There are no official guidelines to assist in answering this question. I will search for relevant research papers instead.
The FDA Drug Labels for escitalopram (PO), duloxetine (PO) do not address this question.
From the Research
Combination Therapy with Lexapro (Escitalopram) and Cymbalta (Duloxetine)
- There is limited research on the combination of Lexapro (escitalopram) and Cymbalta (duloxetine) for the treatment of major depressive disorder outside of cross-tapering scenarios 1, 2, 3, 4, 5.
- A study published in 2019 found that the addition of an antidepressant, such as escitalopram, to cognitive-behavioral therapy (CBT) can be an effective approach to treating residual symptoms in patients who do not achieve remission with CBT alone 1.
- Another study published in 2016 found that combination therapy with duloxetine and other antidepressants can improve effectiveness and have comparable tolerability with monotherapy in the treatment of outpatients with major depressive disorders 2.
- However, a study published in 2019 found that the combination of agomelatine with other antidepressants, including duloxetine, was not always efficacious and that the positive results of agomelatine augmentation with other antidepressants should be confirmed through randomized, double-blind clinical trials 3.
- A review of the efficacy and safety of escitalopram and duloxetine published in 2004 found that both drugs are useful in the treatment of major depressive disorder, but that the safety and tolerability profiles of both drugs are quite benign, with some differences in adverse events 4.
- A study published in 2007 found that duloxetine and escitalopram had similar remission rates over the course of an 8-month study, but that there were some differences in safety and tolerability measures, including discontinuation rates and adverse events 5.
Key Findings
- Combination therapy with Lexapro (escitalopram) and Cymbalta (duloxetine) may be considered for patients who do not respond to monotherapy, but more research is needed to confirm the efficacy and safety of this approach 1, 2, 3, 4, 5.
- The addition of an antidepressant, such as escitalopram, to CBT can be an effective approach to treating residual symptoms in patients who do not achieve remission with CBT alone 1.
- Combination therapy with duloxetine and other antidepressants can improve effectiveness and have comparable tolerability with monotherapy in the treatment of outpatients with major depressive disorders 2.