Womens Health

Which SNRI?

If you're thinking about trying an SNRI you're probably wondering which one is best: Cymbalta or Effexor XR? While only your doctor can make the final decision, you can rest assured that both drugs yield comparable results. The results of a recent study showed that both drugs worked well for 65%-70% of the participants, though Cymbalta (duloxetine) caused more nausea, and Effexor XR (extended-release venlafaxine) sometimes increased blood pressure.

Similar Results

Other studies have proven that Cymbalta gets better responses in general than does a placebo (inactive sugar pills). These studies showed that Cymbalta yields similar results to antidepressants of the SSRI (selected serotonin reuptake inhibitors) class, including Prozac (fluoxetine) and Paxil (paroxetine). Separate studies done on Cymbalta and Prozac seemed to show very little difference between these two drugs in terms of their effectiveness.

An analysis done on more than 40 studies, in which Effexor XR was tested in some 4,000 patients, found that this drug had a higher rate of success than any other type of antidepressant. For the purposes of this analysis, the medication was considered a success if improvement were shown in half or more than half of the rating scales that are used to measure depression. Using these parameters, 73.7% of the participants treated with Effexor XR were considered to have achieved remission. This is in contrast to 61.1% of those treated with selected serotonin reuptake inhibitor (SSRI) and only 57.9% of those taking a tricyclic antidepressant or TCA. An additional benefit was seen in that the patients on Effexor XR were able to stop taking their medication before the study had come to its conclusion.

Another study compared the effectiveness and side effects of Effexor XR with extended-release bupropion (Wellbutrin XL) over the course of 12 weeks. While the two medications seemed to work equally well, Effexor XR caused sex-related side effects so that more patients in this group terminated their treatment.

Better Option

Wyeth says that its medication known as Pristiq, another SNRI, may be a better treatment option for patients who are taking many medications. That's because Pristiq has a very low risk for drug interactions. This can be an important consideration because depression is often co-morbid with serious chronic illness which necessitates the patient taking many medications at once.

Here's a list of the most common side effects seen with both Cymbalta and Effexor XR use:

*Nausea

*Dizziness

*Fatigue

*Sleep disturbances

*Loss of appetite

*Sweating

*Nervousness

*Visual disturbances

*Abnormal ejaculation

*Constipation

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