Cymbalta vs Effexor – Which Is The Best SNRI For Anxiety?


It is the brand name of duloxetine, a serotonin-norepinephrine reuptake inhibitor (SNRI). It works by changing the balance of norepinephrine and serotonin in the brain. This can lead to pain relief and improved mood.


This drug is typically used to treat generalized anxiety disorder, major depressive disorder (a mental disorder which is described by at least 14 days of low mood), painful peripheral neuropathy (occurs when nerves that transport messages are damaged), and osteoarthritis pain.


The dose of this drug will be different for different sufferers. Follow the directions on the label or your healthcare professional’s instructions.

The usual recommended dose for depression is 60 mg once per day. Some individuals may start on a lower dose of 30 mg once per day. However, do not exceed 120 mg a day.

It may take 1 week to 1 month or even longer before you feel the full benefits of this medicine. Do not stop taking this drug without talking to your healthcare provider.

Side Effects And Precautions Of Duloxetine

Common side effects may include:

  • sexual dysfunction (delayed ejaculation and orgasm and decreased sex drive)
  • dry mouth;
  • nausea;
  • sleepiness;
  • constipation;
  • seizures;
  • increased blood pressure;
  • dizziness;
  • difficulty sleeping;
  • fatigue.

Rare side effects may include:

  • decreased appetite;
  • diarrhea;
  • vomiting;
  • tremor;
  • hot flashes;
  • suicidal thoughts;
  • pneumonia;
  • bleeding problems;
  • irregular heart rhythm;
  • glaucoma (an eye disorder that causes damage to the optic nerve);
  • hives;
  • rash;
  • liver damage.

Interaction with other drugs may lead to serotonin syndrome. Symptoms include:

  • heavy sweating;
  • diarrhea;
  • agitation;
  • muscle rigidity;
  • confusion;
  • twitching muscles;
  • dilated pupils;
  • rapid heart rate.

Weight Gain

According to a 2006 study done at the Inova Fairfax Hospital, people treated with this drug experienced weight loss after short-term treatment. However, it was followed by weight gain on longer-term treatment.

Moreover, this medicine can affect the capacity to think clearly, make decisions, therefore, it is not recommended to operate heavy machinery or drive until you know exactly how the medicine affects you.

Drug Interactions

In addition, do not take this drug within 14 days after or 5 days before you have used an MAO inhibitor (medicines that inhibit the activity of one or both monoamine oxidase enzymes), like – linezolid, isocarboxazid, phenelzine, methylene blue injection, selegiline, rasagiline, or tranylcypromine.


It is the brand name of a drug called venlafaxine, a serotonin-norepinephrine reuptake inhibitor, which is used to treat depression.

This drug works by increasing the amount of norepinephrine and serotonin (chemicals released by nerves within the brain in order to communicate with one another) available in the brain.

The brand version of this drug has been discontinued in the US, however, its generic form is still available.


Note – it is not approved by the US Food and Drug Administration for the treatment of depression in children.

It is typically used to treat the symptoms of anxiety causing distress in social anxiety disorder (social phobia), generalized anxiety disorder, and panic disorder as well as to treat depression.


The usual recommended dose is 37.5-375 mg per day.

Side Effects And Precautions Of Venlafaxine

Common side effects may include:

  • blurred vision;
  • dizziness;
  • unusual dreams;
  • headaches;
  • sexual problems;
  • increase in heart rate;
  • dry mouth;
  • vomiting;
  • nausea;
  • diarrhea;
  • constipation;
  • loss of appetite;
  • sweating;
  • shaking;
  • change in sleep habits;
  • feeling tired.

More importantly, an excess of serotonin in the body (brought on by the use of medicines that raise serotonin levels) leads to serotonin syndrome. Symptoms include:

  • diarrhea;
  • vomiting;
  • nausea;
  • lack of coordination;
  • fever;
  • racing heart;
  • mental confusion.

