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Can you take Cymbalta® with Lexapro®?

Evidence-based interaction check between Cymbalta® and Lexapro®

MajorEditorially reviewed · last updated April 15, 2025

High risk — avoid this combination unless there is no good alternative.

Serotonin syndrome with the same constellation as the SSRI+SSRI case: agitation, racing heart, high blood pressure, tremor, muscle rigidity, fever. Can be life-threatening.

Why this happens (mechanism)

Duloxetine (Cymbalta) is an SNRI and escitalopram (Lexapro) is an SSRI — both increase serotonin levels in the brain, and duloxetine adds a norepinephrine effect on top. The serotonin-syndrome risk is at least as high as combining two SSRIs.

What to monitor

  • Vital signs — pulse, BP, temperature
  • Hyperreflexia, clonus (rhythmic muscle jerks), tremor
  • Mental status changes — confusion, agitation
  • GI symptoms

Dose adjustment

Do not combine. Cross-tapering between an SSRI and SNRI should be supervised — the typical approach is to taper one to a low dose before starting the other, or use a brief washout window.

Safer alternatives to consider

Single SNRI or single SSRI titrated to effect

A single agent dosed correctly is the standard approach; layering two serotonergic drugs is rarely justified.

Add a non-serotonergic agent (e.g. bupropion, mirtazapine)

Augmentation with a non-serotonergic antidepressant carries dramatically lower serotonin-syndrome risk.

Always discuss alternatives with your prescriber before making any change. The right choice depends on your other medications, conditions, and what is working for you today.

Evidence and sources

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No known interactions found

No documented interactions between Cymbalta® and Lexapro® in our database.

Always consult your healthcare provider - this tool does not replace medical advice.

What this means

This summary is based on published interaction data from FDA prescribing information and clinical literature. It does not account for individual health factors, dosages, or other medications you may be taking. Always consult a qualified healthcare provider before making changes to your medication regimen.

Frequently Asked Questions

Is it safe to take Cymbalta® with Lexapro®?

High risk — avoid this combination unless there is no good alternative. Serotonin syndrome with the same constellation as the SSRI+SSRI case: agitation, racing heart, high blood pressure, tremor, muscle rigidity, fever. Can be life-threatening. Always discuss your full medication list with your prescriber.

What happens if you take Cymbalta® and Lexapro® together?

Duloxetine (Cymbalta) is an SNRI and escitalopram (Lexapro) is an SSRI — both increase serotonin levels in the brain, and duloxetine adds a norepinephrine effect on top. The serotonin-syndrome risk is at least as high as combining two SSRIs.

What should I monitor if I take both?

Vital signs — pulse, BP, temperature. Hyperreflexia, clonus (rhythmic muscle jerks), tremor. Mental status changes — confusion, agitation. GI symptoms.