Triple the max dose does seem like a lot. I don't have experience going higher than 20 on Lexapro, but my pdoc did have me exceed the max dose of Paxil by 25% years back. She said that folks with a lot of anxiety sometimes need a little extra.

In many ways she was a good pdoc, but in retrospect, Paxil probably wasn't helpful enough at typical doses because I was BP and not "just" anxious/depressed.

Best,
EJ