I've been doing great on just 20mg cymbalta...miraculously stable for about 3 years...never had to increase the dose. Cymbalta has been a miracle drug for me. I started by opening the capsules and worked my way up to 20mg because I am sensitive to meds. Cymbalta is all I take with my hypothyroid meds. I rarely faint or have the exhausted shaky episodes and I have both NCS and POTS. I take my pill each morn. Problem is I am considering pregnancy and I don't think it's OK with that so I will be in trouble then. By the way, I was fainting regularly with my ovulations and sometimes at other times too. I tried midodrine but got headaches and it brought my BP way too high and caused it to jump around also. Salt and liquid loading did not work for me either.