Cymbalta (vs. Effexor) for depression and anxiety

So I've been on assorted SSRIs for anxiety, the most recent being Paxil. After having some depression symptoms, my p-doc tried Prozac (which I hadn't had before), which helped depression, but sent my anxiety through the roof. So a couple months ago, she had me try Effexor XR. I thought it was helping at first (certainly better than Prozac!) but in the past two months I've been on it, I've had , which is something I haven't had in many years.

Met with p-doc today, and she thinks I'm in a major depressive episode (also very weepy over minor things, etc.) Although there are contributing factors, it could be that the Effexor either isn't being effective or is contributing to the depression/other stuff. She's trying me on Cymbalta. Has anyone had experience with that, particularly if you've also been on Effexor? From what I read, it sounds like a higher risk of some side effects, and lower for others.

One concern is the possibility of liver damage--so guess I need to cut back on beer consumption, which has been a bit of a coping mechanism as of late. But I should be cutting back on that anyway. And if Cymbalta makes me feel better, then I hopefully won't want/need some other coping mechanism (at least not alcohol).

Just nervous--and she's having me just stop the Effexor and start right up with the Cymbalta, since they both act on the same transmitters. Any thoughts?

In my experience, both medications were very similar in terms of the way they made me feel and the side effects. Effexor was probably slightly better for depression. I believe the variation in people reporting one being more effective than the other is very high.

I have taken both. I was taking them for depression and also for fibromyalgia pain, so I was taking a high dose of Effexor (375 mg).

I was able to switch directly to 60 mg Cymbalta and could hardly tell I had switched meds as far as any new side effects or withdrawal.

Both meds worked great for me for about 3 years and then they "pooped out".

I'm guessing you know about the withdrawal syndrome from the SNRI antidepressants? I'm not saying not to take that type of drug but just know that it will probably take a long taper-down if you want to stop it after you've been on it for a while.

I'm prone to having low-level suicidal thoughts and had them lots on both Effexor and Cymbalta. They're much better at the moment, but I attribute that to therapy. (I still take Cymbalta.)

Just curious - what dose of Effexor XR are you taking?

Thanks for your response! I only got up to 75 mg of Effexor XR. I'm pretty sensitive to meds (was only on 15 mg of Paxil before this and, before that had issues on Zoloft when I tried to go up to the regular therapeutic dose). I'm a little concerned that p-doc is starting me on 60 mg of Cymbalta, when she said that 60-90 mg is a regular therapeutic dose. And they're capsules, so I can't gradually move up.

It also doesn't help that I talked to my mother-in-law when we picked up my daughter tonight, and she said Cymbalta made her into a raving lunatic Then again, every drug affects people differently, so I guess I need to give it a shot.

And I do know about withdrawal from SNRIs--she said I shouldn't have to worry about it because I'm going from one SNRI to another. I was on Paxil before this and gradually tapered it down while going up in Effexor and staying on Effexor at 75 mg for a few weeks before stopping the Paxil.

The good thing is I have therapy appointments Monday (marriage counselor, though he's willing to talk about some of my individual issues, since they affect our marriage), Tuesday (individual T), then p-doc Friday. So I should have lots of support, plus my husband is aware of what's going on and has been pretty understanding. I just want the depression and any self-harm or suicidal thoughts (I know they're somewhat different things) to go away. Ideally without any major side effects. Which I feel like is asking a lot...

For some reason my old nurse practitioner had me stop effexor or cold turkey and I didn't have any withdrawal effects that I remember. But I've never really had withdrawal effects from quitting any med. I usually just feel better afterward. Never tried cymbalta but my wellbutrin is working pretty well and my pdoc won't even prescribe me any snris because he's convinced they will cause mania even though effexor didn't cause it at all. He's just ultra conservative and I hate it. He won't even evaluate me for adhd and I've been asking him for months and he's already said he would never prescribe me a stimulant because of potential mania even though I've taken stimulants before and those didn't cause mania either. The only things that seem to cause mania are extreme stress and extended sleep loss. No med has ever made me manic. I was even on celexa for over two years right before I was diagnosed and that ssri didn't even cause mania. My pdoc is just ridiculously paranoid and med-centric. He didn't even listen to me when I suggested that my last breakthrough manic symptoms were caused by the stress of finals week last term. I'm getting fed up with him. Sorry to rant.

