Good morning Diane @sunny2 and John @johnbishop, A big welcome to you. You are among folks who, while not having a medical background, have personal journeys that can help others. You are asking about Duloxetine. May I ask for what condition you are expecting help from this medication and when in your day you are supposed to take it.

As I understand the reason I am taking it is to start the day without anxiety. As I experienced it...my anxiety about the pain resulted in more pain which resulted in an increase in anxiety and then I was in a loop. Neuropsychological tests confirmed that my memory issues were predominantly a result of anxiety.

For a month I took 20 mg of Duloxetine (Cymbalta) every morning. I had few side effects and what I did get almost immediately was a relief from both pain and mental anguish. Month two I took 40 mg every morning. I may have had some nausea at that level...which was helped with a cup of tea and some nan or skinny toasts. My PCP is just tremendous and together we have a collaborative partnership. She wanted me to go to 60 mg for the same reasons as others have mentioned........to be prepared for our symptoms to become more challenging.

Can you share what your other symptoms are at this time? My request is always to make sure the dosage is right, the possibility of interaction with other medications or protocols has been evaluated, and the time of day for best relief has been explored.

Regarding the side effects.....my PCP said to take some of that with a grain of salt. Side effects are sometimes listed to fend off legal issues. I probably would spend some time researching the validity of the tests for liver damage. Or, I might just ask John to do that for me and instead...go for a lovely walk along the river. John is our resident research expert. We appreciate his efforts tremendously.

May you have comfort and relief today. Chris