Table of ContentsView AllTable of ContentsKey Differences Between Cymbalta and LexaproUsesHow Do They Work?Which Is More Effective for Depression?Side EffectsWarningsDrug InteractionsChoosing Between Cymbalta and Lexapro
Table of ContentsView All
View All
Table of Contents
Key Differences Between Cymbalta and Lexapro
Uses
How Do They Work?
Which Is More Effective for Depression?
Side Effects
Warnings
Drug Interactions
Choosing Between Cymbalta and Lexapro
Cymbalta (duloxetine)and Lexapro (escitalopram) are antidepressant medications. Though these two medications have some similarities, there are a few key differences.
Read on to learn more about the similarities and differences between Lexapro and Cymbalta and why a healthcare provider may recommend one of these medications over the other to treat depression.
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Cymbalta and Lexapro are alike and different in many ways. Both are commonly taken to treat depression and anxiety disorders. But Cymbalta is approved to treat other conditions as well.
They also belong to different drug classes, have slightly different mechanisms of action, and may cause different side effects.
Cymbalta, on the other hand, is a brand-name medication also known as duloxetine. It belongs to theserotonin-norepinephrine reuptake inhibitor (SNRI)drug class.
The table below compares key facts about the two medications.
What Are Cymbalta and Lexapro’s Uses?
The U.S. Food and Drug Administration (FDA) has approved Lexapro and Cymbalta to treat depression and anxiety. However, Cymbalta has been approved for other uses as well.
Specifically, the FDA approved Lexapro to treat:
Cymbalta’s FDA-approved uses include:
SSRIs vs. SNRIs: How Do They Work?
Serotoninandnorepinephrineare neurotransmitters. Neurotransmitters are chemicals that help neurons (nerve cells) communicate. Theseneurotransmittersperform key roles in regulating mood, behavior, sleep, and more.
When someone has depression, it may be due to a chemical imbalance in their brain. Without a sufficient amount of serotonin and/or norepinephrine available, neurons may not communicate effectively, leading to difficulty regulating mood and mental health changes.
SSRIs
All SSRIs have the same mechanism, but a person may have a better response to one SSRI than another. Other examples of other SSRIs include:
SNRIs
SNRIs, such as Cymbalta, have a similar mechanism but target two neurotransmitters instead of one.
By binding to specific receptors on neurons, SNRIs block serotonin and norepinephrine reuptake, allowing more of these neurotransmitters to stay active in the brain. This helps to improve communication between nerve cells and may help to ease symptoms of depression or anxiety.
All SNRIs work this way. However, same as it is with SSRIs, some people may respond better to one SNRI than another. Examples of other SNRIs include:
SSRIs and SNRIs take a couple of weeks to start working, and dose adjustments are often necessary. It’s important to follow up with your prescriber to discuss any changes in your symptoms or dosage.
SSRIs vs. SNRIs: How They Work
Is Cymbalta or Lexapro better? This question can be tricky to answer because each person may respond differently to each medication.
However, clinical trials provide some information that helps compare the two medications regarding how well they work for treating depression.
Researchers measure the effectiveness of an antidepressant in clinical trials with various assessment metrics, such as symptom rating scales.
What Is a Symptom Rating Scale?A symptom rating scale is an assessment measurement system for rating symptoms before treatment begins. It’s repeated after the participants have taken medication (or placebo) for a certain length of time. One suchmeasurement toolis the Hamilton Rating Scale for Depression (HRSD).
What Is a Symptom Rating Scale?
A symptom rating scale is an assessment measurement system for rating symptoms before treatment begins. It’s repeated after the participants have taken medication (or placebo) for a certain length of time. One suchmeasurement toolis the Hamilton Rating Scale for Depression (HRSD).
In separate clinical trials, Cymbalta and Lexapro were similarly effective in reducing depression symptoms when compared to a placebo.
Compared to a placebo, taking Cymbalta led to a 10- to 12-point improvement on a depression rating scale after two months of treatment.Similarly, taking Lexapro resulted in a reduction of 12 points compared to placebo after two months.
A head-to-head clinical trial is a better way to measure the relative effectiveness of two medications. A few trials have compared Cymbalta and Lexapro for MDD. Here’s what these studies found:
Meta-analysis is another tool that can help researchers draw conclusions based on data from multiple individual studies.
A 2018 meta-analysis reviewed various studies of Cymbalta and Lexapro to compare the two medications. Overall, the results suggest that Cymbalta and Lexapro are similarly effective in reducing depression symptoms.
