however, rates of both types of diabetes in children, adolescents, and teens is increasing. More men than women have diabetes in the US, and the disease can affect men differently than women.Warning symptoms of diabetes that men have and women do not include low testosterone (low-t), sexual problems, impotence (erectile dysfunction), decreased interest in sex, and retrograde ejaculation. Type 1 and type 2 diabetes symptoms and signs that are the same in men and women include skin infections, numbness or tingling in the feet or hands, nausea, excessive thirst or hunger, fatigue, irritability, blurred vision, weight gain, weight loss, urinary tract infections (URIs), and kidney problems. Treatment for type 1 diabetes is insulin, and treatment for type 2 diabetes are lifestyle changes like eating a healthy diet, getting exercise daily, and if necessary, diabetes medications.
Type 1 vs Type 2 Diabetes (Similarities and Differences)
Diabetes mellitus is a metabolic condition in which a person's blood sugar (glucose) levels are too high. Over 29.1 million children and adults in the US have diabetes. Of that, 8.1 million people have diabetes and don't even know it. Type 1 diabetes (insulin-dependent, juvenile) is caused by a problem with insulin production by the pancreas. Type 2 diabetes (non-insulin dependent) is caused by: Eating a lot of foods and drinking beverages with simple carbohydrates (pizza, white breads, pastas, cereals, pastries, etc.) and simple sugars (donuts, candy, etc.) Consuming too many products with artificial sweeteners (We found out that they are bad for us!) Lack of activity Exercise Stress Genetics While the signs and symptoms of both types of diabetes are the same, which include: Increased urination Increased hunger Increased thirst Unexplained weight loss. However, the treatments are different. Type 1 diabetes is insulin dependent, which means a person with this type of diabetes requires treatment with insulin. People with type 2 diabetes require medication, lifestyle changes like eating a healthy diet, and getting regular exercise.
Diabetes Symptoms in Women (Early and Late)
Diabetes symptoms in women include vaginal itching, pain, or discharge, loss if interest or pain after having sex, polycystic ovarian syndrome (POS), and urinary tract infections or UTIs (which are more common in women. Symptoms of diabetes that are the same in women and men are excessive thirst and hunger, bad breath, and skin infections, darkening of skin in areas of body creases (acanthosis nigricans), breath odor that is fruity, sweet, or acetone, and tingling or numbness in the hands or feet, blurred vision, fatigue, tingling or numbness in the hands or feet, wounds that heal slowly, irritability, and weight loss or gain. Complications of type 1 and type 2 diabetes are the same, for example, skin, eye, and circulation problems, low blood sugar (hypoglycemia), high blood sugar (hyperglycemia), ketoacidosis, and amputation. If diabetes is not managed a person may not survive.
Anxiety is a feeling of apprehension and fear characterized by symptoms such as trouble concentrating, headaches, sleep problems, and irritability. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults. Treatment for anxiety may incorporate medications and psychotherapy.
Pain management and treatment can be simple or complex, according to its cause. There are two basic types of pain, nociceptive pain and neuropathic pain. Some causes of neuropathic pain include: complex regional pain syndrome, interstitial cystitis, and irritable bowel syndrome. There are a variety of methods to treat chronic pain, which are dependant on the type of pain experienced.
Depression in teenagers may be caused by many factors. Symptoms of teen depression include apathy, irresponsible behavior, sadness, sudden drop in grades, withdrawal from friends, and alcohol and drug use. Treatment of depression in adolescents may involve psychotherapy and medications.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Depression in Children
Childhood depression can interfere with social activities, interests, schoolwork and family life. Symptoms and signs include anger, social withdrawal, vocal outbursts, fatigue, physical complaints, and thoughts of suicide. Treatment may involve psychotherapy and medication.
Muscle Pain (Myofascial Pain Syndrome)
Neuropathic pain is a chronic condition that leads to ongoing pain symptoms. Patients can be predisposed to developing neuropathic pain who have conditions such as: diabetes, cancer, stroke, HIV, vitamin deficiencies, shingles, and multiple sclerosis. Patient history and nerve testing are used to diagnose neuropathic pain. Antidepressants, antiseizure medications, and other types of medications are used to treat neuropathic pain. Many people with neuropathic pain are able to attain some level of relief.
