Effexor is equal to duloxetine as far as difficulty to discontinue. See The Maudsley Deprescribing Guidelines: Antidepressants, Benzodiazepines, Gabapentinoids and Z-Drugs by Mark Horowitz and David Taylor, published 2024. I second @bajjerfan's suggestion to speak with your pharmacist about your options.
Good luck with your shoulder surgery. Sorry you are having to deal with these issues at the same time. You'll get through it, one day at a time. Breathe deeply. Hugs to you.

Hi rockjock79,
Terribly sorry about what you're going through. I know because I'm going through the same process here in Canada. I am currently in an attempt at going cold turkey with one of the duloxetine generics, because it, while a tiny bit better than two other generics I've tried (Sandoz, TEVA), is having such a negative impact on my body and mind, I'm thinking I'm better off with nothing than I am with all the side effects of these horrible generics.

Today is the 8th day since I had my last 60 mg capsule of ACCEL generic Duloxetine (a Montreal company), and for the first 3 days I felt ok-ish, but the withdrawal side effects have mushroomed since. (I'm at this moment waiting for my doc to call to discuss this, i.e. to drop down to 30 mg and do a proper tapering out over the next few months or continue cold turkey). Couple of things have helped with the cold turkey approach, and that is, during the day, to stay in a recliner and either read or watch TV, and take a Percocet tablet at three points during the day - morning, noon, early evening, on an empty stomach. We're in early winter here in SW Ontario, and so I don't want to go out much, but when I can, for golf or lengthy walks, during the warmer weather, I take a Percocet at points during the walk or golf game so I can actually do the walking and swinging a golf club (debilitating lower back issues).

Since Cymbalta was toast, I have taken generic duloxetine for the lower back nerve pain relief as well, but am stopping these useless generics because the side effects are far worse than any benefit.

My (amateur) take on the difference between Cymbalta and generics is this: Eli Lilly had clearly mastered the timed release of duloxetine over 24++ hrs, so that it came through our bodily systems seamlessly i.e. no noticeable jolts or dips in coverage of the drug during the 24++ hrs. A smooth release of powerful medication during a two day period (I have no doubt that Lily added that 24+ hour buffer period to provide for smooth overlap day-to-day plus an extra period if a dose was missed).

With the generics (all three that I've tried), the jolts of the crude timed release of duloxetine at various points causes problems in my experience - I can actually detect when a blast of drug release is happening throughout the 24 hours! It produces a short period of gross nausea during each release point. It's a series of sickening experience during the release periods, which add up to a very bad experience overall. That's my guess, for what it's worth.

I don't know if my experience helps you sort through this nightmare, but your thread may have a chance to awaken those in a position to help - such as the FDA, who should find out for all of us who thrived on Cymbalta, why Cymbalta cannot or will not be manufactured any longer. At the very least, our voices may point out that if we, in these early days of prescription renewals for many of us, get our plight from this nightmare exposed, it may well explode as a nasty reality to the horror of the FDA and Eli Lily. I don't wish harm here, BUT WE NEED HELP. All the best rockjock, I'll keep monitoring this thread.