Worse than Lexapro? I took Paxil and Venlafaxine for about 10 years each and had unwanted side effects with each. I was taking 40mg of escitalopram (Lexapro) with zero side effects. I've taken a few tricyclics and the only one I found helpful was Amitriptyline (Elavil). It has a hypnotic effect that can open the sleep window for those who suffer severe insomnia with depressive episodes. I don't know that any of the tricyclics are used to treat pain.