RecapUltimately, Lexapro and Cymbalta are similarly effective for treating depression. However, individual results can vary.If one of these medications does not work well, trying the other remains an option. The decision to stay on a particular antidepressant versus switching to a different one often boils down to how well a person tolerates the medication.
Recap
Ultimately, Lexapro and Cymbalta are similarly effective for treating depression. However, individual results can vary.If one of these medications does not work well, trying the other remains an option. The decision to stay on a particular antidepressant versus switching to a different one often boils down to how well a person tolerates the medication.
Ultimately, Lexapro and Cymbalta are similarly effective for treating depression. However, individual results can vary.
If one of these medications does not work well, trying the other remains an option. The decision to stay on a particular antidepressant versus switching to a different one often boils down to how well a person tolerates the medication.
Side Effects of Cymbalta vs. Lexapro: Which Is More Tolerable?
Most people can take Cymbalta or Lexapro without having side effects, and if they occur, they’re usually temporary or mild.
Because these medications work similarly in the body, they share many of the same potential side effects.
Mild side effects that are common for Cymbalta and Lexapro include:
Some mild side effects are unique to one medication. Taking Cymbalta may also result indry mouth,constipation, and decreased appetite.Those taking Lexapro may experienceinsomniaor fatigue.
Based on comparative studies, Lexapro is generally a better-tolerated medication and causes fewer side effects than Cymbalta. In head-to-head trials and other studies, more participants stopped taking Cymbalta because of side effects than those who were taking Lexapro.
October 2024 RecallStarting in October 2024, over 200,000 bottles of duloxetine delayed-release capsules were recalled over concerns about the presence of nitrosamines, which can increase the risk of cancer.If you take duloxetine, check your medication packaging to see if it was part of the affected lots or call your pharmacist to find out. You should also contact your prescriber, as abruptly stopping a medication like duloxetinecan be dangerous.The recalled lots have expiration dates from November 2024 to December 2025. You can check the lot numbers in the FDA enforcement reports released inOctoberandDecember.
October 2024 Recall
Starting in October 2024, over 200,000 bottles of duloxetine delayed-release capsules were recalled over concerns about the presence of nitrosamines, which can increase the risk of cancer.If you take duloxetine, check your medication packaging to see if it was part of the affected lots or call your pharmacist to find out. You should also contact your prescriber, as abruptly stopping a medication like duloxetinecan be dangerous.The recalled lots have expiration dates from November 2024 to December 2025. You can check the lot numbers in the FDA enforcement reports released inOctoberandDecember.
Starting in October 2024, over 200,000 bottles of duloxetine delayed-release capsules were recalled over concerns about the presence of nitrosamines, which can increase the risk of cancer.If you take duloxetine, check your medication packaging to see if it was part of the affected lots or call your pharmacist to find out. You should also contact your prescriber, as abruptly stopping a medication like duloxetinecan be dangerous.
The recalled lots have expiration dates from November 2024 to December 2025. You can check the lot numbers in the FDA enforcement reports released inOctoberandDecember.
Though rare, taking either Cymbalta or Lexapro may result in severe side effects. Examples include:
Taking Cymbalta may result in additional potentially severe side effects. These include:
Additionally, both Cymbalta and Lexapro carry aboxed warning, the most serious warning the FDA provides.
This warning speaks to the increased risk ofsuicidal thoughts and behaviorsthat either medication may cause in children or young adults. They encourage close monitoring for individuals who are starting either Cymbalta or Lexapro for any worsening or emerging suicidal thoughts or behaviors.
Lexapro and Cymbalta interact with many other medications. These interactions may limit the medications' effectiveness or raise the risk of side effects.
Cymbalta and Lexapro should not be taken withmonoamine oxidase inhibitors (MAOIs), which means they should not be taken at the same time or within 14 days of each other. MAOIs include Marplan (isocarboxazid), Zyvox (linezolid), and methylene blue. Taking MAOIs with antidepressants may dangerously increase the risk of serotonin syndrome.
Though less severe, some other medications may interact with both Lexapro and Cymbalta, such as:
Some additional medications interact with Cymbalta but not Lexapro. Examples include:
This is not a complete list of medications that may interact with Cymbalta or Lexapro. Before combining medications, check with a healthcare professional or pharmacist.
Several factors are important to consider when deciding between Cymbalta and Lexapro.
Though both are similarly effective for treating depression in some people, others may not find the same success. If one of these drugs does not offer improvement, trying the other medication may work.
Another important consideration is side effects. Some studies suggest that Lexapro provides effective treatment with more tolerable side effects. Therefore, considering potential side effects is essential when selecting one of these medications.
