"started on 18mg and did not notice any difference in my ability to concentrate, but noticed that my appetite had decreased. my dosage was switched then to 32mg and i noticed that my attention span had increased slightly but the more noticable change was to my mood and my anxiety. my hands shake from this medication and i get hot flushes although my hands are cold and clammy. i sweat more unconsciously and this is uncomfortable. i went back to talk to my psychiatrist and was told that side effects tend to even out, and sometimes an increase in dosage can speed up this process, so i went up to 54mg. although the medicine has made a change in my attention, my appetite has gone in the day and i have lost around 7kgs."