Compare Pristiq vs. Cymbalta

Head-to-head comparisons of medication uses, side effects, ratings, and more.

Pristiq
(Desvenlafaxine)

Cymbalta
(Duloxetine)

Improves mood. Pristiq (Desvenlafaxine) is basically the same medication as Effexor, which is cheaper because it's available as a generic.Improves mood and relieves certain kinds of pain. Cymbalta (Duloxetine) is good for treating depression and anxiety, and may help with chronic pain. More likely than other antidepressants to cause problems if you drink or have high blood pressure.
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Reviews & ratings
Button Group. All currently active
Button Group. All currently active
4.64Pristiq
Reviews for Pristiq (Desvenlafaxine)
48%
of people say Pristiq (Desvenlafaxine) is worth it
45%
say it works well
25%
say it's a big hassle
Reviews for Cymbalta (Duloxetine)
59%
+11% vs. Pristiq (Desvenlafaxine)
49%
+4% vs. Pristiq (Desvenlafaxine)
24%
+1% vs. Pristiq (Desvenlafaxine)
Side effects
PristiqCymbalta
  • Nausea 31%
  • Excessive sweating 17%
  • Dry mouth 16%
  • Dizziness 11%
  • Constipation 10%
  • Impotence 10%
  • Sleep difficulty 9%
  • Decreased appetite 8%
  • Drowsiness 8%
  • Fatigue 7%
More Pristiq side effects »
  • Nausea 15%
  • Dry mouth 8%
  • Drowsiness 8%
  • Constipation 7%
  • Somnolencee 7%
  • Decreased appetite 7%
  • Fatigued 6%
  • Sleep difficulty 5%
  • Dizziness 4%
  • Fatigue 4%
More Cymbalta side effects »
How it works
PristiqCymbalta
Pristiq (Desvenlafaxine) is a serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressant. It increases serotonin and norepinephrine activity in the brain, which regulates mood.Cymbalta (Duloxetine) is a serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressant. It increases serotonin and norepinephrine activity in the brain, which regulates mood.
Type of medication
PristiqCymbalta
Antidepressant
Serotonin-norepinephrine reuptake inhibitor (SNRI)
Prescription only
Antidepressant
Serotonin-norepinephrine reuptake inhibitor (SNRI)
Prescription only
Available as
PristiqCymbalta
  • Extended release
  • Extended release
Used for (click to learn more)
PristiqCymbalta
How well it works for depression
The free Iodine Start program helps people track how well they are improving, and find the right antidepressant faster.

After 4 weeks using Start and Pristiq (Desvenlafaxine), here’s how much better people feel.

After 4 weeks using Start and Cymbalta (Duloxetine), here’s how much better people feel.

Risk factors for serious side effects
PristiqCymbalta
  • Age 24 years or younger
  • Using other medications that affect serotonin
  • Stopping Pristiq (Desvenlafaxine) suddenly
  • History of high blood pressure
  • Taking other blood-thinning drugs
    • History of bipolar disorder
    • At risk for bipolar disorder
    Detailed Pristiq (Desvenlafaxine) risks & warnings »
    • Age 24 years or younger
    • Using other medications that affect serotonin
    • Stopping Cymbalta (Duloxetine) suddenly
    • History of high blood pressure
    • Taking other blood-thinning drugs
      • History of bipolar disorder
      • At risk for bipolar disorder
      Detailed Cymbalta (Duloxetine) risks & warnings »
      Pregnancy category
      PristiqCymbalta
      CFDA pregnancy category (Weigh risks vs. benefits)

      Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

      See the FDA package insert
      CFDA pregnancy category (Weigh risks vs. benefits)

      Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

      See the FDA package insert
      Alcohol
      No specific alcohol-related info.No specific alcohol-related info.
      Food
      No specific food-related info.
      • Take with food to avoid upset stomach.
      Kidneys and liver
      No specific kidneys and liver-related info.
      • Not a good option if you're a heavy drinker, or if you have liver or kidney problems.
      Sex
      • Can cause sexual side effects (usually low libido or the inability to have an orgasm or ejaculate).
      • Pristiq (Desvenlafaxine) can cause lower sex drive or difficulty having an orgasm. If the problem persists after the first 2 to 3 months, you can talk to your doctor about alternative antidepressants or performance-enhancing medications.
      • Cymbalta (Duloxetine) can cause lower sex drive or difficulty having an orgasm. If the problem persists after the first 2 to 3 months, you can talk to your doctor about alternative antidepressants or performance-enhancing medications.
      Sleep
      • Stopping Pristiq (Desvenlafaxine) suddenly may cause withdrawal symptoms such as nausea, anxiety, agitation, flu-like symptoms, trouble sleeping, and dizziness. Withdrawal symptoms usually occur within 3 days of stopping the medication, and go away within 1 to 2 weeks. Work with your doctor to gradually reduce your dose.
      • Stopping Cymbalta (Duloxetine) suddenly may cause withdrawal symptoms such as nausea, anxiety, agitation, flu-like symptoms, trouble sleeping, and dizziness. Withdrawal symptoms usually occur within 3 days of stopping the medication, and go away within 1 to 2 weeks. Work with your doctor to gradually reduce your dose.
      Weight
      No specific weight-related info.No specific weight-related info.
      Upsides and benefits
      PristiqCymbalta
      • Effective at relieving symptoms and lowering relapse rates for depression.
      • Six out of ten people who use an antidepressant for the first time find that it works for them.
      • Effective at relieving depression and anxiety symptoms.
      • Lowers relapse rates for depression.
      • Can relieve some types of chronic pain. Might be particularly good at pain relief for people who are also depressed.
      • Six out of ten people who use an antidepressant for the first time find that it works for them.
      Downsides and risks
      PristiqCymbalta
      • Similar to Effexor, without any extra benefits in clinical studies.
      • Can cause sexual side effects (usually low libido or the inability to have an orgasm or ejaculate).
      • Not available in generic form, so it's more expensive.
      • Like most antidepressants, can cause higher risk of suicidal thoughts and behavior for people age 24 and younger.
      • The first antidepressant you try doesn't always work or it can cause side effects you really don't like. You might need to try a few different medications until you find one that works for you.
      • Not a good option if you're a heavy drinker, or if you have liver or kidney problems.
      • Not the best option for people with high blood pressure.
      • Like most antidepressants, can cause higher risk of suicidal thoughts and behavior for people age 24 and younger.
      • The first antidepressant you try doesn't always work or it can cause side effects you really don't like. You might need to try a few different medications until you find one that works for you.
      Tips from our pharmacists for people taking the medication
      PristiqCymbalta
      • Takes 8 to 12 weeks to see full effects on mood.
      • Can cause sweating and high blood pressure.
      • Stop taking slowly to avoid withdrawal symptoms.
      • Tell your doctor if you notice sudden mood changes or unusual thoughts.
      • Take with food to avoid upset stomach.
      • Full effects in 8 to 12 weeks for mood, 2 weeks for pain.
      • Stop taking slowly to avoid withdrawal symptoms.
      • Tell your doctor if you notice sudden mood changes or unusual thoughts.
      Learn more
      More about PristiqSide effectsReviews & ratingsAlternativesFDA package insert
      More about CymbaltaSide effectsReviews & ratingsAlternativesFDA package insert