Overwhelming panic

Each morning I awaken with a racing heart, and it does not abate, even with the use of anti-anxiety drugs. I have tried Paxil, Celexa, Remeron, and Zoloft, all of which I could not tolerate due to side effects. My psychiatrist recommended the addition of neurontin to the Xanax to help boost its effects, but I ended up sleeping the entire day instead. I know I need to find a medication that works, but am so discouraged and frightened because I have not been successful so far, and am getting worse. The strange thing is, every evening, the symptoms subside, and I begin to feel calm and "normal" again. My heart rate returns to normal and I begin to feel more like myself. I feel like if I could just control this anxiety and panic, I could cope, but it takes such a high dose of anything to allay the symptoms, I am still unable to function. I have been hospitalized before for similar symptoms, but not for many years. I fear losing control, and fear having suicidal thoughts out of desperation. In no way do I want to die, I just want to feel better. I am at my wits end, and don't know what to do next.
Please help with your suggestions in regards to medication. Am I correct in that the panic/anxiety is depression driven? And why does it follow this pattern? Panic in morning, calm in evening?
Thank you.

[Roger Gould, M.D.]

I think you should continue to explore your very important observation about the pattern of your anxiety. I will give you one probability but you may have to either dig deeper or pursue this further.  That pattern can be  read as facing the day scares you while no longer having to face the day relieves you. The question is what frightens you? MOst of the time it is a decision about making a change in your life or facing a challenge or having to adapt and grow.  That is what you and your psychiatrist should explore.

Regarding medications, ask your doctor about the combination of a low dose antidepressant you haven't yet tried like Zoloft and Klonopin instead of Xanax.  That may help.

[wozza]

Hi I