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

By Frank DiVincenzo, MD
Medically reviewed checkmarkMedically reviewed
March 21, 2022

About 13.2% of adults in the U.S. take antidepressants.

Of the many types of antidepressants available, Cymbalta and Lexapro are commonly prescribed for the treatment of major depressive disorder (MDD) and generalized anxiety disorder (GAD). 

You may be experiencing adverse reactions with your current medication and considering your other options.

Although these two drugs have a similar mechanism of action—both affect the levels of serotonin in the brain—there are some differences.

In this article, we’ll discuss the differences and similarities between Cymbalta and Lexapro, the conditions they treat, and their effectiveness.

We’ll also compare the coverage and the cost of the medication, the common side effects, and the possible drug interactions of Cymbalta and Lexapro.

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What Are the Differences & Similarities Between Cymbalta and Lexapro?

Cymbalta and Lexapro are prescription drug antidepressants used to treat major depression and generalized anxiety disorder. 

Cymbalta, the brand name for duloxetine, is a serotonin-norepinephrine reuptake inhibitor (SNRI).

This class of antidepressants works by preventing the reuptake (reabsorption) of two neurotransmitters in the brain called serotonin and norepinephrine. 

The resulting increased levels of these chemical messengers helps to relieve symptoms of major depressive disorder and generalized anxiety disorder.

The FDA has also approved Cymbalta for the treatment of some pain conditions. 

Lexapro, the brand name for escitalopram, is a selective serotonin reuptake inhibitor (SSRI).

It works by preventing the reuptake of serotonin in the brain, thereby increasing the levels of available serotonin. 

Since serotonin is a neurotransmitter responsible for mood, sleep, and other bodily functions, increased amounts in the brain help ease symptoms of major depressive disorder and generalized anxiety disorder. 

The table below provides an overview of how the two antidepressant medications compare:

CymbaltaLexapro
Drug classSerotonin-norepinephrine reuptake inhibitors (SNRI)Selective serotonin reuptake inhibitors (SSRI)
Generic nameDuloxetineEscitalopram
Standard dosage60 milligrams (mg) once daily10 mg once daily
Dosage strengths available20 mg, 30 mg, and 60 mg5 mg, 10 mg, and 20 mg
Dosage formsOral capsuleOral tablet and oral solution
Recommended age group7 years and older (generalized anxiety disorder)  12 years and older (major depressive disorder) 

What Conditions Are Treated with Cymbalta and Lexapro?

Both Cymbalta and Lexapro are prescription medications for the treatment of major depressive disorder and generalized anxiety disorder

Cymbalta is also approved for treating some pain-related conditions, including fibromyalgia, diabetic peripheral neuropathic pain, and chronic musculoskeletal pain.

Cymbalta is the only antidepressant approved to treat neuropathic pain. 

Lexapro is prescribed off-label for the treatment of conditions such as panic disorder, premenstrual dysphoric disorder, and obsessive-compulsive disorder. 

When a doctor or healthcare provider prescribes a drug off-label, they prescribe it for a condition that the FDA has not approved.

Off-label prescription is not illegal, but your doctor should explain how the drug may help your condition.

Below is a summary of the conditions that Cymbalta and Lexapro are used to treat:

ConditionCymbaltaLexapro
Major depressive disorder (MDD)YesYes
Generalized anxiety disorder (GAD)YesYes
Irritable bowel syndrome (IBS)YesYes
FibromyalgiaYesNo
Chronic musculoskeletal painYesNo
Diabetic peripheral neuropathic pain (DPNP)YesNo
Panic disorderNoOff-label
Obsessive-compulsive disorder (OCD)NoOff-label
Premenstrual dysphoric disorderNoOff-label
Posttraumatic stress disorderNoOff-label
Social anxiety disorderNoOff-label
Vasomotor symptoms of menopauseNoOff-label
Chemotherapy-induced peripheral neuropathyOff-labelNo
Stress urinary incontinenceOff-labelNo

This list is not conclusive.

Consult your doctor to know which medication is suitable for you. 

Effectiveness of Cymbalta and Lexapro

A comparative study of escitalopram (Lexapro) and duloxetine (Cymbalta) found that escitalopram was superior to duloxetine for short-term treatment of depression.

