First, Pristiq isn't novel, it's just Effexor with part of it cut off, as was done with Celexa/Lexapro. Some will say it's just a way to get another drug on patent, but since people do have very different reactions to Celexa vs. Lexapro, there probably are differences here, too. Second, Cymbalta isn't an ssri, it's an snri like Pristiq. Third, snris can be very stimulating because they target norepinephrine.