Hi Barnburner,

In general, if Cymbalta is used to treat depression, generally 60 mg is the dose that is shown to be effective. I believe above this, there's no improvement but I may be wrong on that. In my case, at 120 mg it is being used solely as a pain reduction strategy.

In this light, the 120 mg Cymbalta has been far superior to Cipralex (25 mg), Amitryptiline (12.5-50 mg), and Nortryptiline for pain relief. At 22 months, my headaches while still constant and daily are tolerable, though working is still not possible.

One other thing I'll throw out there is that I've gone from Amitryptiline to Nortryptiline, which was a positive move (side-effects of Am, particularly at 50 mg, are not fun). More recently, I've been off Nor for 3-4 weeks now and I feel much less dark than before... I'm not a fan of TCA class (trazodone included) antideppresants. For me, they are negative mood amplifiers, make you feel groggy, and aren't great for pain relief.

So, for me Cymbalta at a higher dose has been pretty good. My sleep isn't great with it, and I do feel kinda crummy all the time, but it's better than where I've been since the accident. As well, Cymbalta has a relatively long usage history with many of the side-effects known... in the end, give it a try and see if it's for you.

Hope that helps.