increase the Tenex to 2 mg a day (1 mg BID from .5 mg BID). I didn't see THAT one coming. He's pretty confident we'll see an improvement in M's increased irritability, lowered tolerance for environmental triggers, and daily outbursts within 3 days to a week. Me, I'm not so sure. Then, it sounds like his second line of defense might be to increase the Celexa! (he made a comment to the effect that he's had patients at higher doses before or something along those lines) He said if we didn't see an improvement from the Tenex within the week, I was welcome to call him (I almost laughed, because in the past he is far from prompt in returning my calls, if AT ALL) and I said I would certainly give him a call before we leave for vacation if need be!