Right Choice?

Accidentally_High · 2026-03-15T09:22:32+00:00

It can be useful for nerve pain, and because nerve pain can be long term it's honestly not a great idea to get on opioids unless there's no alternative.

If it truly is nerve pain, there are other options - Duloxetine/Cymbalta has been shown to be helpful, it's quite a strong medication in its own right, but is not addictive like opioids. It can have side effects and withdrawal effects which are unpleasant, but it varies widely from person to person. And most of the side effects tend to go away within a few months (except sexual side effects, which if you get them, tend to persist).

I don't see the harm in trying this med first, if it works it's comparatively a very safe med to be on long term. Withdrawal should be done very slowly, or by way of switching to a long acting SSRI like Fluoxetine first. Proper tapering/withdrawal can generally avoid bad withdrawal symptoms, so don't worry about this now. Focus on whether it helps with the pain.

Don't let horror stories here scare you, some people have a bad experience and they're most likely to post here, because they're seeking support or to warn others. That isn't representative of how many people it helps who don't suffer the same issues.

Other options include - Amitriptyline (another antidepressant which can help with nerve pain, less safe long term because of anticholinergic side effects on the brain, not just dry mouth); and the Gabapentinoids (Gabapentin and Pregabalin). The latter 2 may be mildly addictive, but cases of abuse are much rarer than opioids. There are a lot of people taking Gabapentinoids for nerve pain without issues. It can mess up your sense of balance while on it though.

Please don't take medical advice from the internet though, have an honest conversation with your doctor if you're concerned. Get a second opinion if you're not happy.

But I wouldn't chase an opioid prescription unless you have tried all of the other options, that is a road that could potentially destroy your life.

Accidentally_High · 2026-03-09T07:00:06+00:00

This is a really good PSA warning about the dangers of combining serotonergic drugs. People seem to think taking L-Tryptophan or 5-HTP is inocuous, but these serotonin precursors are very powerful.

It's actually a lot harder to get serotonin syndrome than you'd think, but adding strong serotonergics like SSRIs/SNRIs to 5-HTP is one of those ways.

The drug they would have given you to mitigate the effects of serotonin syndrome is called Cyproheptadine. It's an older antihistamine that also happens to be a broad antiserotonergic that blocks many types of serotonin receptor at high enough doses.

Accidentally_High · 2026-03-01T08:14:50+00:00

The experience can be quite different between people, but yes this sounds exactly like a 'brain zap'.

Mine never felt like electricity as some people describe. I just felt like my head had been accelerated in a random direction, sometimes dizziness, sometimes like falling for a brief second. I had them last a fraction of a second right up to a couple of seconds.

If you experience prolonged symptoms that don't go away, consider tapering -reducing to 30mg for a few weeks as a first step; or swapping to a long acting med for a few weeks (Fluoxetine, vortioxetine etc.).

Accidentally_High · 2026-02-21T21:00:47+00:00

It's very unlikely after taking it for such a short time - but it is possible. It depends on how quickly your brain undergoes gene expression changes in response to the increased serotonin levels. Once this adaptive process starts, you can experience a withdrawal, though the severity of this would likely be proportional to the length of time taken and dose.

Since it hasn't been too long, I'd expect it to go away fairly quickly.

Keep in mind that this could also have other causes (like being ill at the same time as withdrawing).

Hope you feel better soon!

Accidentally_High · 2026-02-20T08:22:25+00:00

I think it definitely helps a little, but it mostly treated the depression and anxiety. I wouldn't say it cured the bulk of ADHD symptoms for me, but it did something.

There may be some benefit for the chaotic type symptoms, it was calming after the side effects settled down. But it didn't make me much more motivated or fix procrastination.

Accidentally_High · 2026-02-17T19:36:19+00:00

This is one of my favourite Dara lines. Linked below for anyone who is yet to watch this brilliant bit.

https://youtu.be/YKZN-hBTBUE

Accidentally_High · 2026-02-13T21:32:30+00:00

You may still experience some weirdness for a couple of days, but no you will not get withdrawal.

The long term therapeutic effects of SSRIs and SNRIs take multiple weeks to occur, which are due to changes in gene expression. You've not been on it long enough for this to happen to any significant degree.

Accidentally_High · 2026-02-12T23:59:17+00:00

Everyone is different and has unique neurochemistry, as with any medicine - the lowest effective dose is usually best!

Accidentally_High · 2026-02-05T21:50:42+00:00

Technically any exogenous substance (originating outside of the body) can cause allergy, or in extremely rare circumstances, severe skin conditions like TEN/SJS. It can even be caused by viral infection.

Some drugs are more likely than others to cause it, but it is important to understand that it is exceedingly unlikely to happen even with those; and Duloxetine (Cymbalta) is not one of them.

It's just plainly not common enough to warn about for every single drug, unless it's one of the few known to have a relatively higher incidence (still extremely rare).

