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Cymbalta Alternatives to Consider — Talkspace

Published on: 30 Nov 2023


Cymbalta (duloxetine) is a common antidepressant for treating depression and anxiety. It’s also sometimes prescribed for diabetic peripheral neuropathy and other medical conditions that cause pain, like arthritis, fibromyalgia, and chronic back pain. Cymbalta is in a class of drugs known as serotonin-norepinephrine reuptake inhibitors (SNRIs). SNRIs balance norepinephrine and serotonin levels — neurotransmitters associated with mood regulation and alertness — in the brain.

While Cymbalta can be very effective for some people, it’s not always the right medication for everyone. It might cause undesirable Cymbalta side effects, adverse drug interactions, not be effective in relieving symptoms, or you might just be looking for natural alternatives to Cymbalta use. Holistic treatment options are becoming more appealing and familiar, whether combined with medication or therapy or when used independently. 

Whatever your reason is for looking into Cymbalta alternatives, we’re diving into everything you need to know about natural remedies and other drugs similar to Cymbalta. 

Alternative Medications to Cymbalta

There are a variety of medications that may be viable alternatives to Cymbalta for depression or other conditions. Since every drug has unique traits, benefits, risks, and side effects, exploring each option and checking with a healthcare provider is vital before switching from Cymbalta.

1. Lexapro 

Lexapro (escitalopram) is an alternative to Cymbalta that might be good for people who are concerned about Cymbalta’s effects when used long-term. Lexapro is in the class of drugs called selective serotonin reuptake inhibitors (SSRIs), which work by increasing serotonin levels in the brain to enhance mood. There are many aspects to consider when looking at Cymbalta vs Lexapro.

Differences between Cymbalta and Lexapro: 

  • Cymbalta is a serotonin and norepinephrine reuptake inhibitor (SNRI) while Lexapro is a selective serotonin reuptake inhibitor (SSRI).
  • Cymbalta is FDA-approved to treat more conditions than Lexapro.
  • There might be fewer adverse side effects of Lexapro than Cymbalta.
  • In some studies, Lexapro was more effective in treating major depressive disorder (MDD).

Similarities between Cymbalta and Lexapro: 

  • Both can treat major depressive disorder (MDD) and anxiety
  • Both drugs should not be used with anything else that increases serotonin levels.
  • Cymbalta and Lexapro shouldn’t be used with NSAIDs or other drugs that can cause bleeding.

2.Effexor (venlafaxine)

Effexor might be a good option to explore since it’s one of the drugs similar to Cymbalta. Because they’re in the same class of antidepressants — SNRIs — they work similarly.

However, it’s important to note that Effexor may cause significant blood pressure changes compared to other antidepressants. So, monitoring your BP regularly and consulting a medical professional when taking this drug is critical. 

Differences between Cymbalta and Effexor: 

  • Cymbalta is used to treat more medical conditions.
  • Effexor can be an option to treat panic disorder and social anxiety disorder.
  • Effexor is more likely to decrease sex drive as a side effect.
  • Cymbalta is more potent and can be used in lower doses.

Similarities between Cymbalta and Effexor: 

  • Cymbalta and Effexor are both SNRIs.
  • Both drugs can treat MDD and generalized anxiety disorder (GAD).
  • Shared side effects include dry mouth, drowsiness, loss of appetite, and nausea.
  • Neither drug should be used in addition to monoamine oxidase inhibitors (MAOIs).

3. Prozac (fluoxetine)

Prozac is a common and popular antidepressant medication in the SSRI class of drugs. It’s prescribed to treat major depressive disorder and obsessive-compulsive disorder. It’s also approved to treat the eating disorder bulimia and panic disorder in adults.

Differences between Cymbalta and Prozac:

  • They are in different classes of drugs — Cymbalta is an SNRI and Prozac is an SSRI.
  • Prozac is approved to treat more mental health conditions.
  • Prozac can be used to treat some disordered eating conditions.
  • Cymbalta is approved to treat pain related to some medical conditions, whereas Prozac is not.