The researchers also concluded that escitalopram is as effective as and more tolerable than duloxetine for long-term treatment.

Due to adverse reactions, the withdrawal rate of patients on duloxetine was 8% higher than that of patients on escitalopram. 

Another study showed similar results: Escitalopram was better tolerated and at least as effective as duloxetine for treating major depressive disorder.

This is not to say that Lexapro is better than Cymbalta for treating depression, but rather that people were more likely to discontinue Cymbalta due to common adverse reactions.

Coverage & Cost of Cymbalta and Lexapro

Medicare and commercial insurance plans usually cover at least some of the cost of both generic versions and brand-name Cymbalta and Lexapro. 

The exact cost of your medication varies depending on the brand and dosage, as well as your insurance and pharmacy.

A month’s supply of 30-milligram Cymbalta can cost almost $350, while a month of 20-milligram Lexapro can cost up to $260.

You may be able to save money using coupon codes with participating pharmacies.

Common Side Effects of Cymbalta and Lexapro

Cymbalta and Lexapro share similar side effects, although some are more pronounced using one drug than the other.

The table below covers the possible side effects, though this list is not exhaustive.

CymbaltaLexapro
Side effectApplicableApplicable
NauseaYesYes
SweatingYesYes
Dry mouthYesYes
DrowsinessYesYes
DizzinessYesYes
Decreased appetiteYesYes
Decreased libidoNoYes
ConstipationYesYes
HeadacheYesNo

Most symptoms do not last past the first few weeks of starting either medication.

If you experience any of these symptoms, speak with your doctor.

They can help you manage them and, depending on how severe they are, may suggest switching to another antidepressant.

Have questions about an antidepressant prescription? Chat with a doctor today.
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Drug Interactions & Warnings 

Cymbalta and Lexapro can have unpleasant reactions with other drugs.

Before starting either medication, inform your doctor of the other medicines you’re using, including vitamins and supplements.

Cymbalta and Lexapro should not be used within 14 days of using any monoamine oxidase inhibitors (MAOIs).

This class of antidepressants includes:

  • Isocarboxazid (Marplan)
  • Phenelzine (Nardil)
  • Selegiline (Emsam)
  • Tranylcypromine (Parnate)
  • Linezolid (Zyvox)
  • Intravenous methylene blue

Cymbalta and Lexapro also interact with other serotonergic medications such as:

  • Tricyclic antidepressants
  • Triptans
  • Lithium
  • Fentanyl
  • Buspirone
  • Tramadol
  • Tryptophan
  • St. John’s wort
  • Amphetamine

Lastly, using Cymbalta and Lexapro with aspirin, non-steroidal anti-inflammatory drugs (NSAIDs), warfarin, and other anticoagulants increases bleeding risk, including life-threatening hemorrhages.

Cymbalta or Lexapro also have side effects of their own.

People taking either medication for major depressive disorder or other psychiatric disorders are at risk for increased suicidal thoughts and behavior.

If you have any concerning thoughts, seek care immediately.

How K Health Can Help 

Your choice of an antidepressant can affect the quality of your life. You need to consult a doctor to know which treatment plan will be best for you.

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

Which is better for depression, Cymbalta or Lexapro?
Studies show that duloxetine (Cymbalta) and escitalopram (Lexapro) are equally effective at treating major depressive disorder long term. However, a randomized controlled trial reported that escitalopram was better tolerated. Your doctor can discuss all of the pros and cons with you when prescribing the right antidepressant for you.
Is Cymbalta a good replacement for Lexapro?
Since Cymbalta and Lexapro have similar efficacy in the treatment of depression, it can be a suitable replacement. One concern is that Cymbalta tends to be less tolerated, so people may be more likely to discontinue the medication. Also, Lexapro is prescribed off-label for some conditions that Cymbalta cannot be used for. Your doctor or healthcare provider can provide you with more information about whether it is a good choice 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.

Frank DiVincenzo, MD

Dr. Frank DiVincenzo has been a physician with K Health since 2020. He grew up near Chicago, Illinois, but left the big city to go to college and then attend graduate school in Missouri. He received a Bachelor of Science in Mathematics and a Master of Science in Microbiology before graduating from the University of Missouri–Columbia School of Medicine.