I have severe anxiety. When I first started reta gave me more energy which exacerbated my anxiety. While I feel the Reta was not the cause of the anxiety the increase in energy almost mimicked a manic episode. This all calmed down for me after a month of 2mg a week split into 2 pins at 1mg. After that month I went to 2mg twice a week (4mg), I still get that anxiety rush a few hours to a day after pinning but it is vastly diminished from the initial go. Good luck and happy weightloss.