Cymbalta vs. Effexor: Similarities, Differences, & Side Effects

By Latifa deGraft-Johnson, MD
Medically reviewed checkmarkMedically reviewed
March 11, 2022

Medication can be incredibly helpful for people who have depression and anxiety.

And the variety of options is a great thing, because you’re more likely to find a treatment that’s compatible with other medications you may be taking as well as your lifestyle.

Cymbalta (a brand name of duloxetine) and Effexor (a brand name of venlafaxine) are two common medications for treating major depression and anxiety disorders.

While these are both serotonin and norepinephrine reuptake inhibitors (SNRIs), each drug is slightly different.

To help anyone considering the two drugs, in this article, we’ll cover the differences and similarities between Cymbalta and Effexor, including what they treat, which one is more effective, possible side effects, and potential drug interactions.

Always consult your doctor before ending or changing the use of these medications.

What Are the Differences & Similarities Between Cymbalta and Effexor?

Cymbalta and Effexor are both SNRIs, or serotonin and norepinephrine reuptake inhibitors. They work by boosting levels of serotonin and norepinephrine in the brain. These two neurotransmitters play a role in mood. 

Healthcare providers prescribe Cymbalta and Effexor to treat major depression, anxiety disorders, and other psychiatric disorders. 

The chart below breaks down the main similarities and differences between Cymbalta and Effexor.

CymbaltaEffexor
Drug classSerotonin-norepinephrine reuptake inhibitorsSerotonin-norepinephrine reuptake inhibitors
Generic nameDuloxetineVenlafaxine 
FormOral delayed-release capsule Extended-release tablet
Standard dosage 60 milligrams (mg) once daily 75 mg once daily 
Half-lifeAbout 12 hours Up to 11 hours 
How the drug is metabolizedThrough the liverThrough the liver
Have questions about Cymbalta and Effexor? Talk to a doctor through K Health.
Get Started

What Conditions Are Treated with Cymbalta and Effexor?

Cymbalta and Effexor are both prescribed to treat major depressive disorders and generalized anxiety disorders.

Each is also prescribed for a few other medical conditions, as outlined below.

(Note: “Off-label” means healthcare providers prescribe the medication for this condition, however, the medication does not have FDA approval to treat that condition.)

ConditionCymbaltaEffexor 
Major depressive disorder YesYes 
Generalized anxiety disorder YesYes 
Panic disorder Off-label Yes 
Social anxiety disorderOff-label Yes 
Chronic musculoskeletal painYesOff-label 
Fibromyalgia Yes Off-label 
Diabetic neuropathy Yes Off-label 
Chemotherapy-induced peripheral neuropathyOff-labelNo
Stress urinary incontinenceOff-labelNo
Obsessive-compulsive disorder NoOff-label
PTSDNoOff-label
CataplexyNoOff-label
Premenstrual dysphoric disorder NoOff-label 
Hot flashes (menopausal)NoOff-label
Migraine preventionNoOff-label
Attention-deficit disorderNoOff-label
Chronic fatigue syndromeOff-labelNo

Is Cymbalta or Effexor More Effective?

Few clinical studies directly compare Cymbalta and Effexor. Additionally, everyone may respond differently to each medication.

That said, according to a systematic review of 70 studies, both Cymbalta and Effexor are more effective than placebo for the short-term treatment of major depressive disorder.

Additionally, Effexor may be more tolerable and effective for people who wish to switch from selective serotonin reuptake inhibitors (SSRIs) or tricyclic and tetracyclic antidepressants. 

And, according to another study, duloxetine and venlafaxine are equally effective and tolerable for treating generalized anxiety disorders. 

Cost & Coverage of Cymbalta vs. Effexor

The cost of Cymbalta and Effexor varies depending on your insurance provider or Medicare plan, pharmacy, and dosage.

A 21-day supply of 60-mg Cymbalta costs around $250, while duloxetine is about $20 for a month’s worth of the same strength pills.

Many insurance companies cover Cymbalta or the generic duloxetine so you only pay a copay. Medicare covers duloxetine.

Effexor costs about $520 for a 30-day supply of 75-mg tablets, and venlafaxine is about $12 for the same dosage and number of pills. Medicare and many insurance plans cover the generic venlafaxine.

What Are the Side Effects of Cymbalta and Effexor?

Cymbalta and Effexor share many common adverse effects. The chart below outlines these effects. Keep in mind that everyone reacts differently. You may experience very few or none of these.

