Q:  Can Effexor and Cymbalta be taken together, since they each affect different brain chemicals?  I also take lithium.


Dear TG -- 
Well now, that is an interesting one. My first thought is "why would someone want to do this, use this combination?". It would be a very unusual thing to do, as these two medications are generally thought to be relatively similar to one another. Both are "dual-acting" antidepressants (venlafaxine and duloxetine are the generic names).

Of course I had to go make sure that my understanding is correct, namely that their mechanism of action is very similar to one another, since you have a different impression. Not that I would trust Wikipedia for everything, but their description is consistent with a few other sites I checked, describing venlafaxine as a serotonin/ norepinephrine/dopamine inhibitor (reference). Similarly, "Duloxetine works by preventing serotonin, norepinephrine, and to a lesser extent dopamine from being reabsorbed into the nerve cells in the brain"  (reference; again, this simple explanation from Wikipedia is consistent with other sites I checked). 

Dr. Phelps