Yep I've definitely noticed that I'm still getting that heightened anxiety about 3 to 4 hours after taking my meds (usually about 2-3pm) and I'm still getting nausea and indigestion plus my appetite is very on and off. Its been two weeks since I started the 10mg...wondering if taking them at night might help instead? I wouldn't want to be kept up at night with side effects though especially as poor sleep was one of the first reasons I went on this medication! I feel so low like I'll never feel better without side effects still plaguing me...I'm emetephobic so the nausea makes me especially anxious in public places. The worst feeling is that I my general all round anxiety is decreased but I'm still getting these anxious spikes as you put it.