Do you often or always find yourself sighing, worrying, sad, irritable, frustrated, or hopeless? Do things you enjoyed before no longer bring you joy? Are you also having trouble falling asleep, staying asleep, or waking up in the morning?
If you answered yes to any or all those questions, please see a doctor or therapist ASAP. Those are symptoms of depression, affecting 16 million American adults yearly. They can also indicate anxiety disorders, often co-occurring with depression.
The good news is that, for most people, medications help.
To that end, we created this guide comparing Cymbalta vs. Lexapro, two of the most popular medications for anxiety and depression. Read on, as what you learn here can help give you a better idea of how they work and if they can benefit you.
Cymbalta vs. Lexapro: The Chief Differences
Cymbalta and Lexapro are prescription drugs indicated for treating major depressive disorder (MDD). Both also have FDA-approved indications for the treatment of generalized anxiety disorder (GAD). However, they belong to different classes of depression medications.
Cymbalta (duloxetine) is a selective serotonin-norepinephrine reuptake inhibitor (SNRI). Lexapro (escitalopram) is a selective serotonin reuptake inhibitor (SSRI). So, they work differently when treating depression and anxiety (we’ll explain this in more detail later).
How they work also makes their side effects different. For the same reason, their off-label uses also vary.
For example, the U.S. FDA has approved duloxetine to treat some pain conditions. These include fibromyalgia, chronic musculoskeletal pain, and neuropathic pain. It’s the only FDA-approved antidepressant for neuropathic pain.
How They Work
Before discussing how Cymbalta and Lexapro work, let’s cover norepinephrine and serotonin first. In particular, their roles in depression and anxiety.
Norepinephrine and serotonin are primarily neurotransmitters. You can think of them as chemical messengers. They carry chemical signals from one neuron (a nerve cell) to a target cell.
Norepinephrine (noradrenaline) plays many roles, like providing energy and maintaining metabolism. However, too much of it can cause anxiety and irritability. Conversely, too little can lead to depression, lack of energy, and poor memory.
Serotonin, one of the body’s natural “feel-good” chemicals, helps regulate moods and sleep. So, it’s no wonder experts link low levels of it with depression and poor sleep quality.
Now that you know more about norepinephrine and serotonin, let’s discuss what they have to do with Cymbalta and Lexapro.
How Cymbalta Works
As an SNRI, Cymbalta inhibits the “reuptake” of norepinephrine and serotonin. This means it blocks nerve cells from reabsorbing these two neurotransmitters.
As a result, more norepinephrine and serotonin become available. So, the body can use more of them to influence and create positive moods.
How Lexapro Works
As an SSRI, Lexapro blocks the reuptake of serotonin.
That increases the serotonin levels in the brain. Other neurons can then use the neurotransmitter for tasks like emotion regulation.
Their Varying Off-Label Uses
“Off-label use” is when a doctor prescribes an FDA-approved drug to treat a non-FDA-approved condition.
Some of Cymbalta’s off-label uses are for the following:
- Chemotherapy-induced peripheral neuropathy
- Stress urinary incontinence
As for Lexapro, doctors may prescribe it off-label for these conditions:
- Social anxiety disorder (SAD)
- Obsessive-compulsive disorder (OCD)
- Panic disorder
- Posttraumatic stress disorder (PTSD)
- Premenstrual dysphoric disorder
- Management of menopause-related vasomotor symptoms
If you feel worried about using either drug for an off-label prescription use, don’t. It’s a legal practice and one so common that one in five prescriptions are for drugs used off-label.
The Difference in Side Effects
Cymbalta and Lexapro share similar medication side effects, like nausea, dry mouth, and sweating. Both can also cause “somnolence,” the state of feeling drowsy.
However, these two drugs also have different adverse effects.
For example, Cymbalta may cause the following that Lexapro may not:
- Elevated blood pressure
Conversely, these side effects may occur in Lexapro users but not Cymbalta users:
- Agitation or restlessness
- Fever and headaches
- Appetite changes
- Increased urination
While the list is longer for Lexapro, it doesn’t mean Cymbalta is always better.
Indeed, research suggests patients tolerate escitalopram better than duloxetine. They experience fewer adverse events when taking escitalopram. So, they’re less likely to stop its use (compared to people taking duloxetine).
The Price Difference
Do a quick online search on their prices, and you’ll find that Cymbalta costs less per unit than Lexapro. For example, Drugs.com lists the price of one 60 mg delayed-release capsule of Cymbalta at about $10. By contrast, one 10 mg tablet of Lexapro costs nearly $15.
Fortunately, both are also available in generic form. Generic drugs are often cheaper than their brand-name counterparts.
But whether you go for branded or generic, you can often find both as discounted medication online.
When to Take Which
The best and safest way to determine which drug to take is to speak with a doctor or psychiatrist. This is especially crucial if you’re already on other medicines. Cymbalta and Lexapro can interact with them and cause even more side effects.
An example is taking either with other serotonin-boosting drugs (e.g., other SNRIs and SSRIs). This can lead to a condition known as serotonin syndrome. It occurs when there’s too much serotonin in the body and is potentially life-threatening.
Your doctor may also advise against drinking alcohol while you’re on either drug. Alcohol may increase or worsen their side effects.
What if you’re not on any medication?
You should still see a specialist. For one, you can only buy Cymbalta and Lexapro with a prescription.
Still, your doctor may put you on Lexapro first since it often has fewer side effects. But if you also deal with pain-related conditions, they may prescribe Cymbalta.
Get Started on Your Treatment Today
Remember: This Cymbalta vs. Lexapro comparison guide is only for educational purposes. It’s not meant to replace a licensed doctor’s or psychiatrist’s advice.
So, if you think you can benefit from either drug, please see a specialist ASAP. The sooner you do, the sooner you can start treatment. And within a few weeks of doing so, you may already experience relief from symptoms.
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