To start off, I have had Generalized Anxiety since childhood. I am 28 now. I started taking Duloxetine for Generalized Anxiety and Depression, 30 mg daily at the beginning of Feb 2023, and noticed a tremendous positive change but not without side effects. I quit cold turkey two months ago and can see my initial conditions of Generalized Anxiety coming back. This post is to ask for help and to seek information that may help me decide to either start again or give it up for good. I hope the answers not only help me but also can be informational to thousands of others going through the same. Sorry for the long post but it will be a quality one.

Short Story: Was prescribed Duloxetine 30 mg daily in Feb 2023 along with Vyvanse (ADHD) 30 mg. I noticed really positive benefits and was very happy with them till I noticed some, not very apparent, bad side effects. So I decided to quit cold turkey two months ago and was successful. Now I can confirm that the side effects have gone but also the positive effects and I am back to square one. But knowing the benefits, I am highly interested in figuring out how can I get those back while minimizing the side effects. I definitely am going to seek professional medical help as well but I wanted to gather information before I go to the doctor so that I can know what are not only my orthodox options but also the unorthodox ones. I am going to highlight the pros and cons for me below:

Pros:

Anxiety eliminated: No longer anxious without any reason and also with reason, it is so managable. My general anxiety would always keep me in flight or fight mode and if triggered, it would make my hands shake and my brain totally stop. So really bad. But after taking Duloxetine for a month, I could see that even when triggered by external stimuli, I was very cool and calm and could think rationally through it.

Confidence Gain: My communication skills and confidence improved drastically. I work in a very high paced banking job and, not being a native English speaker, my spoken english was deteriorating. Although i could still do a fine job with the written one. But after taking Cymbalta, I could feel that I was not fishing for words any longer and was very articulate and confident while speaking. Since quitting, I can notice quite tangibly that I am back to finding words to express my self and using incorrect phrases (Even though i know the right ones). Not to forget the positive impact it had on my public speaking.

No longer binge eating: I also suffer from a weird bulimia, in a way, that I binge eat and my stomach doesn't tell my brain properly when I am full. Before Duloxetine, I used to take fluoxetine as well and both helped me with keeping my eating in order. Also, the ADHD med contributed to it as well.

Cons:

Obvious sexual side effects: Soft erections, severe delay in orgasms and general loss of libido. Used to have sex with wife twice a week atleast if not everyday and we were down to having it one in two months. After quitting, i can feel my erections are a lot harder and I am more sexually active.

Laziness and lethargy: I always was an early bird to the extend that my wife would get pissed off at me for waking up everyday at 4 am and being so active in the morning. After duloxetine, I couldn't get out of bed even at 8 am, though I would have slept at 9 PM last night. I didnt feel like working out or doing chores and would rather just sit on the couch and watch TV.

Weight Gain: The worst was my weight gain. I gained 15 kgs since February even though I was not binge eating. Its also partly due to my lethargy and laziness to work out anymore. But even when I explicitly tried to become active again, and did that, I couldn't see any weight loss. Even though I have been super good in the past to lose weight when I wanted.

Motivation Loss: I have been super good at learning new things. I was always into doing certifications and courses and people would be in awe of how much time I spent on learning new things, work and otherwise. Now, I completely lost the motivation to study and learn new things. After quitting, I could see the clear difference that I was a lot more motivated to study. I have been waking up at 3 these days to complete a certification that i signed up for.

Extreme Sweating and body heat: I used to sweat above average but nothing compared to what I was doing while taking duloxetine. I mean, I would be sweating profusely even when it was 5 degrees Celsius out there. If I biked or worked out, then I knew that I just won't be able to stop sweating even an hour after it. It made me very self-conscious as I would be sitting at work and sweating like a pig in a shirt when everyone else was all right.

Now that I have quit, I miss that confidence and non-anxious behavior which are very crucial and key to my progress at work. Even though I am fairly successful in my career, I have always felt that my anxiety has held me back and stopped me from living up to my potential. And having seen that I can actually address and get rid of those, I would really like to try and see if Cymbalta can work for me.

So if you experienced folks can provide me information on these questions:

Is there a way to manage these side effects? 30 mg dose is the lowest I can get in my country.

Does powering through these side effects potentially eliminate them?

Are there any other meds that I can take to control my anxiety (I have already tried Fluoxetine and Escitalopram before and both made my mind go numb and dumb)

Please help me out. I have been struggling with this for a long time now and really want an end to this anxious lifestyle.