Question: Dr Cho, my prescribing psychiatrist, is a little slow in responding to my messages to her. I've asked her if it would be okay for me to increase the daily dose of Lexapor from 10 mg to 12 mg, but instead she's responded to an older message and said that perhaps I can try Mind Analytics for an EEG and genetic testing to find a "statistically better match" with some other medication. I don't want to switch, as I believe that Lexapro is still continuing to improve my condition, and I've already started 12 mg to see what happens, and so far it's been positive. I will probably be seeing Dr Cho in her new office either this month or the next, as soon as I hear back from her.

As i said, the problem with Dr Cho is that either she says 1) decrease dose, 2) increase dose, 3) keep it at 10 mg, or 4) try another medication. I cannot do all four. This is why I am keeping a dialogue with you about this.

What's your opinion about "statisticaly matching patients with drugs", and is it realy a good time now for me to try? Before I saw Dr Cho the first time, UCLA had suggested such a thing for me but it was nearly impossible to schedule such a test at UCLA within a reasonable time frame, so I never followed up with that.

Dr Cho has been prescribing me Lexapro in liquid form which has allowed me to steadily ramp up my initial dose of 5 mg a day to 10 mg a day, and now I'm experimenting a bit with 12 mg a day. I've already sent her messages that I'd like to increase it to 12 mg a day, but she's not responded to them yet. I know she will eventually, so I'll wait.

Yesterday I had a long bad day, 10 hours almost nonstop work and stress, and while I felt like a wreck afterwards, I was able to recover without alcohol or any anti-anxiety herbals, and slept a long time last night. That's one reason why I believe I am continuing to improve.

By now you actually know more about what's been happening with me in the past months than Dr Cho does, and that is why I consider your service valuable. Can you tell me why you are recommending increasing the dosage? I think the trouble with Dr Cho is that she's still thinking that I am complaining about side effects of Lexapro, and I am trying to get a dialogue going with her to keep her updated about my condition.

Now that my condition is gradually (very gradually!) stablizing, it's becoming easier to sort out the moods and sensations I'm experiencing throughout the day. For example, I can sense that bit of drowiness in the morning that's probably from the Trazadone, which is different from the feeling of "stupor", which is again is different from the feeling of "anxious and feeling wired" (the kind of feeling that makes me want to go grab a shot of booze). Yes, I am learning now that the feeling of "stupor" is in fact another manifestation of anxiety, because that tends to be worse too after a period of stress or worry.

In retrospect, I might have had this problem building up over the years without realizing it, increasingly suffering from what I call "bad battery syndrome", i.e., I had decreasing ability to sustain stress and frequently felt like my battery has drained too soon. If my condition, however sudden the severe level of anxiety had developed, was in fact years in the making, what would be your advice on how to proceed, other than staying with Lexapro at a moderately higher dose for some time? If I were able to recover back to the condition I was a year ago, could Lexapro still help me beyond that?

I got a response from Dr. Cho who agreed that I could go ahead and try 12 mg Lexapro daily for "several weeks" to see if that improves things before any further changes. If I have any further questions, I'll start another thread.