I had it up to 40 when I went off. However the 20 has helped so much. I still am stuck. I started to get off the Cymbalta. I am going back to counseling for the PTSD next week. It has to be this med. I did have a very rough year last year with my Dad dying. My jobs letting me go due to disabilities and such. I went thru 5 jobs last year. My doctor fears that more Prozac out this time may do more harm, however, 40 of Prozac helped much better. I have never been so afraid to drive or go outside. It is getting my Anxiety so much worse.