Hello, Welcome to Health Care Magic. Thanks for writing. I am Dr.Saddiq ul Abidin. I have read you question completely, i understand your concern and will try to help you in best way possible. It would have been more appreciable if you would have narrated the circumstances in which you were prescribed Escitalopram (Nexito) and whether it was a decision of a psychiatrist or was it second by a psychiatrist after been prescribed by a GP? If it is so, and the assessment of condition, apart from your headaches, for which it has been prescribed, hence the decision to decrease or continue its present dose, would lye in the domains of a psychiatrist. As far as its long term use is concerned, such medicines and other to belong to SSRI are actually meant for quite long time usages. Although these have shown to have some side effects like dizziness, dependency, Long QT syndromes ( certain heart beat abnormalities), withdrawl effects and certain drug interactions, still their use shouldn t be discontinued at your own discretion. Also regarding your query, to use stomach protection, isn t necessary along it, rather it has shown to have certain interactions and increased tendency of some skin infections in the outcomes of certain trials done for their concomitant use with Omeperazole (PPI), a stomach medicine. Your sinusitis can entirely be a different entity or can also be, on other hand, contributing to the headaches, for which you should have a detailed ENT examination and X-ray Para nasal sinuses, to diagnose it, and if proven, then it may necessitate the use of certain antibiotics, along with antihistamines and anti-inflammatory medicines for its proper management. Regards, Dr.Saddiq ul Abidin M.B.B.S(Licensed Family Physician) Resident Medicine.