Absolutely agree. The SNRI's are tricky - they worked for me (until recently)...but they have a devilish reputation upon withdrawal. I'm three weeks into my Effexor tapering (down to 37.5mg from 150mg) and will be moving to zero this week. But as you say, everyone reacts differently....For me, the norepinephrine (the N in SNRI) seems to be the key.....

When Cymbalta came on the market, it's main "advantage" was that one generally didn't need to titrate on to the drug - which is/was considered one of the disadvantages of Effexor. Cymbalta also sought/received some other approved indications - in part, I recall, because Effexor had such a dominant share of the market that Cymbalta's no-titrate up advantage was not that big an advantage.

My psychiatrist (new relationship) uses genetic testing - although I have such a long history with antidepressants and the same therapist - that at this point it's probably not something we are going to do. Right now the task is finishing the Effexor taper...then we'll look at whether I will benefit from a different medication (my primary diagnosis has moved from anxious depression/dysthymia to ADD). The DNA tests are not consistently covered by insurance - so that may be a financial deterrent to some people.