Panic Down Under or med experts - I need some advice please

[milliemoo]

So I have failed on Clomipramine, I couldn't handle the side effects even at 10mg, so I have an appointment with my GP this afternoon to try something else. This is my medication history!
2004 - postnatal depression and anxiety successfully treated with citalopram 40mg
2007 - anxiety treated with successfully treated with 40mg citalopram
2011 - anxiety and OCD - citalopram didn't work but the sertraline at 150mg did.
2014 - Anxiety started again but sertraline didn't work, so I have tried venlafaxine up to 225, then with added mirtazapine. Then tried duloxetine for 4 weeks and got worse, then was put on fluoxetine up to increasing doses to 60mg and that didn't work. Since January I've tried escitalopram, lofepramine.

I was thinking about going back to citalopram or sertraline - what are your thoughts?? Or trying amitryptiline?

Anxiety got so bad this week I've actually taken diazepam, which I've never done before!!

[panic_down_under]

Since January I've tried escitalopram, lofepramine.

I was thinking about going back to citalopram or sertraline - what are your thoughts?? Or trying amitryptiline?

Escitalopram and citalopram are essentially the same med so if one doesn't work then the other is unlikely to either. Given you seem to have stopped responding to serotonergic antidepressants and sertraline failed relatively recently, it is probably a long shot too. Which leaves amitriptyline.

[milliemoo]

I was thinking also about going back to venlafaxine. I did really well at 75mg ans was on,y on it for 4 weeks and then had a blip so dr increased that's when I went downhill!

[panic_down_under]

I did really well at 75mg ans was on,y on it for 4 weeks and then had a blip so dr increased that's when I went downhill!

Did you switch from another antidepressant, or start it from a clean slate? If the latter then at only 4 weeks it probably wasn't doing much.

[milliemoo]

I went on it directly from 200mg sertraline.

[panic_down_under]

I went on it directly from 200mg sertraline.

While antidepressant dose equivalence isn't an exact science, 75mg venlafaxine would be much less than 200mg sertraline which explains the blip. But you said it still didn't do much even at 225mg.

[milliemoo]

I am going to give duloxetine another go. I didn't really give it a chance last time, I did a week at 10mg, 1 week at 30mg then straight to 60mg and only lasted 10 days as anxiety tripled!!