I have been on cymbalta, then tried Paxil, then gone on to effexor, then tried zoloft, then back to cymbalta. I thought I’d share my experience here.
In the beginning I didn’t think cymbalta was working at all for me. I would take it at night. However looking back, I think it helped me be more functional during the day. The next night, I don’t think I had enough cymbalta in me and maybe my declining levels would fuel bad night flares.
Effexor (150-225 mg ) felt very similar – I think it too offered a gentle level of constriction. Taking it at morning seemed to help all day (not enough, but still helpful) I thought the link below was interesting
esp.
“The pathogenesis of primary erythromelalgia is not known for
certain, but histologic studies of affected skin show evidence of
decreased sympathetic innervation and deficient sympathetic
regulation. By inhibiting norepinephrine reuptake, venlafaxine may
address those defects”
When I transitioned off effexor onto zoloft (effexor contributed to heart racing for me, and I wasn’t aware of how much it was helping me) it was like 10 steps backward. Scary blood pooling unless I was constantly elevating. I noticed the same when I transitioned from cymbalta to paxil.
I think effexor might (?) provide slightly more blood vessel control than cymbalta, but cymbalta helps more with the nerve pain, given the same level of skin hotness imo. I currently take 70 mg cymbalta in the morning definitely feel it kicking in during the day. I need more help but personally I am so much worse without an SNRI.
In case that helps anyone!