Talking with a healthcare provider will work best when selecting one of these medications. This professional will understand your health background and what key factors they should address to ensure safe and effective care with either Cymbalta or Lexapro.
Help Is AvailableIf you or someone you know is having suicidal thoughts, dial988to contact the988 Suicide & Crisis Lifelineand connect with a trained counselor.
Help Is Available
If you or someone you know is having suicidal thoughts, dial988to contact the988 Suicide & Crisis Lifelineand connect with a trained counselor.
Summary
Lexapro and Cymbalta are two antidepressants commonly taken to manage depression and anxiety. Lexapro belongs to the SSRI drug class, while Cymbalta is part of the SNRI class of medications.
Clinical trials suggest these medications are similarly effective, but individual responses may vary.
Though both drugs may commonly cause side effects like nausea and sexual dysfunction, Cymbalta tends to have more side effects compared to Lexapro. Both medications can interact with various medications, but Cymbalta’s interactions may more significantly interfere with its effectiveness.
When choosing between the two medications, your healthcare provider should consider factors such as individual response, side effect profiles, and interactions.
6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institutes of Health DailyMed.Label: Lexapro- escitalopram tablet, film coated.National Institutes of Health DailyMed.Label: Cymbalta- duloxetine hydrochloride capsule, delayed release.New Frontiers Psychiatric & TMS.Neurotransmitters involved in depression. December 5, 2023.Khan A, Bose A, Alexopoulos GS, et al.Double-blind comparison of escitalopram and duloxetine in the acute treatment of major depressive disorder.Clin Drug Invest.2007;27:481-492. doi:10.2165/00044011-200727070-00005Pigott TA, Prakash A, Arnold LM, et al.Duloxetine versus escitalopram and placebo: an 8-month, double-blind trial in patients with major depressive disorder.Curr Med Res Opin.2007;23(6):1303-1318. doi:10.1185/030079907X188107.Food and Drug Administration.What to Know and Do About Possible Nitrosamines in Your Medication.
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institutes of Health DailyMed.Label: Lexapro- escitalopram tablet, film coated.National Institutes of Health DailyMed.Label: Cymbalta- duloxetine hydrochloride capsule, delayed release.New Frontiers Psychiatric & TMS.Neurotransmitters involved in depression. December 5, 2023.Khan A, Bose A, Alexopoulos GS, et al.Double-blind comparison of escitalopram and duloxetine in the acute treatment of major depressive disorder.Clin Drug Invest.2007;27:481-492. doi:10.2165/00044011-200727070-00005Pigott TA, Prakash A, Arnold LM, et al.Duloxetine versus escitalopram and placebo: an 8-month, double-blind trial in patients with major depressive disorder.Curr Med Res Opin.2007;23(6):1303-1318. doi:10.1185/030079907X188107.Food and Drug Administration.What to Know and Do About Possible Nitrosamines in Your Medication.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institutes of Health DailyMed.Label: Lexapro- escitalopram tablet, film coated.National Institutes of Health DailyMed.Label: Cymbalta- duloxetine hydrochloride capsule, delayed release.New Frontiers Psychiatric & TMS.Neurotransmitters involved in depression. December 5, 2023.Khan A, Bose A, Alexopoulos GS, et al.Double-blind comparison of escitalopram and duloxetine in the acute treatment of major depressive disorder.Clin Drug Invest.2007;27:481-492. doi:10.2165/00044011-200727070-00005Pigott TA, Prakash A, Arnold LM, et al.Duloxetine versus escitalopram and placebo: an 8-month, double-blind trial in patients with major depressive disorder.Curr Med Res Opin.2007;23(6):1303-1318. doi:10.1185/030079907X188107.Food and Drug Administration.What to Know and Do About Possible Nitrosamines in Your Medication.
National Institutes of Health DailyMed.Label: Lexapro- escitalopram tablet, film coated.
National Institutes of Health DailyMed.Label: Cymbalta- duloxetine hydrochloride capsule, delayed release.
New Frontiers Psychiatric & TMS.Neurotransmitters involved in depression. December 5, 2023.
Khan A, Bose A, Alexopoulos GS, et al.Double-blind comparison of escitalopram and duloxetine in the acute treatment of major depressive disorder.Clin Drug Invest.2007;27:481-492. doi:10.2165/00044011-200727070-00005
Pigott TA, Prakash A, Arnold LM, et al.Duloxetine versus escitalopram and placebo: an 8-month, double-blind trial in patients with major depressive disorder.Curr Med Res Opin.2007;23(6):1303-1318. doi:10.1185/030079907X188107.
Food and Drug Administration.What to Know and Do About Possible Nitrosamines in Your Medication.
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