I’ve read + been told that it is the norepinephrine part of SNRI’s and tricyclic antidepressants that primarily helps with pain (I guess norepinephrine + serotonin actions together…)

The main issue I want help with though is the burning I feel whenever I am too “activated”, like when I talk to anyone, or think hard about a problem, etc. I really try to maintain a sense of calm and meditate, but it’s like my body is just hypersensitive to any “activating” signal. (Not working now but really want to return to my job.)

I’m wondering if I’m understanding this correctly, that maybe, at least in my case, there might be a trade-off of the norepinephrine part of cymbalta and other drugs – in that it might help with pain but also make me more “activated”.

Thank you

i’m slowly getting effexor in my system for this same reason
i would like to return to work - will need to be modified duties. as it stands now however… i am an open book (in poker terms i am a walking ‘tell’ - facial burns let everyone know what’s up)

i get slightly stressed for a moment - just a fleeting thought and the blood will run out of my hands causing them to freeze and go numb… and shunt it into my cheeeks and ears causing them to burn.


Hey Cherry -

Sounds like you and I are similar. Keep me posted on the effexor and other txs and how things are going, ok?

My doc once said to me that I’m just “extremely efficient” at shunting blood away from one area and to another area, etc. The areas that get too cold when blood is shunted away - they always always rebound later w/ bad burning.

Things actually seem quite a bit better for me in recent months (knock on wood…) The “burning while talking to people” is still a problem, but I think getting totally off vasoconstrictors (clonidine/beta blockers/midodrine), while upping my magnesium, and stacking antidepressants/boosters (effexor, remeron, deplin) has been helpful. Also, lyrica.

I’m at an “ssri” dose of effexor right now though (150 mg). I don’t notice much of a difference when I’m at an “snri” dose (or cymbalta) but wonder if an “snri” dose might be more helpful when added to the lyrica now.

Take care