I know that some have benefited from Cymbalta and other similar medications, but everything you and others have mentioned are reasons I personally chose with my care team not to try it. I’m very sensitive to medication, and even things that are “generally well-tolerated” either aren’t, or I need to start at a much smaller dose.

But for what it’s worth, my neurology NP specifically didn’t recommend it for me when it came up because I tend to experience strong side effects. She also said her patients have had significant difficulty weaning off it if they need or want to stop it. I’m always very cautious around any kind of drug like that, but everyone has a different comfort level.

PT geared toward pain neuroscience and neuroplasticity has been a much better fit for me, and in a way it’s the most effective thing I really have access to because my central sensitization affects how I process medication. From living with chronic pain for almost a decade (!) now, it’s my opinion there still aren’t great options for chronic pain, especially for those of us hesitant or sensitive to medications. Then again, some people report life changing experiences with things like Cymbalta, Lyrica, etc.

I also take LDN (low dose naltrexone). It helps with fatigue, but I can’t really say for certain it’s helped my neuropathy.