Thanks for sharing you experience. Do you have the option to get a new p-doc? Sounds like he isn't really listening to you and your experiences. My p-doc says that everyone responds to meds differently, which is what makes prescribing so complicated. I actually switched to her maybe 6 months ago when she joined my T's practice because my previous one didn't seem to listen to me. Mine just seemed to downplay any side effects or symptoms I had. My new one is pretty new to the field and up on the latest research. She also really listens to me and seems to be really trying to find the right drug for me. So I'd try someone else if you can!

I don't know that this will help at all, but I had a horrible reaction to Effexor.

My best friend stopped by the high school at lunch to see how I was doing. The guy literally just said "Hi" and I cussed him out, walked about 5 steps and sat down in the middle of the sidewalk and cried. Crying was not something I did in public at the time EVER. Don't think I've ever cussed anyone out for saying "hi" either. We stopped the Effexor immediately.

I never tried Cymbalta, though, so I have no comparison for you. (Yeah, this was probably not helpful at all, sorry.)

Good Luck!!!!

Thanks for the response. Wow, that's a pretty strong reaction! It's helpful knowing that others have had similar emotional responses to Effexor. No cussing anyone out for me, but I've been getting weepy really easily and over seemingly minor things since being on the Effexor. (I guess that could be the depression, too, but if it is, then Effexor clearly isn't helping it.)

Took my first Cymbalta this morning, so we'll see...I'll update with how it's going.

I've nearly reached the point of emotionality (is that a word?) recently without any medical care at all that I was at with the Effexor. I cry over everything and my anger is as bad or worse as it was on Effexor. I took my first Seroquel Friday morning and slept for 15 hours straight, woke up at 1:30am in a state of panic because I thought I was supposed to be at work at 11:00pm. I called work and got laughed at (she wasn't being mean, we've all done it) for freaking out over nothing and went back to bed for another 4 hours. I'm still hoping it's just the initial reaction and that I'll even out on it, but I've tried quite a few meds and nothing has worked out very well for me, always the extremes.

Good luck to the both of us! Maybe this time, eh?

Hi, I was inspired to comment on this discussion because I too was on Effexor and I had a rough time with it. My anxiety was worse after being on it for 5 months. I started having panic attacks and even passed out. I weened myself off in a month and the withdraw was terrible .... I just started 30mg of Cymbalta for my depression - anxiety with the hopes it will help with my Fibromyalgia pain. I hope for the best for everyone as we all just want to feel BETTER SOON! I'm new here but I will be keeping up with posts..

Cymbalta has been the best medication for me to date. It's helped anxiety and depression

Just to update this (since other people commented), maybe two months after being on Cymbalta, I did end up . P-doc increased my dose, and I started having myoclonic jerks (basically a jerking movement) in my legs and arms. So she brought the dose back down and added Wellbutrin. That decreased the jerking but seemed to add more anxiety to the depression--I already have generalized anxiety disorder and panic disorder, but the panic part had been mostly under control. I ended up having some serious depression and anxiety issues at one point, so was switched to Wellbutrin and Zoloft. While on that, I had what almost seems like a mixed episode (I sometimes suspect I could be bipolar II), leading again to . So now I'm just on Zoloft, and doing a bit better. I just think maybe SNRIs and Wellbutrin, which also acts on the "N" part, just don't work well with my brain chemistry. And the jerking stopped a few weeks after I stopped the Cymbalta, too.

Please note that I'm not advising anyone against taking Cymbalta--this is just my experience. I tend to be sensitive to meds in general. I think I'm just avoiding any SNRIs from now on... I'm glad they work for others, though!

I have myoclonic jerks, too, or periodic limb movement disorder as it's sometimes called. I've had them since before I started taking SNRI meds, but I have noticed that they get worse at higher doses. Actually, I was taking Zoloft when they started. I have read that SSRIs can make them worse. Maybe it's different for different people.

I need the SNRI med for fibromyalgia pain, so unless I figure out something else to take for that, I guess I'll keep having the PLMD.

Thanks for the update. Sorry to hear that you had a bad experience with Cymbalta.

hi lonesome,
im on Cymbalta 90mgs right now. my psychiatrist raised it last month cuz of my ptsd symptoms came back full force cuz of my dad's anniversary of his passing. it is helping me out in a big way . even though im still taking the Vistrail w it every night still , I still need the Vistrail to counteract w the Cymbalta cuz its so strong at 90 mgs. it is balancing me out now . im able to focus on things better than the paxil that I was on . its keeping me from getting too hyper like the paxil the paxil wanted me to keep moving and causing my impulses to go shopping alot when I was supposed to save money instead of spending it .







Diagnosis: Anxiety and depression
meds : Cymbalta 90mgs at night
Vistrail 2 25 mgs daily for anxiety prn
50 mgs at night for insomnia