Panic Attacks since increasing meds

[sammie13s]

So I was on 30mg for the best part of 2 years. Really considered this as an amazing drug. I felt so well that I decided to drop down to 15mg. Worse mistake ever. I had awful derealization. Felt spaced out and generally weird. So panicked and went back to 30mg after about 3 weeks. Was on the 30mg for about a week or so and saw zero improvement so my psychiatrist put me to 45mg. Iv not had a panic attack for over a year but being put to 45mg has given me the worst type. I'm having like 3 a day. I could be relaxed and boom all of a sudden my heart beats weird and I find I'm not getting enough oxygen like I just can't get that breath. It's terrifying. Iv convinced myself there's something wrong with my heart. Debating as to whether I should go back to 30mg. Any advice would be great please.

[anxiousjomo]

Hi,

Sorry to hear you are having such a rough time

It sounds to me like there may have been too much going up and down with the dosage too quickly. Certainly sounds like 45mg may be too much for you - I also think you needed to give the 30mg more than a week to get you back to normal, particularly after having been on 15mg for 3 weeks. I think it takes a least a week to get the blood plasma levels stable, and then longer than that to get acclimatised.

My instinct would be that, if 30mg was working well for you previously, you should try sticking with that for a month or so at least (and perhaps use valium/ativan or something similar to help you get over the hump).

However, at the end of the day your psychiatrist knows much more than me, and knows you much better. Maybe discuss with them?

Good luck - and try to remember that this is just short term and is a result of your body chemistry getting out of whack. Once things have settled down again I am sure you will be fine.

[sammie13s]

Today venlafaxine was introduced due to derealization. Praying I see some effect very soon. Told to go back to 30mg mirtazapine xx

[Benjammin69]

It will be the noradrenaline effect of the higher dose of mirt either lower the dose to 30mg or offset the noradrenaline with a steady dose of propranolol - 80mg slow release will help... I take 160mg slow release propranolol alongside 45mg mirt.