"have been on effexor, wellbutrin, pristiq and on cymbalta, none of them with the exception of effexor have helped me. i noticed a difference after only 1-2 days on the medicine. generally it takes between 2-4 weeks to get a build up but this seems almost instant. i started on 20mg and am still on 20mg until later this week when i go up to 40mg. the first day or two i was really wired and i think it is because i drink a lot of caffeine which i recommend cutting down on with the medicine and i got some weird electric shock sensation in my tongue but that has gone away and now i am getting the runs but i hope that goes away too. once my body was used to the new medicine i was like a zombie, now i actually feel &quot;normal&quot; again."