I take pristiq. I've also been on effexor. In the past, the doctors have tried nearly every type of anti depressant, mood stabilizer and anti psychotic on me and they ALL make me worse. I refuse to try anything other then effexor or pristiq and I'm on lower doses then normal because I can't handle normal doses.
I also have herniated discs and cns involvement with the Lyme and Bart. I take tramadol for pain and anxiety. It's not common for Drs to give it for anxiety, but the normal meds don't work for me and this does. Again I'm on abnormally low doses because of my sensitivity.
My suggestion is that if you start them, listen to your body. Drs will try to get you to wait weeks to "adjust". I never adjusted to any of them even after two months. Some of them would make me suicidal almost overnight.
The tramadol is like an snri and the pristiq is an snri. SSRIs make me worse. You may be different or the opposite though. Good luck with whatever you choose
Lyme, bartonella, mycoplasm. 2018, in treatment, abx and glutathione.