Question: It's now been 5 weeks since I started on Lexapro. Dosage was 5 mg for the first 2 weeks, then variable from 6 mg to 9 mg in the next 3 weeks, and now starting on 10 mg. People say that I have improved, I'm not having bad anxiety attacks any more, I am sleeping sufficiently and regularly. However, I am still not myself. At times I feel almost normal, but other times I feel diminished in my capacity to do. Stress is still hard to handle. I do the work that must be done, but most of the rest of the time I am just killing time to get by each day. I'm still not been able to go out and be with friends. I'm essentially housebound. I worry a lot about what is going to become of me.

I am taking Lexapro in 2 mg doses about every 2 to 3 hours, which does seem to even out the symptoms I get from it.

How much more can I expect to improve in the next month?

Right now these days, you are the only doctor I'm talking to you about this. I'm at 10 mg a day, what's a reasonable time frame to increase it up to 20 mg? I'll be talking to Dr Cho about the appropriate time to increase the dose from 10 mg.

You seem to be of the opinion that I probably shouldn't have to consider switching to another medication, and that I should just stay on Lexapro because apparently there has been "significant improvement"? Remember, no other doctor is telling me how well I am progressing or not. Dr Cho only asks me how I am feeling and then discusses dosing.

Okay, now I have a new problem. Lately it seems like my blood pressure and heart has been acting up. I'm now taking about 9 mg to 10 mg Lexapro a day. My resting blood pressure and heart rate is usually around 125/75 65, but in just the past few days, it seems to have jumped up to 150/90, and my heart rate is either very low, < 60, or it's high. When it is very low, it seems to be skipping beats every other 5 , 10, or 15 beats. It's acting funny, and I'm concerned about it. I've normally kept fit before all this, and about 3 months ago UCLA ran tests on my heart, including a treadmill stress test, and it was fine, except that I do have a mild Right Bundle Branch Block, which does result in a lower resting heart rate but in my case is being considered benign because I don't have any other symptoms from it. I'm seeing my cardiologist fairly soon. What worries me is that my pulse pressure, which is the difference between systolic and diastolic, is normally between 40 and 50, but lately it's been as high as 70.

Is Lexapro the cause of this? I know you are not a cardiologist, but I'm hoping you'd be aware of what effect Lexapro could have on my cardiovascular system. I will say that in the past 5 weeks, I haven't been doing much walking like I've normally done before, so I wonder if this could be the reason, or hopefully the cure... walk more every day.