Well they can just put you on 40mgs until you are over this rough patch and then lower it again, my husband has been on it for years and has done that several times. They up it a bit to help him out when he hits a rough time in life and is struggling, then when he is less stressed and things are better, they lower it again. So when you do have that option, and later when things improve for you, you can talk to your doctor about it. My husband has usually been able to switch back to a lower dose with no adverse effects.
As to dependence, well that can happen with anything you use all the time, even orange juice. Your body just gets used to having. Though my DH has never had any severe symptoms if he forgot to take it, usually just some tiredness and a little irritability, and like I said, he has been on it for years now, a little over ten years actually, since our son was just a few months old and he is now 11.
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