I'm with Mizzy--doses affect different people differently. While 20 mg. may work all the time for one person, it may not for another. Often enough when a med seems to work for a short time and then seems to stop it's because it was an initial dose that needs to be upped. The other common reason to increase is a change (increase) in stress, or even your monthly AF, or the PMS part. DO talk to your doctor about what is going on with you and how your dose seems to have "stopped" working. S/he will know all the right questions to ask, and you will have all the information and concerns you want to convey.
Just FYI, Celexa's initial dose is 20 mg. and its top published dose is 40 mg., but if you are working with a psychiatrist they know more about it.
2 small kids, a dog, a work-from-home-job AND a husband?? Well, *I* don't know how you manage to work with 2 kids at home. Getting a shower before noon with small kids around is a major Olympic medal event!! Oh? Okay, it should
Let us know how it goes.