... years now for major depression/anxiety. After a while it stopped working and my depression and anxiety showed up with no mercy. My doctor upped my dose to 40 mg and it just got worse to the point i went to the ER. The next day I was out they said it's akathisia (side effect) so i was afraid of serotonin syndrome and I cut back to 20 mg... feels better but need to know if 20 mg will be enough dose for me? I am suicidal and I need help. I live in a third world country and have no tools to handle it