The psychiatrists I've seen don't see snris as first line treatment if anxiety is your main problem as they can be very stimulating by targeting norepinephrine. Normally, they first try tricyclics or ssris. Of course, everyone's different. As for how quickly they work, never took an snri, but hard to believe any of them work that quickly -- usually takes some time just to work up to a therapeutic dose if the psychiatrist is being careful. Your doc probably only knows Prestiq because it's still under patent and therefore is being heavily pushed by pharmaceutical company rep. I'd see a good caring psychiatrist if you decide to try medication, though if what you describe is as bad as it gets I'd probably say it's too soon for medication, you haven't said if you'd tried therapy yet. As for sinus, a clogged sinus or a sinus infection can make the whole head feel stuffy, even make your teeth hurt.