<s>[INST] Hi about one week ago I was standing in the kitchen and started having these palputations and my body shaking with dizziness it lasted for about Half an hr. that night I felt palputations all night and on Sunday for a little more.I currently have just constant flutters with some dizziness. The doctor thinks that my body is used to taking lexapro which I have been for 3 years and never experienced this I have been taking 5ml every three days for the last 1 1/2 years.The doctor has told me to increase the frequency as this may stop the fluttering.Not sure what to do Thanks Kristina [/INST] Hello! Thank you for asking on Chat Doctor! I understand your concern, and would explain that the first thing to do in this situation is to exclude a possible cardiac arrhythmia. Learn chronic use can lead to ECG changes, which can induce a cardiac arrhythmia. From the other hand, anxiety (related to a lower dose than needed of learn) may mimic this clinical scenario. I recommend performing : - a resting ECG- a chest x-ray study - thyroid hormone levels-blood electrolytes. An ambulatory 24-48 hours monitoring may be necessary to exclude a possible cardiac arrhythmia. If all the above tests result normal, I recommend following your doctors advise increasing the frequency and dose of learn. Hope to have been helpful! Best wishes,  </s>