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I've had depression for a year now, I take Pristiq 100 mg and Lexapro 20 mg? But for some reason this month it's getting worse, even with exercise. I was thinking of increasing my Pristiq dose when I go to see my Psychiatrist but maybe there's something else I can do? Answers : Only your psychiatrist can determine whether to increase your medication, or even if you need something different. Sometimes you can acquire a bit of a "tolerance" which requires more of the drug than previously needed for similar results. 20 MG of lexapro is a fairly low dose- I've been on as much as 60. So there is always room to go up, or to try something different. Be open and honest with your doctor, and they will help you the best way they know how. You may also want to increase the frequency of your appointments until you are stabilized. 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