I have been taking between 50mg and 200mg trazodone for 4 weeks and now want to switch to cymbalta (duloxetine). can i change without tapering.

Are you: treating yourself? If you are a health professional treating your self for mental illness may not be a good idea. Discuss with your doctor while you intend to make the change and is always better to taper of such medications.

I suggest taper: I always recommend a taper to my patients on trazodone since sudden withdrawal has been associated with a number of very uncomfortable and in some individuals dangerous symptoms. I have had 2 patients in my career go into convulsive withdrawal episodes within 24hrs of cold turkeying this medication. I would also not dove tail Cymbalta (duloxetine) but rather get Trazodone OUT and then, start cymbalta (duloxetine)

Trazodone switch: Not advised, due to possible rebound insomnia. Let your doctor show you way to taper & switch.

It would be best if your medication is managed by a Psychiatrist. If you are not confident with your doctor please see another for a second opinion. If you are not feeling well you may need a physical exam to find out if you are ill. Your Doctor may recommend a sleep study.