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Seroquel XR for Panic Attacks (dosage level)?
mhicks21 posted:
Hello everyone,

I've suffered from panic attacks since childhood, and the severity of them has sort of fluctuated throughout my life span. I'm currently experiencing another really rough patch, to the point where it's difficult to go to classes (I'm trying to get my masters degree) or do any of my part time work because just leaving the house gets my hyperventilating.

Over the past couple of months, I've been playing "musical medications" trying to find something to take everyday to keep everything more balanced and then something to take as needed if I feel an attack coming on or just want to take one preemptively. My combination since middle school was varying amounts of Effexor XR every day and Klonopin as needed. I recently started feeling like they weren't effective anymore, but now my intensity/frequency of anxiety and panic has been worse than ever since I've stopped them and have been experimenting with other things.

Tried Zoloft and Prozac, and they were total no-go's. Then my doctor gave me some regular Seroquel at 25mg as needed and it seemed to help a bit, so she decided to try me on 50mg of the XR everyday. However, I just feel like this has been a disaster. It makes me so exhausted that I never feel rested, and it makes my head feel fuzzy, which makes me even more anxious. I called the doctor and she told me to try going up on the dosage to 100mg, which just seems counter-intuitive when I'm already experiencing side effects at the lower dosage.

I remember my psychiatrist saying something about how some people had bad side effects to begin with, but then they went up in dosage and they experienced the good effects of the drug and the side effects went away. Has anyone experienced this?

I'm also wondering if I should try Effexor XR again now that I've weaned myself off of it completely and it's out of my system. In the past, that was what was most effective, and I'm just wondering if I reached my threshold and needed to go off of it for awhile or something.

I don't know what to do. I'm having panic attacks all the time and crying and just feel hopeless. I'm so anxious I can barely eat. Would really appreciate any suggestions or stories of experiences of Seroquel XR with panic disorder or anyone who weaned off of Effexor XR and later returned to it.
Patricia Farrell, PhD responded:
I know this has to be very difficult for you, especially since you're going for an advanced degree. As I see it, there has been no mention of anything regarding cognitive therapy which would help you to learn ways to help yourself in terms of controlling or eliminating your panic and anxiety. I believe this is a missing component in your treatment plan and your doctor should provide a referral to an experienced, licensed cognitive psychologist to provide this service. Changing medications and bringing the doses up and down is not going to teach you anything and that's really what cognitive therapy will do. No one knows what medication is the best one for any anxiety disorder and, unfortunately, patients are left suffering as a result. True, some of them do have short term effect, but research has shown that the best treatment plan includes both medication, where indicated, and cognitive therapy. In fact in some cases, cognitive therapy has been shown to be as effective as medication.

So, work with your doctor regarding medication that you find effective and also get a referral for a cognitive psychologist who deals with anxiety disorders. If your doctor cannot provide one, call the local state psychologists association and they will provide the names of several psychologists in your area. Then, as I have written in a chapter in my book, How to Be Your Own Therapist , interview them and decide which one would be the one you might wish to work with.

In the meantime, also, watch the relaxation breathing video we have in our Tips column because relaxation breathing is highly effective. You need to do it when ever you feel a twinge of anxiety coming on so that you can short circuit the panic which will build. It is effective and you can learn it within minutes.

Dr. Farrell
Anon_236284 replied to Patricia Farrell, PhD's response:
I want to add that I'm on Zoloft but have only been on it for a fairly short time and have had panic attacks all my life. Anxiety and Phobia work book helped me. I use lots of lavender(chemecally reacts to the brain to calm) and roll breathing. The relaxation excercises helped me to go several years without a full blown panic attack after having a year where I seemed to stay in a state of panic.

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