Similarities between Cymbalta and Prozac:

  • Cymbalta and Prozac can be used to treat major depressive disorder.
  • Studies suggest that both drugs have similar efficacy and safety results.

4. Wellbutrin (bupropion)

Wellbutrin is an antidepressant approved to treat major depressive disorder (MDD) and seasonal affective disorder (SAD). It’s also prescribed for smoking cessation. In the norepinephrine and dopamine reuptake inhibitors (NDRIs) class of drugs, Wellbutrin has some of the same adverse effects as Cymbalta, including the potential to cause dry mouth, dizziness, difficulty sleeping or insomnia, and nausea. 

Differences between Cymbalta and Wellbutrin:

  • Cymbalta and Wellbutrin belong to different classes of drugs.
  • Cymbalta can cause diarrhea and fatigue; Wellbutrin generally does not.
  • Wellbutrin might be a better option for people who experience weight gain on Cymbalta.

Similarities between Cymbalta and Wellbutrin:

  • Both drugs are used to treat certain types of pain.
  • Both Cymbalta and Wellbutrin can be effective in treating depression.
Drug Class of Drugs Treatable Conditions Common Side Effects
Cymbalta (duloxetine) SNRI Major depressive disorder
General anxiety disorder
Nerve pain caused by diabetes
Chronic muscle and joint pain
Fibromyalgia
Drowsiness
Constipation
Nausea
Dry mouth
Loss of appetite
Increased sweating
Lexapro (escitalopram) SSRI Major depressive disorder
Generalized anxiety disorder
Dry mouth
Nausea
Difficulty sleeping
Confusion
Diarrhea or constipation
Headache
Sexual dysfunction
Dizziness or drowsiness
Effexor (venlafaxine) SNRI Depression
Generalized anxiety disorder
Panic disorder
Social anxiety disorder
Nausea
Dry mouth 
Dizziness 
Drowsiness
Constipation
Loss of appetite
Blurred vision
Prozac (fluoxetine) SSRI Major depressive disorder
Obsessive-
compulsive disorder
Bulimia
Panic disorder
Bipolar depression
Nausea
Dizziness
Drowsiness
Loss of appetite
Difficulty sleeping
sweating
Wellbutrin (bupropion) NDRIs Depression
Seasonal affect disorder
Smoking cessation
Headache
Sweating
Sleep issues
Dry mouth
Dizziness

Natural Alternatives to Cymbalta

Medications like Cymbalta can work well for some people, but others might want a natural alternative. Whether it’s to avoid side effects or because you prefer a holistic approach, there are several non-pharmaceutical Cymbalta alternatives available.

6. Omega-3 fatty acids

Omega-3 fatty acids are known for heart health benefits and the ability to support mental health. Omega-3s are critical to brain function and performance, and some research has shown they can reduce symptoms of depression. Omega-3s are found naturally in food sources like salmon or they’re available as supplements.

7. Vitamin D

Known as the sunshine vitamin, Vitamin D can boost mood, which might make it a potential alternative to Cymbalta for depression. Studies have found that people with depression often have low vitamin D levels, so supplementing might help.

8. L-theanine

L-theanine is a unique amino acid found in green tea leaves. It’s gained popularity recently as a result of the calming effect it can have on the body and mind. In research, l-theanine has been shown to be effective in stress relief, mood enhancement, and improved sleep quality.

9. Lifestyle changes 

Adjusting your lifestyle by focusing on healthy habits can be a surprising alternative to Cymbalta that many people might not consider. Implement the following into your days to see if you find a reduction in depressive symptoms and anxiety.

  • Work out regularly: Research shows that getting the heart rate up releases endorphins, known as the feel-good hormones. Even something as simple as walking briskly daily can improve your mood.
  • Eat healthy: Try to eat a balanced diet full of nutrient-rich foods. It may not cure your depression, but it can help naturally lift your mood.
  • Practice mindfulness: Mindful activities like meditation and journaling can change your mindset and improve your mood.
  • Seek therapy: Countless studies have confirmed the improved efficacy of combining therapy and medication vs. using one or the other alone.