Side EffectCymbaltaEffexor 
Nausea Yes Yes
HeadacheYes Yes
DrowsinessYes Yes 
Dry mouth Yes Yes 
ConstipationYesYes
Increased sweating Yes Yes 
Decreased appetiteYes Yes 
Fatigue YesYes
Diarrhea Yes Yes 
Insomnia YesYes 
DizzinessYesYes 
Abdominal pain Yes Yes
Abnormal vision YesYes
Heart palpitations YesYes
Decreased sex drive Yes Yes 
Have questions about Cymbalta and Effexor? Talk to a doctor through K Health.
Get Started

Drug Interactions & Warnings

Both Cymbalta and Effexor, like other antidepressants,  carry black box warnings, which indicate that there is increased risk of developing worsening depression, suicidal thinking and behavior, that can be markedly increased in children, adolescents, and young adults, but can happen to anyone.

If you or your loved ones are taking either of these medications or any antidepressant, please watch out for the following warning signs that will require immediate medical attention: 

  • Unusual changes in behavior
  • Worsening symptoms of depression including hopelessness, feeling of worthlessness)
  • Increase in conversations about death
  • Thoughts or talk of self-harm 

If any of the above symptoms occur, please seek immediate medical attention.

Cymbalta and Effexor can interact with some other medications, which could make the SNRI less effective or increase the risk of harmful side effects.

That’s why it’s important to tell your doctor about any medicines that you take, including prescriptions, over-the-counter (OTC) drugs, herbal supplements, and vitamins.

That way they can help you determine the best and safest treatment for you.

Cymbalta and Effexor should not be used with: 

  • Other serotonergic drugs: Taking Cymbalta or Effexor when you also take selective serotonin reuptake inhibitors (SSRIs, like fluoxetine (Prozac) or paroxetine (Paxil)), other serotonin norepinephrine reuptake inhibitors (SNRIs like Desvenlafaxine (Pristiq) and Levomilnacipran (Fetzima)), or tricyclic antidepressants (TCAs, like amitriptyline or nortriptyline).  The combination of medications may increase the risk of serotonin syndrome. This is when the brain has dangerously high levels of serotonin, and lead to symptoms such as confusion, headaches, and—in more severe cases—hallucinations, seizures, or a coma. 
  • Monoamine oxidase inhibitors: Using MAOIs like phenelzine (Nardil) or isocarboxazid (Marplan) can also increase the risk of serotonin syndrome. Do not use Cymbalta and Effexor within 14 days of discontinuing an MAOI either. 
  • Nonsteroidal anti-inflammatory drugs: NSAIDs include Aspirin (Bayer, Excedrin), ibuprofen (Motrin, Advil), and naproxen (Aleve). When combined with Cymbalta or Effexor, these can increase the risk of bleeding.
  • Anticoagulants or blood thinners: These also increase the risk of bleeding.

Lastly, anyone with severe kidney or liver problems should avoid Cymbalta, as there is a potential risk of further damage to these organs. However, Effexor may be safe to take in lower doses for those with kidney or liver issues. 

How K Health Can Help

Did you know you can get affordable primary care with the K Health app? Download K to check your symptoms, explore conditions and treatments, and if needed text with a doctor in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.

Frequently Asked Questions

Is Cymbalta better than Effexor?
The best medication for depression or anxiety depends on the individual and the condition being treated. Both Cymbalta and Effexor are FDA-approved for treating major depressive disorders, and generalized anxiety disorders.. Cymbalta is also FDA-approved for some chronic pain disorders (like fibromyalgia and diabetic peripheral neuropathy). Both prescription medications also come with potential side effects and interact with other drugs. Speak to your healthcare provider about which antidepressant is the right fit for you.
Are Cymbalta and Effexor the same?
Cymbalta and Effexor are not the same. However, both are part of a class of drugs known as SNRIs or serotonin and norepinephrine reuptake inhibitors. They increase the availability of serotonin and norepinephrine in the brain. These neurotransmitters impact mood and can influence psychiatric conditions. Both Cymbalta and Effexor can be used to treat major depression and anxiety disorders, and Cymbalta is also prescribed for some chronic pain disorders and muscular conditions. Talk to your doctor about which medication is best for you.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.

Latifa deGraft-Johnson, MD

Dr. Latifa deGraft-Johnson is a board-certified family medicine physician with 20 years of experience. She received her bachelor's degree from St. Louis University, her medical degree from Ross University, and completed her family medicine residency at the University of Florida. Her passion is in preventative medicine and empowering her patients with knowledge.