Hi and welcome. I’ve not taken duloxetine but have taken lithium and mirtazapine.. Mirtazapine is a very effective AD for a lot of people. I’ve had it in combination with various ADs and with lithium. It makes you very drowsy so is normally taken at night - so if you struggle with sleep it’s a good one to try. The biggest side effect it has is that it does cause weight gain - and most people have this side effect. Don’t ever take the soluble tablets - they taste foul

Lithium is a mood stabiliser. It doesn’t work until there’s a sufficient level of lithium in your bloodstream so you’ll be getting frequent blood tests to begin with to increase the dose til it’s at the right level. Of all the meds I’m on, lithium is the one I’d never let them stop as it’s the key to my health. However, it does come with risks of a lot of side effects. It can affect your thyroid, your liver, kidneys etc. Lithium toxicity is a risk too so you’d need bloods every 3 months to check all these factors. Lithium is also contraindicated with all sorts of other medications inc anti inflammatories - it doesn’t play nicely.

Given all this, I’ve been on lithium for over a decade which, I think, speaks volumes to how effective it is for me - I’d rather deal with all the side effects than stop taking it. But when my psychiatrist first talked to me about it, she told me to go away and research the drug before we made a decision as it’s not an easy drug to deal with.

When I’m well, I do feel the full range of emotions but they are easier for me to deal with itms. Hope this helps