Medically reviewed by Jill Johnson, FNP
Written by Our Editorial Team
Last updated 7/20/2022
The world of antidepressants is a well-populated one, especially when compared with medicine even a few decades ago. Along with the increasing number of conditions these medications treat (from diabetic neuropathy and bipolar disorder, to seasonal affective disorders, panic disorder and everything in between), you also have a lot of specific medications to choose from (Cymbalta vs Effexor, Lexapro® vs Paxil®, Prozac® vs Zoloft®, etc.).
Cymbalta and Effexor are two medications belonging to the selective norepinephrine reuptake inhibitors (SNRIs) class of medications. They have a lot of things in common, but they also share a few key differences.
If you’ve been researching them and have questions, we have answers about how Effexor and Cymbalta can be compared.
Let’s start at the ground level: the difference between Effexor and Cymbalta.
Cymbalta is a brand-name version of the generic drug duloxetine, which is from the class of medications known as serotonin and norepinephrine reuptake inhibitor, or SNRI. Effexor is the “brand-name drugs” version of venlafaxine hydrochloride: another SNRI.
SNRIs are one form of effective antidepressant, similar to a selective serotonin reuptake inhibitor (SSRI), that crosses the blood-brain barrier to work on chemical imbalances in your brain.
Both of these particular medications work on the levels of serotonin and norepinephrine in your brain, which are two neurotransmitters responsible for balancing your mood. When these medications increase the available supply of serotonin and norepinephrine in your brain, they make it more difficult for your brain to suffer the sudden extremes of mood often present in a mood disorder or psychiatric disorder.
Where these medications differ most obviously is in how they are employed in the treatment of psychiatric conditions.
Cymbalta is generally used in the treatment of patients with generalized anxiety disorder and major depressive disorder, but may be used to treat neuropathy, neuropathic pain, diabetic neuropathy, the painful condition fibromyalgia and certain causes of musculoskeletal pain — along with other medical conditions and conditions that cause chronic pain.
Effexor is prescribed for the treatment of depression, major depression, social anxiety disorder, some forms of neuropathy, as well as hot flashes, migraines and posttraumatic stress disorder or PTSD. Effexor is sometimes used off-label for obsessive-compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD) and post-traumatic stress disorder (PTSD).
Far as side effects go, there aren’t many differences when it comes to Effexor vs Cymbalta.
Both venlafaxine and duloxetine may increase your risk of experiencing both suicidal thoughts or, when stopped abruptly and without the guidance of a healthcare professional, a potentially fatal issue called serotonin syndrome.
And common side effects of both include insomnia, fatigue, heartburn, muscle cramps, diarrhea, nausea, increased urination and other common adverse effects associated with SNRIs in general.
Cymbalta, Effexor and other SNRIs generally should also not be used alongside monoamine oxidase inhibitors (MAOIs) for safety reasons.
At low doses, Effexor operates similarly to an SSRI, and the effects on norepinephrine levels only come into play at higher doses. Oral venlafaxine is available from 25mg in a tablet up to 225mg in an extended release format.Common starting doses tend to land around 37.5mg per day, and it’s very unlikely you’ll exceed 375mg for a daily dose for safety concerns.
With Cymbalta, there’s a narrower range of dosages. The maximum is 120mg per day, and generally speaking, doses will start at 30mg for most people, regardless of whether it’s treating generalized anxiety disorder, fibromyalgia, major depressive disorder or something else.
If you’re still wondering whether Effexor or Cymbalta is the right medication for you, it’s possible you’re asking the wrong question. Instead of picking between pills, you should be seeking the medical advice of a mental health professional.
While there are certain contexts in which one or the other of these medications may be better suited on paper, the truth is that your individual needs and your individual brain chemistry make it hard to determine the best medication for depression by reading.
Your unique antidepressant treatment should match your unique brain function, and that may mean a bit of trial and error — a healthcare provider may have you try one or more medications before you ultimately find the right one for your needs and desired quality of life.
Like medications, depression will affect you differently than other people, so while a friend or family member may have great results from Effexor, Cymbalta may be more suited to your needs — and vice versa. Still, neither of these medications may ultimately be your ideal solution — all of this is up to you and a healthcare professional.
Depression isn’t something you should try to manage entirely with medications, regardless of what you read about these and other pills on the market. The most effective depression management strategy isn’t about medication, it’s about the combination of different treatment types, including medication, therapy and lifestyle changes.
Let’s talk about lifestyle for a second. Whether you’re not getting enough sleep, neglecting exercise, making bad dietary choices, smoking, drinking or using recreational drugs to excess, you’re doing some harm to your body, and that harm can increase your risk of depression — and make existing depression worse.
Fighting back may require changes to your behavior and lifestyle — in fact, clinical studies have shown that even just a little regular exercise can have similar effects to medication.
Your body and brain chemistry can only do so much of the heavy lifting, though, and that’s where therapy comes in.
Therapy is a great way to get help unlearning unhealthy ways of thinking and replacing them with better ways of seeing the world around you.
That’s the purpose of Cognitive Behavioral Therapy (CBT) anyway, which is a therapeutic system in which patients learn to take note of negative, depression-centric thoughts and replace them with positivity and self-confidence.
Being the best version of yourself is ultimately what this is all about, after all, and why it’s important not to lose sight of the goal when choosing medications and therapies.
Conversations about the efficacy of duloxetine or venlafaxine are important, but they’re details that you work out with a healthcare provider.
Whether you choose Cymbalta or Effexor isn’t really the big decision here — in fact, it may be a decision you let someone else make on your behalf. That person should be a healthcare professional, though.
Whether you’re struggling with a depressive disorder or something else that antidepressants may help with, the best way to get the right one for your individual needs is to talk to a healthcare provider.
Ready to take the next step? Consider using hers’ online therapy for that guidance.