"it took four months before i could titrate up from 50mg to 75mg.  i&#039;m on it for dysautonomia, nuerolgia, fibromyalgia, depression. at that point i felt significant improvement from the depression and panic attacks. i weaned myself off at one point for fear that i was having a bad side effect. i had forgotten how much pain relief it provided until i was off of it. this is one of the most helpful medications i&#039;ve ever taken! it helps with pain, dysautonomia and depression! i don&#039;t think it gives me bad side effects. i&#039;ve had serious bad side effects from ssri&#039;s so i was very nervous but had to try something. i&#039;m also on gabapentin which helps with sleep and pain but coupled with this drug i&#039;ve done so much better."