Effexor vs Pristiq vs Cymbalta: Side Effects & Cost

Effexor (venlafaxine), Pristiq (desvenlafaxine) and Cymbalta (duloxetine) are antidepressants that belong to the same class of drugs. The class of drugs is called Selective Serotonin-Norepinephrine Reuptake Inhibitors (SNRI). The work for depression symptoms by increasing the effects of serotonin and norepinephrine (aka noradrenaline) in your brain.

While the three antidepressants work similarly, they have have important differences.

Effexor Side Effects vs Pristiq & Cymbalta Side Effects

Like most antidepressants, Effexor, Pristiq and Cymbalta commonly cause nausea, headache, sweating, dry mouth and constipation (remember, you can always use docusate sodium for help with constipation). The SNRI antidepressants are more likely to cause high blood pressure, fast heart rate and decreased appetite than antidepressants like Zoloft or Lexapro. They may be slightly less likely to cause sexual side effects than Zoloft or Lexapro, though.

Pristiq is more likely to cause nausea than Effexor; it’s less likely to cause decreased appetite. Cymbalta is more likely than Effexor or Pristiq to cause urinary retention. Urinary retention is a condition where your bladder struggles to relax; urination becomes difficult and incomplete. Common symptoms of urinary retention are: incontinence, dribbling pee, an urge to pee, and a feeling of bladder fullness. Also, Cymbalta is unsafe if you have angle closure glaucoma.

Drug Interactions

Effexor is least likely to interact with other drugs. Cymbalta is most likely to interact with other drugs.

Effexor Cost vs Cost of Pristiq & Cymbalta

As Effexor is older, it’s much cheaper than Pristiq and Cymbalta.

Bottom Line:
The differences between Effexor, Pristiq and Cymbalta are minor. Given that it’s less expensive, Effexor may be more cost-effective. Also, some research (Montgomery et al) shows that Effexor may be more effective than other antidepressants for severe major depressive disorder. Cymbalta may be better for depression that’s associated with physical pain.

Works Cited:
Montgomery S, Baldwin DS, Blier P, Fineberg NA, Kasper S, Malcolm L, et al. Which antidepressants have demonstrated superior efficacy? A review of the evidence. Int J Neuropsychopharmacol 2007;22:323–329.

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