I have been on duloxetine for ten years at 40mg. Recently (past six months or so) I've noticed a return of my depression. I have just started my new dosage of 60 mg. per day and on day one felt foggy, confused, and tired. It's been so long since I have thought about even being on an antidepressant, I don't remember if a dose increase causes these symptoms. Any similar experiences out there?