Changing meds

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Originally Posted by Candy6

I’m having a really bad time at the moment with panic/low mood. I’ve been on my current meds (lofepramine)/for years and I really don’t think it’s working any more.

How much are you taking?

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I’ve spoken to my GP about this but she tells me that I’ll need to come off one before going onto another.

Doing a washout before starting another AD is only necessary when switching to/from a MAOI class AD. For all other ADs cross tapering is the better option, although most can handle an overnight switch from one SSRI to another.

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I’m so fragile at the moment that I don’t think I can put myself through this in case they are holding me together. I’m also scared of what I’ll go on - I’ve heard a lot of good things about sertraline or citalopram but I did try an SSRI (fluoxetine) many years ago and this made my anxiety a lot worse.

I suggest switching to imipramine via a cross-taper before trying a SSRI. Imipramine (Tofranil) was the 'gold standard' AD for panic disorder for many decades until the SSRIs and SNRIs became available. It wasn't replaced by SSRIs because they were more effective, but because they are safer in overdose, although it turns out this isn't true of all of them.