Okay. The quick background story: I started Lexapro 10 mg in September for depression and anxiety (but anxiety being my real, ongoing thing, kwim?). It started to work at about 5 weeks. I felt normal again, for the entire month of October and into November. Then, I had the blues set in mid month, for no obvious reason. Family doc upps me to 20 mg. After a week or so at 20, I start to feel normal again, then some major stuff in my family hits the fan that is quite devastating. Really, really bad timing. Still, a week or so after the stuff hits the fan, I feel myself going back on an even keel.

Then, just a few days before my long awaited appt. with a psychiatrist, I feel myself getting down and anxious again, for no obvious reason. By the time of my appt. with him, I'm a wreck. Fortunately, I took a liking to him and had a really good session. He felt that Lexapro was providing me with *some* benefit, but I was probably one of many for whom a good therapeutic dose was more like 30 or 40 mg, rather than 10 or 20. The teaching hospital he is affiliated with is doing major research on this which is backing this up.

His advice was this: He suggests I up to 30 mg. Wait a week, watch for side effects. I started 30 mg the day I saw him, Dec. 16. He said that if I feel better by week's end and am not having s/e, to stay at 30 mg until my follow-up with him. If I wasn't feeling better and not having side effects at the end of that week, then to up to 40 mg. It seemed clear and simple.

So, here's what happened. I did feel better in a week at 30 mg. This lasted up until new year's day, when I woke up feeling an unspecified "off." Over the last three days it's evolved into full blown blues and anxiety.

Now, do I go ahead and *now* up to 40 mg? Or do I try to hang on (with the help of the odd Ativan) until Thursday when I see him for me scheduled follow-up?

I don't want to jump the gun, if you kwim, but at the same time I have a feeling he's going to tell me to up it to 40 mg anyway, so why not sooner rather than later???

Unfortunately he's out of the country and I can't call him. Argh.

Suggestions?