Panic attacks are sudden feelings of terror that strike without warning. These episodes can occur at any time, even during sleep. A person experiencing a panic attack may believe that he or she is having a heart attack or that death is imminent. The fear and terror that a person experiences during a panic attack are not in proportion to the true situation and may be unrelated to what is happening around them. Most people with panic attacks experience several of the following symptoms: racing heartbeat, faintness, dizziness, numbness or tingling in the hands and fingers, chills, chest pains, difficulty breathing, and a feeling of loss or control. There are several treatments for panic attacks.
Diabetic Neuropathy (Symptoms, Causes, Diagnosis, Treatment)
Diabetic neuropathy a condition in which nerve damage has occurred as a complication of diabetes. The pain from the nerve damage can be severe with tingling or numbness in the part of the body affected. Diabetic neuropathy can occur anywhere in the body. Diabetic neuropathy can cause symptoms like intense pain, numbness, burning, or tingling in the part of the body affected by the condition. There are four types of neuropathy include peripheral, autonomic, proximal and focal. Natural therapies and medications may help relieve the pain and other symptoms of diabetic neuropathy.
Type 1 Diabetes (Symptoms, Causes, Diet, Treatment, Life Expectancy)
Type 1 diabetes mellitus (juvenile) is an auto-immune disease with no known cause at this time, although there are a few risk factors. Symptoms of type 1 diabetes include frequent urination, unintentional weight loss, dry and itchy skin, vision problems, wounds that heal slowly, and excessive thirst. Type 1 diabetes is diagnosed with blood tests. A healthy lifestyle and controlling blood glucose levels can improve life expectancy.
Postpartum depression is a form of depression that occurs within a year after delivery. It is thought that rapid hormone changes after childbirth may lead to depression. Symptoms of postpartum depression include crying a lot, headaches, chest pains, eating too little or too much, sleeping too little or too much, withdrawal from friends and family, and feeling irritable, sad, hopeless, worthless, guilty, and overwhelmed. Treatment typically involves talk therapy and medication.
Pain Management: Musculoskeletal Pain
Natural menopause is the permanent ending of menstruation that is not brought on by any type of medical treatment. For women undergoing natural menopause, the process is described in three stages: perimenopause, menopause, and postmenopause. However, not all women undergo natural menopause. Some women experience induced menopause as a result of surgery or medical treatments, such as chemotherapy and pelvic radiation therapy.
Tips for Managing Type 1 and 2 Diabetes at Home
Managing your diabetes is a full time commitment. The goal of diabetic therapy is to control blood glucose levels and prevent the complications of diabetes. Information about exercise, diet, and medication will help you manage your diabetes better. Blood glucose reagent strips, blood glucose meters, urine glucose tests, tests for urinary ketones, continuous glucose sensors, and Hemoglobin A1C testing information will enable you to mange your diabetes at home successfully.
Depression in the Elderly
Depression in the elderly is very common. That doesn't mean, though, it's normal. Treatment may involve antidepressants, psychotherapy, or electroconvulsive therapy.
Holiday Depression, Anxiety, and Stress
Though the holidays are a fun time for most, for others, they're a sad, lonely and anxiety-filled time. Get tips on how to avoid depression and stress during the holiday season.
Pain Management: Neuropathic Pain
Neuropathic pain is chronic pain resulting from injury to the nervous system. The injury can be to the central nervous system (brain and spinal cord) or the peripheral nervous system (nerves outside the brain and spinal cord).
Diabetes: Caring for Your Diabetes at Special Times
Taking care of a disease such as diabetes is a life-long process. Learn how to care for yourself or loved one with diabetes in situations such as illness, work, school, travel, or a natural disaster.
Treatment & Diagnosis
Medications & Supplements
- Antidepressants (Depression Medications)
- Cymbalta (duloxetine)
- venlafaxine, Effexor XR (Effexor has been discontinued in the US)
- Cymbalta vs. Wellbutrin Comparison
- Celexa vs. Cymbalta (Comparison of Differences and Similarities)
- desvenlafaxine (Pristiq, Khedezla)
- Lexapro vs. Effexor
- Savella (milnacipran)
Health Solutions From Our Sponsors
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.