Is 50mg enough to get a therapeutic benefit?

I started fluvoxamine a little less than 2 weeks ago for OCD, MDD, and severe anxiety. I started to feel some benefits pretty quickly, along with some side effects - mainly insomnia and diarrhea. My initial dose was 50mg at night. I also take Nefazodone and Klonopin.

I checked in with my psychiatrist at the end of the week to let him know how I was doing. He said to take the dose in the morning to help with the insomnia and to increase the fluvoxamine to 100mg. I immediately changed to morning dosing which might have helped a little with the insomnia.

I tried taking 75mg of fluvoxamine in the morning the last 2 days. The insomnia came back worse - tossing and turning all night and wide awake at 4AM and cannot go back to sleep. Plus I have terrible nausea and have thrown up shortly after taking my dose. I am feeling much worse on 75mg. My anxiety is horrible and I just don’t feel right. The anxiety is so bad, klonopin hardly touches it. I’m going to lower back down to 50mg.

I see my psych on Friday and will talk to him about all this but was wondering if 50mg was enough of a dose for anyone? Or maybe I need to give 50mg more time before increasing to 100mg?

Any thoughts or advice would be appreciated. Thanks so much!