I have been on a low dose(10 mg.half in afternoon and half at night) which is really helping me to sleep through the pain better. I used to use Tylenol PM but could not shake the blues that it caused. I think the key for me is to use this antidepressant for sleep and try to stay on the lowest dose as then I will not get side effects. I feel much more positive about things now and can accept stresses much better. I am 69 and have had FM and OS since my 30's.