“Therapy is a great way to develop insight into symptoms and diagnosis. It helps to facilitate awareness and understanding of the issues that the person is facing. You can also learn health coping strategies to help manage symptoms. Sometimes medication and therapy are combined to treat the person and have a positive outcome.”

Talkspace therapist Bisma Anwar, LPC, LMHC

Considerations for Switching to a Cymbalta Alternative

If you’re considering switching from a medication like Cymbalta to a different drug or a holistic treatment plan, there are several important factors to remember. Finding a suitable alternative is only possible if it fits your unique needs and goals for improvement.

Consider the following:

  • Why do you want to transition from Cymbalta?
  • Do the side effects of the drug outweigh any positive outcomes?
  • Have you talked to your doctor about other medications you’re currently taking?

“It is important to work closely with your psychiatrist when switching medications to avoid Cymbalta withdrawal. Discuss and be open about your symptoms and concerns with your providers so they are aware of how you are doing.”

Talkspace therapist Bisma Anwar, LPC, LMHC

Find the Right Alternative with Talkspace 

If you’re trying to decide whether to change medications or take a holistic approach to your treatment plan — or if you’re curious about combining medicine with therapy or non-pharmaceutical treatment options — Talkspace is here. 

Talkspace is an online platform with a team of mental health professionals who can provide therapy, prescriptions, and medication management.

We offer telehealth from the comfort of your home as you make critical decisions about your medication and treatment plan. Our team is here to help you navigate the complexities of medication changes.

Sources:

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  2. Kıvrak Y, Güvenç TS, Akbulut N, et al. Accelerated hypertension after venlafaxine usage. Case Reports in Psychiatry. 2014;2014:1-4. doi:10.1155/2014/659715. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4190979/. Accessed September 24, 2023. 
  3. Eckert L, Lançon C. Duloxetine compared with fluoxetine and venlafaxine: Use of meta-regression analysis for indirect comparisons. BMC Psychiatry. 2006;6(1). doi:10.1186/1471-244x-6-30. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1552056/. Accessed September 24, 2023.  
  4. Larrieu T, Layé S. Food for mood: Relevance of nutritional omega-3 fatty acids for depression and anxiety. Frontiers in Physiology. 2018;9. doi:10.3389/fphys.2018.01047. https://www.frontiersin.org/articles/10.3389/fphys.2018.01047/full. Accessed September 24, 2023. 
  5. BIČÍKOVÁ M, DUŠKOVÁ M, VÍTKŮ J, et al. Vitamin D in anxiety and affective disorders. Physiological Research. Published online 2015. doi:10.33549/physiolres.933082.https://www.biomed.cas.cz/physiolres/pdf/64%20Suppl%202/64_S101.pdf. Accessed September 24, 2023.
  6. White D, de Klerk S, Woods W, Gondalia S, Noonan C, Scholey A. Anti-stress, behavioural and magnetoencephalography effects of an L-theanine-based nutrient drink: A randomised, double-blind, placebo-controlled, crossover trial. Nutrients. 2016;8(1):53. doi:10.3390/nu8010053. https://www.mdpi.com/2072-6643/8/1/53. Accessed September 24, 2023.
  7. Basso JC, Suzuki WA. The effects of acute exercise on mood, cognition, neurophysiology, and neurochemical pathways: A Review. Brain Plasticity. 2017;2(2):127-152. doi:10.3233/bpl-160040. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5928534/. Accessed September 24, 2023.
  8. How do I choose between medication and therapy? American Psychological Association. 2017. Accessed September 24, 2023. https://www.apa.org/ptsd-guideline/patients-and-families/medication-or-therapy

Talkspace articles are written by experienced mental health-wellness contributors; they are grounded in scientific research and evidence-based practices. Articles are extensively reviewed by our team of clinical experts (therapists and psychiatrists of various specialties) to ensure content is accurate and on par with current industry standards.

Our goal at Talkspace is to provide the most up-to-date, valuable, and objective information on mental health-related topics in order to help readers make informed decisions.

Articles contain trusted third-party sources that are either directly linked to in the text or listed at the bottom to take readers directly to the source.

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