My daughter A is 14 (will be 15 in February) and in 9th grade. Except for two small Lamictal increases last fall and this spring, she has been stable on the same medications since December 2006. Not only has A had a difficult time this fall adjusting to the greater academic and social demands of high schools, but we also believe she is experiencing hormonal shifts (she hasn't yet gotten her period, but we think she is getting closer). She called me to pick her up halfway through school yesterday with a stomachache. She didn't eat much and then didn't go to school today because of a headache and dizziness. No fever, no sore throat, no congestion, no cough. While she could have a virus, I'm suspicious anxiety may be at play because her symptoms are vague and she's experienced somatic issues before when her mood wasn't stable. In the last few weeks, she's been having trouble getting her homework done on time because she says she's not motivated. She claims she doesn't like her classes or her teachers. A is also worried that one of her close friends has a boyfriend, and she doesn't. This is all very unlike her. A week ago we increased her Lamictal dose by 25 mg (to 250 mg), but it either hasn't kicked in or it isn't going to help. She also takes 7.5 mg Lexapro for anxiety/depression and 25 mg Seroquel for sleep. Her psychiatrist is talking about increasing Lexapro to 10 mg, but I'm worried about a bad SSRI reaction. A became nearly psychotic on Paxil at age 10, her brother J has had manic reactions to 5 SSRI/SNRIs (even with a mood stabilizer on board) and her sister M became disinhibited on Prozac. Any thoughts on a Lexapro increase? And if we don't go with a Lexapro increase, any thoughts on what we should do?