Thank you for the list.

I will have to study it in depth as soon
As we return from our vacation (I have
A reference book i use at home)

But I do see an obvious interaction
Right now... 100 mg of Elavil may
Interact with Cymbalta to create Serotonin
Syndrome. Also cymbalta tends to
Raise blood pressure and that would
Interfere with the action of metaprolol.

If that 100mg is not a typo.. I'd seriously
Question the need for ANY Cymbalta.
So please discuss this with your doctor and
Taper down slowly, if a discontinuance
Is decided upon. You can start this process
Now with your doctor to see if you notice
Any changes.

Also beta blockers can cause cold extremities
As a side effect. So some of your cold
Shivering may be due to that.
Changing the time of day you take this
Drug may help. ( Metaprolol)

There is a wonderful drug checker at
www.drugs.com

I'd also suggest you keep track of your
Blood pressures at home several times
a day. Take it also if you have another
Shivering episode. See if it falls very
Low at those times.