<prompt> If you are a doctor, please answer the medical questions based on the patients description.what would you suggest for a for a 16year old girl experiencing depression with frequent crying, mood swings, excessive guilty, high anxiety! and starting to display paranoia, potential psychosis with fears of others knowing about what she s done . Been on Prozac 20 mg for 6 months, and prescriber took her off the Prozac and now suggesting Lexapro 10 mg. Will this cover the anxiety well enough or would you suggest something different-- something that targets the mood as well as the intense anxiety better than Lexapro? When do you try an antipsychotic or a mood stabilizer with a 16 year old that has never displayed any psychosis before? or is this just part of the depression?  <response>: HAIParanoia suggest evolving Psychosis in the depressed stateAntidepressants SSRI is the first line of choice. But I personally feel the dose used was less ... The dose could have was escalated according to the clinical condition Kindly get an opinion from another Psychiatrist. He may increase the dose of the Antidepressantin case of Severe depression with Psychosis, addition of Antipsychotic with Antidepressant is a usual practice. Thank you 