Given you've had problems with anxiety in the past, a more classic SSRI side effect profile might be desirable vs the SNRI. Older SSRI you should be able to get generic versions at low prices as well. However, insomnia is a very serious side effect of SSRI/SNRI, potentially could be an indicator of SSRI induced mania, please let your doctor know. Cymbalta is commonly prescribed for depression/pain. Another interesting option for you to ask your doctor about might be Lyrica which is commonly used for pain management / anxiety.
One more thing... many of the side effects of SSRIs do get better if you can stick with it for a couple of weeks, or increase dosage gradually - this is easiest to do with drugs where the pill can be split, which means avoiding the extended release versions in some cases. Another point to raise with doc.
Last edited by aks; 05/27/19 03:58 PM.