Hi there esperanza22, I am a bit tardy with my response and realized I hadn't connected with you recently. Duloxetine: here's the deal. I was not taking anything in the morning for my SFN (small fiber neuropathy). I was taking Nortriptyline at night for sleeping. After a neuropsychological study, it was found that my pain in the day was being increased by anxiety and depression. A sorry state of affairs, I can assure you. In addition, I had constipation from it.

So....even though it worked for sleep, I tapered off the night-time Nortriptyline in several months. Then I began very slowly to begin and then add to the Duloxetine in the morning. Duloxetine is a much newer medication than Nortriptyline even though it worked as prescribed. Duloxetine is both an anti-anxiety as well as an anti-depressive. Therefore, it helps me get through the day quite well. I have more energy with less pain and a clearer mind. I'll take that.

So what do I do for sleeping? I moved my Gabapentin to the evening also. Helps with pain and my medical cannabis does the rest. I rarely have a bad night, except of course when I have the Neuropathic Itch. And then it is more like a nightmare.

It seems like we all have to create our own paths through this journey of pain, depression, and anxiety. I know that next year things may be different. Right now...I am pleased with the changes and the duloxetine.

May you be free of suffering and the causes of suffering.
Chris