I've only took 3 20 mg doses so far.
The best way to think of initial side effects is to compare it to a very bad flu or cold. So accepting that you will physically feel ill, and not panicking too much over it. The kinds of side effects to be more concerned about are the mental ones - if there is a real shift in your POV, thoughts that didn't used to overwhelm you suddenly cause extended bouts of weeping, or the opposite - you feel like you are flying high, on top of the world. That's the sort of stuff that will warrant immediate stoppage.
You won't go through a withdrawal if you skip a dose at this point, but it's also not going to make a bit of difference, really. Either you can stick it out for a week/10 days through your initial titration and then evaluate how you feel, or you should just stop.
I remember when I went on my first med - Cymbalta - I felt like such crap, and also had strange things like trouble urinating, my mouth tasted like copper...and I really did panic that something bad was happening. The panic then created some increased BP and racing thoughts. If I had not gotten constant reassurance that this was completely normal, I'd not have kept taking it. Altogether, it took me a month to titrate to a working dose, but the most significant side effects passed around day 6. Some funny little ones kept on until I was a good 6 weeks in.
It does take some gritting of the teeth. I'd look at it this way - you need to give it a proper try in order to know whether or not it works. You're already into the process - if you can push through the physical discomfort til day 10, then, you'll know if you can tolerate it.
As I said - if your side effects are predominantly mental, that's different. But if they aren't, my personal recommendation (from experience) is to stick with it.
(For context - I've had seriously bad reactions as well. In both, the mental effects far outweighed the physical effects. The general exception to this rule is side effects that are visibly physical: rashes, hives, swelling, loss of motor function, high fever - these indicate physical intolerance).
