"my doctor put me on basically the fastest titration. 40mg for 4 days then 80mg after that. the first 4 days on 40mg were awful. the worst of the side effects being insomnia. i had to call out of the work for the a few days to catch up on sleep. i could not fall asleep at all. the doc prescribed trazadone to sleep. that helped after being sleeped deprived for a few days. i&#039;ve heard of people upping their dose and having the side effects lessen and positive side effects increased. wrong. first day on 80mg i had crippling nausea, body aches, massive headache, off the chart irritability, burning urination (with white discharge), and thoughts of suicide. no joke. i&#039;ve read of people having this happen them but it&#039;s a rare side effect."