Brief Answer:
Explained below.
Detailed Answer:
Hi XXXXX,
Welcome back!
I think starting escitalopram has led to some improvement in your
anxiety but still, there is significant anxiety. Since escitalopram would take around four to six weeks to show its full response, in my opinion, you can wait for at least a couple of weeks more to assess the level of improvement and decide about dose hike. However, if the anxiety is so high that you are sure that a dose hike will be required even after full response is seen on the current dose, then you need not wait to increase the dose. In such a scenario, you can increase escitalopram to 15 mg per day even now. It is to be taken once a day, preferably in the morning.
Regarding
buspirone, you continue taking it as before, that is 5 mg thrice a day. I would also like you to get your blood pressure checked and ensure that it is under control. Another factor that may be involved is
menopause. If you are menopausal, that can cause a worsening of anxiety, the
shock like feeling and other symptoms.
You will benefit a lot if you can start practicing relaxation exercises regularly. I remember mentioning them previously but I cannot check as the previous query was deleted from my history by the website team many days ago.
Let me know if you need any clarifications. You have been very brave and you just need to hold on.
Best wishes.
Dr Preeti Parakh
MD Psychiatry