Panic attacks and antidepressants

[Bruin Girl]

Back in July of this year, I started tapering off of Effexor XR, 75 mg, so I could get on an antidepressant that was safer for pregnancy. I felt great when I was getting off of it-less muscle tension, less keyed up, felt a broader range of feelings-it was great. when i was almost completely off ( I had to count the granules like one of the other forum participants b/c I, too, am super sensitive to psychotropic meds) i felt a little anxiety coming back, which was situational-I was the maid of honor in a wedding and felt a little overwhelmed). then i switched to lexapro and started at 5 mg-again, because I'm sensitive and felt really apathetic. one week later i increased to 10 mg and felt pretty anxious; maybe i increased it too quickly? my doctor told me to go to 20 mg and I started having panic attacks. so i tried to get back on the effexor, but still felt very anxious and whenever i increased it I got panic attacks. and began having insomnia. my doctor gave me 15 mg of oxazepam which i took for maybe 3 weeks but i'd only sleep 4-5 hours so she gave me lorazepam, 1 mg and it didn't even phase me. i was up all night. finally, klonopin worked, but i only took it once. now i'm off the effexor and 2 days ago i tried lexapro again and only 1/2 a tablet sent me into panic. i tried 1/4 of a tablet (10 mg tablets) and that made me extremely anxious as well. last night was the first night i slept without a benzo, i took 20 mg of elavil instead and slept for about 7 hours but woke up frequently throughout the night. My doctor wants me to only take the ativan for the panic attacks and let me body rid itself of the effexor (she suspects i still had some effexor in me when i took the lexapro which caused the panic/anxiety) and try 1/4 a tablet of lexapro on Monday (today's thursday).

one worry i have is maybe the panic i had this morning is related to not taking the benzo-can you get dependent only after 3 weeks? i was taking it as prescribed; the most i would take of the oxazepam was 3-4 15 mg tablets a day and i stopped that once the effexor stopped making me anxious. then i only took ativan 2 mg for 3 nights in a row for sleep (2 mg did work). or is the lexapro still in my system and making me anxious? i took 1/4 of a 10 mg tablet yesterday and 1/2 a tablet the day before. i've had none today.

my other question is what the hell do i do now? i've tried all the SSRIs and effexor, gabitril and they all make me extrememly anxious and panicky and cause insomnia. serzone and remeron were super sedating, but maybe that's what would work now. i tried buspar with effexor for anxiety-didn't work. i tried wellbutrin with effexor to increase my sex drive and it didn't work and might have given me insomnia. maybe those drugs were no match for the effexor, though b/c i'm so sensitive. i've also started counseling and think i need to go twice a week (i grew up in a very abusive, alcoholic household).

[Roger Gould, M.D.]

Here's my suggestion. Get off of everything except what you need to sleep and concentrate on your counseling. I have seen so many instances like yours where nothing works and the drugs cause more problems than they solve. Deal with the underlying issues and stop try to second guess which drug is doing what.