Myself also, tried to start when off-mostly because I always had trouble adjusting to side effects. I am very prone to GI side effects...so even if it said 1% chance of nausea-I would vomit violently...since I figured this out, md learned to start me on lower than normal dose/work up slowly and I do major med changes /new med whn I can take like 3-4days off to start it..but thn I do work while upping doses