A variety of medications are used in the treatment of anxiety and depression. Two of these medications are duloxetine, sold as Cymbalta, and escitalopram, or Lexapro. Although these drugs are similar in many ways, there are important differences between them.
Mechanism
Lexapro belongs to a class of medications known as selective serotonin reuptake inhibitors. These drugs work by slowing the rate at which brain cells pump the chemical serotonin out of synapses. In doing so, these drugs increase the levels of serotonin, which is important for regulating mood. Cymbalta is a serotonin and norepinephrine reuptake inhibitor, which means that it has a similar mechanism to Lexapro but it also increases the levels of norepinephrine, another chemical which controls mood in the brain.
Uses
Lexapro is generally used for the treatment of depression and generalized anxiety disorder, the latter of which can cause chronic tension and worry that can last for six months or longer. Cymbalta can also be used to treat these psychiatric disorders but it can also be used to treat two other neurological disorders: diabetic neuropathy and fibromyalgia. These two conditions are marked by significant neuropathic pain that can be difficult to treat using conventional pain relievers.
Effectiveness
A 2008 article in the journal International Clinical Psychopharmacology compared the effectiveness of Cymbalta and Lexapro. This study found that escitalopram was more effective than duloxetine at treating severe depression, both in terms of providing symptomatic relief and in the number of patients who responded well to the medications. Studies have not been performed that compare the effectiveness of the two medications for the treatment of less severe depression or anxiety.
Side Effects
Cymbalta and Lexapro produce similar side effects, including nausea, constipation, dizziness, drowsiness and problems with libido. Men taking either medication may also develop erectile dysfunction. Cymbalta can cause heart palpitations, hot flushing and tremors, which are side effects not associated with Lexapro.
Drug Interactions
Both of these prescription medications can interact with other drugs, particularly drugs from the triptan family, which are used to treat migraines, and monoamine oxidase inhibitors, which can also be used for the treatment of mood disorders. RxList states there are fewer drugs that are safe to take with Cymbalta than there are with Lexapro.
