I don’t use Risperdal because of the increased risk of neurological side-effects, and increased prolactin interfering with hormones, including estrogen.  Lexapro is good for anxiety, obsessiveness, and depression, especially sadness, but if your daughter is manic depressed/bipolar the Lexapro can make her more emotionally unstable.  Effexor XR is a broader spectrum medication with potential advantages but would also destabilize if she is bipolar.

How thorough was her examination?  What family history is there for anxiety, depression, or bipolar?

If your daughter needs a mood stabilizer or something to "glue" her thoughts I have had the best luck with Abilify or Seroquel. www.askdrjones.com/2005/02/14/ranking-the-mood-stabilizers/

Age fifteen is such a critical time developmentally so you need an experienced clinician and you need to be seeing some improvement.

Recovery from agoraphobia requires a good understanding of what it is, proper breathing www.askdrjones.com/wp-content/uploads/2006/06/Anxiety_Handout.pdf and complete desensitization.  SSRI’s/SNRI’s are not required unless you are unable to progress with CBT, breathing correctly, and benzodiazepines – including as needed extra doses.  Some patients do better on Clonazepam, or Xanax XR, or Niravam.  If SSRI’s/SNRI’s are needed you have to start with a very low dose – the lowest I ever gave a patient was one granule of Effexor XR.

Treat agoraphobia like a bully that wants to run your life.  If you give an inch it will take a mile.  It’s okay to stop, breathe, take extra medication or call a support person, but don’t leave or avoid. 

Geodon is a medication with a lot of issues so that it is not one of my first choices.  It is a good antimanic mood stabilizer if taken in higher doses (120-160mg).  At lower doses it can destabilize mood.  It is not an anti-anxiety medication.  It usually requires twice daily dosing and wears off fast if doses are missed and if not taken with food.  It only has a 50% absorption.  It is relatively benign from the standpoint of weight gain and metabolic syndrome.  It is not acutely effective for insomnia.  Dosing is more complicated because it is in capsules. 

Abilify is in tablets that can be easily broken in half at the 2.5 and 10mg doses,  has the longest duration of this class, and can be started low and slowly increased.  www.askdrjones.com/2005/02/14/ranking-the-mood-stabilizers/  Both medications are pricey.

Vyvanse has less effect on the cardiovascular system than Adderall but all stimulants have possible cardiovascular side-effects.  You should stop taking it and see if the symptoms go away.  If not you need to see your cardiologist or internist.  If the side-effects do go away you may want to discuss options with your doctor. 

Generic Tenex helps with distractibility www.askdrjones.com/2006/11/07/tenex/ and can be taken with Toprol if it doesn’t lower the blood pressure too much.  You may tolerate a lower dose of Vyvanse, possibly with Tenex or you may do better on one of the forms of methylphenidate, or possibly Provigil.