Lofepramine? Advice please

[panic_down_under]

Which 2 for OCD (I suffer with that also).

The SSRI fluvoxamine (Luvox) and the TCA clomipramine (Anafranil). I think clomipramine is the better of the two because fluvoxamine interacts with many pharmaceuticals and alternative 'meds' which can complicate things if their are other health issues. However, clomipramine is also one of the most serotonergic ADs and you apparently haven't responded to them in the past.

[welshdory]

Hello I have decided to come off this med, due to intense anxiety and not being able to sleep.

Due to my husbands terminal illness and my caring role (so needing to be the best I can) I am considering staying on escitralopram and asking for something purely to help with the anxiety when it spikes. Any suggestions?

[panic_down_under]

I am considering staying on escitralopram and asking for something purely to help with the anxiety when it spikes. Any suggestions?

If you can get buspirone then adding a small dose, 20-30mg/day might boost the effectiveness of escitalopram. If not there aren't many options. Benzodiazepines should be avoided as they reduce AD effectiveness and exacerbate the underlying brain dysfunction which manifests as anxiety and/or depression. Mirtazapine which is more a sedative than AD might help, plus maybe pregabalin, but neither are first line anti anxiety meds. If your anxiety triggers adrenaline surges then a beta-blocker is worth a shot.