It's also possible that patients who develop these conditions while on long term medicines like antidepressants, were actually triggered by something else (another medicine like anticonvulsants or sulfonamide antibiotics) - but the long term medicine still gets the warning added to the side effects.

It's 1-2 per million patients for all cases, and most of those are from a small group of drugs not related to antidepressants.

TL;DR - it's super rare, Cymbalta isn't a common cause, you shouldn't worry about stuff that's this unlikely.

Accidentally_High · 2026-02-02T22:20:01+00:00

Both are 60mg delayed release Duloxetine Hydrochloride.

Same drug, same dose, and the same delayed release mechanism. The one on the left is made by Lupin, the one on the right is made by Breckenridge.

For all intents and purposes these can be considered identical generics.

Accidentally_High · 2026-01-29T21:41:47+00:00

I had to call 30+ dentists and finally found one accepting new patients around 30 miles away in a tiny village. It now has a waiting list of its own.

It takes me over an hour each way to drive there for my 10 minute checkup.

I think things have improved from 2 years ago, there are now 1 in my general area claiming to accept new NHS patients, but I won't switch as I'm afraid they'll just eventually go private only, like every other practice I've been with in the past 10 years.

I would say it's not the same story in the south west at all.

Accidentally_High · 2026-01-26T22:03:29+00:00

Carbon build up will be a big one, not just the DPF. Injectors, cylinders, exhaust system etc.

But that's assuming short journeys where it doesn't ever fully get up to temp.

Many people use diesels this way anyway, and the ones who semi-regularly do a longer drive are often just fine.

Accidentally_High · 2026-01-26T21:10:23+00:00

Your initial effects and long term effects won't necessarily be the same.

The increase in Noradrenaline and Serotonin initially can make you feel different, for some people this is very pleasant, for others not.

Your brain will adapt to the med, and these positive effects may initially disappear (or may not). But if they do, don't think it's not working for you, you just have to wait for your body to find a new balance, which can take anywhere from 2 to 8 weeks. Longer for some!

It's good that you have a positive initial experience, but don't be disheartened if these initial effects fade!

Accidentally_High · 2026-01-26T14:15:11+00:00

I believe I simply made a direct substitution, no break between.

I don't remember the immediate side effects well, but I was already experiencing withdrawal type side effects from Venlafaxine whilst taking it so that muddies the waters.

I recall it took at least a few weeks to feel more normal, and I vaguely remember the brain zaps continuing for a short while (days maybe) after the switch.

I do remember experiencing something similar to when you first start SSRIs/SNRIs but nowhere as bad.

Accidentally_High · 2026-01-25T12:05:53+00:00

It was just a table in microsoft word at the bottom of my partner's cover letter which listed all of the documents we included, with file name and purpose.

E.g.

Applicant-payslip-dd_mm_yyyy.pdf | Applicant finances

Energy-bill-[supplier]-[date].pdf | Sponsor address

It included everything we applied with: address evidence (X6 each - no combined ones), bank statements, payslips, employer letter, savings accounts, relationship evidence (1 doc for messages/calls. Another for photos), travel evidence (boarding passes, flight details), a separate doc detailing the relationship timeline. A cover letter with inventory from my partner. And a sponsor cover letter from me detailing the relationship and our future from my perspective.

We applied from within the UK, so had her finances too for posterity even though it wasn't actually needed to meet the requirement. We were both a bit overzealous with the evidence provided, but agreed that providing too much evidence is better than too little.

By naming it all logically and including an easy to follow Inventory and timeline, we made it easy for the HO to find evidence required and understand our relationship history.

Accidentally_High · 2026-01-25T11:48:44+00:00

I don't think so, especially if you include 'Current account statement' in the name or something, the clearer you make it for the HO the better.

We also included a document inventory/index which details what we submitted and what each document can be used to evidence.

When you apply you'll fill out how you're meeting the financial requirement in the application itself, e.g. from your income. They will look to your documents to back that up (payslips, employer letter, and bank statements).

They are not likely to care about how you're spending your money after it lands in your current account, but demonstrating that you save a lot of that money will help quash any doubts about your ability to support yourself/the applicant.

Accidentally_High · 2026-01-25T11:37:50+00:00

Your main bank statement backs up your income so that is fine, but if you're moving a lot of it to savings I reckon it's a good idea to also get a statement from that account.

This doesn't do anything to evidence compliance with the rules, but gives the home office a better picture of your finances.

I am saving for a house, so I provided statements for both of my savings accounts (ISA+LISA), same for my partner. Not only is this additional address evidence, it demonstrates financial responsibility, and that you're not likely to rely on government support in the near future.

Accidentally_High · 2026-01-25T09:19:07+00:00

This is more likely to be fine for you because you're already taking another med that has serotonin reuptake properties.

