Posted 3/30/2021 6:40 PM (GMT -6)
Under treatment resistant panic disorder, one website said try the ssri’s etc, that you’ve tried, but start off at ½ regular dosage, and give it longer time to take effect.
Another website (Psychiatrictimes.com., Treatment-Resistant Panic Disorder, November 27, 2017), said:
“Switch to another antidepressant agent. Within-class switching may not be a high-yield intervention. However, switching to an agent with a different pharmacodynamic profile is a reasonable step. For example, one good option is imipramine, often overlooked because of its risk of cardiotoxicity in overdose; yet it is one of the most intensively studied antipanic agents available. MAOIs, also seldom used now, can be surprisingly helpful as well.”
“Consider benzodiazepine monotherapy. While clinical guidelines tend to rank benzodiazepines as second- or third-line antipanic agents, this is primarily because of concerns about sedation, physiological dependence, psychological dependence, and the slight risk of benzodiazepine abuse/diversion, especially with longer-term use. In fact, benzodiazepines are similarly effective to antidepressants for panic disorder, and their panicolytic benefit is almost always sustained over the long term."
So, we're back to where we were, and where you are now: benzos. I take one, Ativan, for a physical condition. I'd rather not, but It keeps me functioning.