To make sure this drug is safe for you, tell your healthcare professional if you have ever had or have:

  • kidney disease;
  • bipolar disorder (a brain condition that causes unusual shifts in energy, mood, levels, or activity);
  • diabetes;
  • low levels of sodium in the blood;
  • cirrhosis (a life-threatening condition in which the liver does not function normally because of long-term damage);
  • a thyroid disorder;
  • high LDL and total cholesterol;
  • hypertension;
  • heart disease;
  • blood clotting disorder;
  • narrow-angle glaucoma;
  • seizures.

It may interact with other drugs which make you sleepy, including:

  • naratriptan, sumatriptan, rizatriptan;
  • almotriptan, warfarin, frovatriptan;
  • risperidone, haloperidol, tramadol;
  • ketoconazole, cimetidine, linezolid;
  • monoamine oxidase inhibitors;
  • nonsteroidal anti-inflammatory drugs;
  • medicines for anxiety or seizures;
  • muscle relaxers;
  • sleeping pills;
  • narcotic pain medicine;
  • sedatives;
  • allergy medicines.

More importantly, the Food and Drug Administration has issued a black-box warning for this medicine due to the fact that it can increase the risk of suicidal thoughts, especially in teenagers, children, and young adults.


Do not intake alcohol while taking this medication.

Cymbalta vs Effexor – Which Is The Best SNRI For Anxiety?

Both these SNRIs are effective, however, talk to your healthcare specialist about which is best for you. He will make an educated guess on what is best based on your condition and how you have reacted to drugs in the past.

However, Effexor is more likely to cause more side effects.

Similar Drugs to Effexor and Cymbalta

Other drugs in this class include:

#1 Milnacipran

It is a selective serotonin and norepinephrine reuptake inhibitor which is used for treating the pain associated with fibromyalgia. However, in the United States, it is not approved for the allopathic treatment of major depressive disorder (unlike other countries, where it is used).

#2 Desvenlafaxine

It is a prescription medicine that comes in the form of an extended-release tablet. It is in a class of drugs called selective serotonin and norepinephrine reuptake inhibitors that are used to treat depression by increasing the serotonin and norepinephrine levels in the brain.

#3 Levomilnacipran 

In 2013, this antidepressant was approved in the US for the treatment of major depressive disorder in adults. It works by helping to restore the normal balance of serotonin and norepinephrine in the brain.

10 Alternative Remedies To Treat Anxiety & Depression:

#1 Valerian

This herb has been used to treat depression and anxiety for millennia. Also, it is available in sleep teas at a dose of about 20 mg.

#2 St. John’s Wort

It is a plant that grows in the wild and it is used for health purposes, especially for the treatment of depression in the European Union.

According to recent studies, St. John’s wort can be as effective as prescription medicines for easing symptoms of depression.

#3 Get Enough Sleep

Too little sleep can make depression worse. Aim for at least 7 hours of uninterrupted sleep per night.

#4 Saffron

Extracts made from saffron have been shown to be effective natural antidepressants in a few small clinical trials.

#5 Physical Exercise

Exercise temporarily boosts endorphins levels, the feel-good chemicals, plus, it improves sleep, increases energy levels, and distracts from worries.

#6 Nutrition

Eat foods that support neurotransmitters, like omega-3 fatty acids. Grounded flax seeds are the best source of omega 3. Also include chia seeds and walnuts.

#7 Mindfulness Meditation

Meditation has been shown to have a potent effect on lessening symptoms of depression, like – rumination, negative thinking, and lack of focus.

#8 Spend Time Outside

Expose yourself to sunlight, which can boost mood as well as increases your vitamin D levels.

#9 Acupuncture

This technique has proven itself to be very useful in treating a few mood disorders, including depression. You can expect some improvement within 14 days from starting the acupuncture treatment.

#10 Turmeric

Curcumin, the main active ingredient in turmeric, is renowned for its potent brain-boosting and anti-inflammatory attributes.

Images source – Shutterstock & Getty

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