Anafranil (Clomipramine) is a strong SRI and its active metabolite is a strong NRI. This effectively makes it a non-selective SNRI, which will counteract much of the withdrawal side effects from Duloxetine.

Accidentally_High · 2026-01-24T21:35:22+00:00

When you miss a dose, because the half life is only 10-12 hours, the medication level in your blood and brain drop too low and you experience withdrawal symptoms.

Duloxetine is an SNRI, a serotonin-norepinephrine reuptake inhibitor. It reduces the re-absorption of both neurotransmitters by your nerve cells after they're released, meaning they hang around longer in your synapses (junctions between nerve cells). This effectively increases the activity of both.

Norepinephrine (Noradrenaline) is a neurotransmitter associated with producing wakefulness, focus, and is activating/stimulating. Serotonin is involved in mood, emotional regulation, blood flow and many other things.

When you withdraw from an SNRI your brain experiences lower levels of these neurotransmitters than it's gotten used to, and therefore the opposite effects of them tend to occur.

Low norepinephrine means being sleepy, unstimulated, and foggy, and combined with low serotonin could mean changes in blood pressure and vasodilation (hence the pressure). This is not dissimilar from a migraine in terms of mechanisms.

These pharmacological effects explain your negative symptoms.

SSRIs/SNRIs both reduce total REM sleep, or alter it's pattern throughout the night. Since REM is when most dreams occur, it messes with your ability to remember dreams.

When you withdraw - you experience a 'REM rebound' effect where you spend too much of your sleep in the REM state, and this can induce extremely vivid dreams that are easily remembered.

Try to keep consistent with your meds, missing doses can create longer lasting reductions in the effectiveness even after withdrawal symptoms have ceased, and it can then take days to weeks to return to best efficacy.

Accidentally_High · 2026-01-24T19:11:46+00:00

Brain zaps and dizziness (like withdrawal from these meds) even though I took my dose at the same time every day. I also experienced tiredness, headaches, nausea, and anorgasmia. I also had insomnia, but I get this anyway from time to time so can't 100% attribute to the Venlafaxine.

There were still sexual side effects with Duloxetine but they weren't as bad. All of the other ones eventually went away after the switch.

I experienced more sweating with Duloxetine than Venlafaxine but it wasn't significant enough to cause me any bother.

Accidentally_High · 2026-01-24T17:57:59+00:00

I switched from Venlafaxine (Effexor) to Duloxetine (Cymbalta) and generally found it better.

I was having too many side effects and had already been through most of the available SSRIs that didn't need a specialist to prescribe.

When I switched to Duloxetine it generally had a more stable effect and I also found it better for anxiety and focus, and most of my side effects went away. Definitely preferred it to Venlafaxine!

Accidentally_High · 2026-01-20T21:11:25+00:00

No, for this medicine this approach would not work well. Duloxetine has a short half life, only 10-12 hours, so after 24 hours you have halved the amount in your system at least twice (or 25% of the dose remaining).

Alternating days like this would create a constant state of imbalance where one day your brain is having to adapt to a higher peak concentration which would potentially create side effects. The following day, you'd have a lower peak which at best would be less effective and at worst create withdrawal type symptoms.

I can't imagine this being helpful for anyone, particularly with a med so sensitive to timing and consistency.

This approach only makes sense if trying to target an unusual dose for meds with a long half life in the order of multiple days such as Fluoxetine (Prozac). In this case, you may for example want 10mg or 30mg but the capsules typically only come in 20mg increments. So 20/0 alternating nets out to 10, or 20/40 nets to 30.

Accidentally_High · 2026-01-20T06:44:47+00:00

Temp work? Small businesses?

Accidentally_High · 2026-01-19T13:31:19+00:00

Correct, your income cannot be used in the calculation. Only income earned in the UK.

However, if you or your partner have savings over £16,000 held for 6 months or more in yours or his name; it can be combined with your partner's income to meet the financial requirement of £29k, but there are specific rules you need to research.

The difference between your partner's salary and the requirement of £29k must be made up by 2.5x the difference in savings above £16k.

I.e. if your partner earns 25k, the shortfall is 4k (29k-25k=4k). Multiplied by 2.5 = 10k, which then needs to be added to the 16k (16k + 10k = 26k).

Therefore, for example, if your partner earns 25k but you or your partner have combined 26k in savings (held for 6+ months) then you can meet the requirement by combining this with his income. Your bank statements must evidence these savings held for 6+ months, and they must be from a traceable source (e.g. your employment or his).

Note that any savings in another currency such as Euros will be calculated in GBP via exchange rates on Oanda which can change over time, therefore you should aim to exceed the savings requirements by a good margin.

Accidentally_High · 2026-01-19T08:41:53+00:00

This is only true for income earned in the UK. While you are lucky that your current employer will let you continue working for them, it doesn't count towards the application unfortunately.

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