Anxiety and depression on their own can leave a patient confused about their causes, manifestations, and management. And sadly, the confusion only stands to double or triple when the doctor starts to prescribe medicines or drugs to manage the problem.
The particulars and considerations behind such medications pose an incomprehensible nebulous to some patients. They subsequently prefer to leave all these details solely to their doctors. They don’t want to know how it works; they just want to know that it works. However, the “don’t bother me with the details” attitude may detriment the patient’s recovery, according to many doctors and researchers, especially when it comes to medicines or drugs that partially overlap—namely, Cymbalta and Effexor.
According to a mental-health advocacy and support organization that has been operating for more than a century, Mental Health America (MHA), knowing all the nitty-gritty of your prescriptions actually serves to benefit your recovery.
Take side-effects, for example. If you and your doctor do not talk honestly and in detail about the side effects of your medications, you may be prone to quit taking a prescription because its side-effects caught you off guard or created unplanned discomfort.
“It’s becoming clearer to researchers, providers, and mental health consumers . . . that being actively involved in your treatment can make a great difference in your recovery,” says an article on MHA’s website.
Cymbalta and Effexor XR, both brand-name drugs widely used for anxiety and depression, actually share the same drug classification: serotonin and norepinephrine reuptake inhibitors. They both treat major depressive disorder (MDD) and generalized anxiety disorder (GAD), but the overlaps stop there. One, Cymbalta, actually treats disorders outside of anxiety and depression while Effexor also treats more specialized conditions of anxiety and depression.
What Cymbalta Treats
Cymbalta (generically called duloxetine) is prescribed for not only mental illness but some chronic physical disorders as well.
As mentioned previously, doctors prescribe it for MDD and GAD. However, it also is used in treatment for diabetic peripheral pain caused by high blood sugar (e.g., numbness or pain in feet, legs, or hands) and fibromyalgia; a chronic musculoskeletal pain for which the cause is still uncertain.
What Effexor Treats
Effexor (generically called venlafaxine) is prescribed for the same two disorders that Cymbalta covers: MDD and GAD. However, it treats two specific varieties of depression that Cymbalta does not: social anxiety disorder (the fear of being judged negatively or rejected in a social setting) and panic disorder (sudden, intense moments of fear resulting in physical dysfunctions).
What are the Side Effects?
These two drugs also share some of the same side effects from their use, according to MedicineNet.com, a health-based website. These include dry mouth, dizziness, nausea, and insomnia.
However, unlike Effexor, the use of Cymbalta can also cause diarrhea, constipation, and fatigue. Unlike Cymbalta, Effexor can leave its users with such side-effects as headaches, anxiety, loss of appetite, drowsiness, sweating, and weight loss.
More Severe Side Effects Explained
Each drug also holds the potential for more serious side effects than the aforementioned ones, including impotence, seizures, heightened blood pressure, and sometimes suicidal behavior.
Shared Withdrawal Symptoms
Upon cessation of either drug, a host of withdrawal symptoms can occur, including dizziness, anxiety, nausea, vomiting, nervousness, diarrhea, irritability, and insomnia.
How Cymbalta Works
The control of neurotransmitters—communicators to the brain—lies at the core of what both drugs do to treat various forms of anxiety and depression.
Via nerve cells, Cymbalta halts the reuptake of two particular neurotransmitters—serotonin and epinephrine—upon their release, according to MedicineNet.com. In other words, it prevents the reabsorption of secreted substances by the cell that originally produced and secreted them. This prevention of reabsorption increases the effects of both these neurotransmitters in the brain.
How Effexor Works
Effexor XR works similarly to Cymbalta. It stops the reuptake of serotonin, just like Cymbalta. However, instead of preventing the reabsorption of the secreted substances of these cells in epinephrine, it prevents the reuptake in a neurotransmitter called norepinephrine.
Dosages and Regimens
Not only do the dosages for Effexor and Cymbalta differ, but so do the regimens, mostly due to easing off the drug in the case of Effexor and acclimating to it in the case of Cymbalta.
Recommended Dosages for Cymbalta
For treating depression, doctors commonly recommend 20 or 30 mg of Cymbalta twice a day or 60 mg once a day. However, if patients need to adjust to the drug, doctors may allow them to start out on 30 mg per day for a week or so and then advance to 60 mg per day.
For anxiety disorder and pain connected to diabetic neuropathy, fibromyalgia, or chronic musculoskeletal discomfort, doctors recommend 60 mg per day as well.
Though the maximum dose for patients suffering from any of these maladies is 120 mg per day, research reveals no evidence of added benefits to treatment when patients take the maximum dose.
Recommended Dosages for Effexor
Dosages for Effexor XR vary more widely than those for Cymbalta because of the differing levels of GAD, MDD, and social anxiety disorder from one patient to the next. Its release extends over a greater period of time than Cymbalta—up to two weeks.
It can also be ingested in more ways than Cymbalta. Effexor XR must be taken with meals, but the patient can break the capsule apart to sprinkle the medicine onto food. However, the drug’s release is immediate rather than extended once the capsule is broken.
Doctors generally recommend a dosage of 75-375 mg two to three times a day (every 8 or 12 hours). The dose for extended-release commonly consists of 37.5-225 mg once a day. Often, dosages start on the low end of this spectrum as the doctor adjusts the volume in accordance with the individual’s treatment needs.
More specifically, dosages for generalized anxiety and panic disorder range from 37.5-225 mg once a day when using the extended-release method. Social anxiety treatment generally requires 75 mg per day when using extended-release.
Any sudden cessation of an Effexor XR prescription risks withdrawal symptoms. Therefore, the dosages of this drug should be lowered in strict accordance with the doctor’s instructions.
Fully Informed Patients Aid Recovery
The more patients know about how these two medicines overlap and how they differ, the more likely those patients will speed their recovery and minimize the potential of exacerbating their conditions. If you suffer from one of the conditions requiring Cymbalta or Effexor, make sure you learn about all the ramifications of these two drugs from your physician for your own benefit and peace of mind.