Cymbalta has been marketed for pain; but the latest studies show it is not effective, and that this off-label use is not helpful. But that being said, all antidepressants help pain. They interfere with feedback loops which bring pain signals up to the cortex, and work that way. It's not that they work by curing depression.

While Effexor is just about the same as Cymbalta, it, too, has a withdrawal syndrome. This shouldn't be a problem if, when you decide to stop, you taper off it.

But I don't think there's evidence that either of these drugs is better than Prozac, Zoloft, or Paxil when combined with a stimulant: Wellbutrin or Provigil. And using the two different pills means:

1. no withdrawal: in case you decide it doesnt' work, you can just stop.
2. Your doctor can increase or decrease either medication to just the right amount for you, whereas both effexor and Cymbalta are a fixed combination of SSRI plus stimulant.