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Contact your prescriber sooner if you notice these changes Do not wait for the next routine follow-up if you develop: Chest pain, marked palpitations, or shortness of breath A sharp rise in anxiety, agitation, or irritability Insomnia that starts impairing daytime function Meaningful appetite suppression with weight loss or skipped meals Feeling emotionally flat, unlike yourself, or unusually driven in a way that feels unhealthy Those reports help guide treatment