if you have insurance coverage, ask the prescriber about regular liver function tests. couldn't hurt.

the other thing...maybe effexor (wide dosing range) or Pristiq? Tofranil and the updated Tofranil, Tofranil-PM, worked better for me than Cymbalta, but...tca drugs aren't exactly the easiest to tolerate. On the plus side, Tofranil is dosed at bedtime, put me to sleep, and helped w/ anxiety, low mood, and concentration, w/o as much apathy as Cymbalta.

Some people w/ "treatment-resistant depression" respond well to a combination of Effexor and Remeron. A small study found results comparable to Parnate for some people, with far fewer (and far less dangerous) adverse effects.