I take 60 cymbalta, and 25 topomax, 100 mg of tramadol up to 3 times a day, baclofen 20 up to 3 times a day... plus other crap probably. lol. I am so sick of being on medicine. That might be why because you are on a high dose.... the cymbalta will help you manage your rsd mentally ALOT I could NOT imagine life without cymbalta. What is his reasoning to put you on the topomax... OHHHHH do you take brand name or generic? Because I had HORRIBLE side effects to the generic but the brand name I am fine. The generic one gave me horrific headaches body sweats skin sensitivity probably more but its been months since i have taken the generic. Try the brand name it is pricier but i noticed a day and night difference!!!! Hope that might help!