Is Effexor the same as Cymbalta? (3+ differences)

In this article, we will answer the question “Is Effexor the same as Cymbalta?”. We will discuss some similarities and differences between both medications. We will also discuss how to choose the right medication according to your condition.

Is Effexor the same as Cymbalta?

No, Effexor and Cymbalta are two different medications but belong to the same class of antidepressants so they have many similarities as well.

Effexor (Venlafaxine) and Cymbalta (Duloxetine) are two different medications which belong to the antidepressant class of serotonin and norepinephrine reuptake inhibitors (SNRIs). Both medications are used for different conditions but can be used interchangeably for some depressive illnesses.

Effexor is approved by the FDA for the treatment of major depressive disorder (MDD), panic disorder, generalized anxiety disorder (GAD) and social anxiety disorder (SAD) (1).

Cymbalta is approved by the FDA for the treatment of MDD, GAD as well as fibromyalgia, chronic musculoskeletal pain and diabetic peripheral neuropathic pain (DPNP) (2).

How is Effexor different from Cymbalta?

Although Effexor and Cymbalta belong to the same class of antidepressants they do have some key differences which distinguish them from each other. Some of these are as follows:

Mode of action

Both Effexor and Cymbalta belong to the same class of antidepressants so they have very similar mechanisms of action.

Both medications are inhibitors of the serotonin and norepinephrine reuptake, and increase the levels of these neurotransmitters. However, there is a slight difference between the medications and their affinity for the serotonin and norepinephrine neurotransmitter transporters.

Cymbalta has an equitable affinity for serotonin and norepinephrine transporters whereas Effexor shows a greater preference for serotonin transporters over norepinephrine transporters. In lower doses, Effexor acts on the serotonin transporters and in higher doses it acts on norepinephrine transporters as well (3).

Therapeutic Uses

As both Effexor and Cymbalta are antidepressants belonging to the same class they can be used for similar conditions. However, which medication should be used for which individual, depends on patient characteristics and tolerability.

Effexor is used for the treatment of (1):

• Major depressive disorder (MDD)
• Generalised anxiety disorder (GAD)
• Panic disorder (PD)
• Social anxiety disorder (SAD)

Off-label Effexor can be used for (4):

• Attention deficit disorder
• Fibromyalgia
• Diabetic neuropathy
• Hot flashes
• Complex pain syndromes
• Obsessive-compulsive disorder (OCD)
• Posttraumatic stress disorder (PTSD)
• Premenstrual dysphoric disorder (PMDD)
• Migraine prevention

Conditions that can be treated or managed by Cymbalta include (2):

• Generalised anxiety disorder (GAD)
• Major depressive disorder (MDD)
• Fibromyalgia
• Chronic musculoskeletal pain
• Diabetic peripheral neuropathic pain (DPNP)

Off-label uses of Cymbalta include (5):

• Chemotherapy-induced peripheral neuropathy
• Stress urinary incontinence

Common side effects

Both Effexor and Cymbalta can cause similar side effects. Some of the common side effects are as follows:

• Nausea
• Somnolence
• Dry mouth
• Sweating
• Constipation
• Decreased appetite or Anorexia

In addition to these Cymbalta has a very common side effect of fatigue, and Effexor can cause erectile dysfunction and decrease in libido.

Sometimes rare side effects can also occur like (1,2):

• Seizures
• Suicidal ideation
• Serotonin syndrome
• Activation of mania
• Changes in blood pressure
• Withdrawal syndrome

Treatment duration

The treatment duration of both medications depends on the physiological factors of the individual, the condition under treatment and the response and tolerability of the individual.

Normally Effexor and Cymbalta take almost 2-4 weeks to improve the condition of individuals who respond positively to the medication. However, the onset of action depends on patient-specific characteristics and the medical condition under treatment.

Both medications may decrease the symptoms of the condition being treated but have to be continued well after the symptoms have resolved.

Efficacy rate

A research study, assessing the efficacy of Venlafaxine has reported the efficacy rate to be 69% among the total population treated. Meanwhile, Duloxetine is found to be more effective than other SNRIs including Venlafaxine (6).

Another systematic review evaluating the safety and efficacy of Duloxetine concluded that Duloxetine was more tolerated than other agents for the treatment of various depressive illnesses and chronic pain conditions (7).

Another research study, comparing the efficacy and tolerability of both Duloxetine and Venlafaxine refutes these results and has reported the efficacy of Duloxetine to be much lower than Venlafaxine. This study stated that Duloxetine was much less tolerated than Venlafaxine and other antidepressants (8).

Keep in mind that the response rate and tolerability of both these medications depend on the individual characteristics and response to the drug.

Withdrawal symptoms

Both Effexor and Cymbalta can cause withdrawal syndrome when discontinued. Gradual tapering is necessary if medications have to be switched or treatment has to be discontinued. Abrupt stopping of the medication can aggravate such symptoms.

Some symptoms that can occur due to Effexor withdrawal are as follows:

• Anxiety
• Cofusion
• Anorexia
• Diarrhoea
• Dry mouth
• Agitation
• Somnolence
• Sweating
• Sensory disturbances
• Tremors
• Vomiting
• Impaired coordination
• Headaches
• Dizziness
• Fatigue
• Tinnitus
• Insomnia
• Nausea
• Nightmares
• Irritability

Meanwhile, Cymbalta can cause the following side effects when discontinued:

• Paresthesias
• Irritability
• Nausea
• Headache
• Dizziness
• Fatigue
• Vomiting
• Insomnia
• Anxiety
• Diarrhoea
• Tinnitus
• Seizures
• Hypomania
• Tremors
• Confusion

Can you take Effexor and Cymbalta together?

It is advised not to take both Effexor and Cymbalta simultaneously. Taking both these medications can increase the risk of serotonin syndrome (SS). However, sometimes you may be prescribed both medications.

This situation is likely to arise when the individual has to be switched from one medication to the other. This requires the introduction of one agent while gradually tapering off the other medication. Starting one medication and stopping the other takes much assessment.

You should never start or stop any medication without the advice of your doctor. If you have been prescribed both medications make sure to follow the instructions of your healthcare provider.

How to choose between Effexor or Cymbalta?

The choice of whether the individual will receive Effexor or Cymbalta depends on many different factors. These factors include:

• Individual patient characteristics
• Tolerability and response of the patient to either medication
• Suitability of the medication to the condition being treated
• Patient symptoms and medical history
• Underlying comorbidities

Your healthcare provider will assess your situation, consider all these factors and prescribe the best available medication to help manage your symptoms.

In this article, we discussed the similarities and differences between Effexor and Cymbalta. We discussed the kind of side effects that can occur if both these medications are used simultaneously.

To the best of my knowledge, and according to published research both Effexor and Cymbalta are SNRIs and are used for similar conditions. However, the choice of medication depends solely on the individual characteristics and condition under treatment.

References