<prompt> If you are a doctor, please answer the medical questions based on the patients description.I am currently on 75mg of Effexor XR and have been for the past 7 weeks. I am still anxious and have a sick stomach and cant sleep. Im also taking 0.5 of Ativan in the morning and at night. I am thinking about switching to Celexa. How should I switch over? Should I taper off of Effexor slowly?  <response>: Hithanks for using Chat Doctor if u want to switch over to Elena, then first start both Chat Doctor. 5 mg a day and Elena 10 mg a day. Then after one week, stop effector and increase dose of Elena and maintain on same dose for two weeks. If still u do not get sufficient improvement, then gradually increase the dose 10 mg every two weeks maximum up to 40 mgday. U can also consult a psychiatrist. Thanks 