The first 6 weeks or so can be a rollercoaster when it comes to side effects, but that is pretty well known. Not an ideal antidepressant for those who are naturally anxious as it can make you more anxious with its stimulant effect. Sleep was hit or miss for me during those first 6 weeks, and I seemed to be very dehydrated. I am glad I stuck it out though as all of that literally disappeared around the 6 week mark.Made me hyper, horny and messed up my sleep. Tried it several times and always the same. And this was low dose. The majority of doctors, whether primaries or even psychiatrists, are going to opt for prescribing an AD rather than run a full hormone panel AND even if they do, they have to know how to interpret the results, not just say "It's all okay. You're normal".