Well, the dose of Pristiq that you are taking is appropriate and shall not be increased until 1 month of seeing your symptoms subsiding , if the symptoms do not subside then you shall ask your doctor to increase it to 100 mg , but until 1 month just observe and wait for improvement..
Now , i believe , in order to control your panic attacks , the xanax that you are taking needs to be altered a bit , meaning that , it needs to be changed to xanax xr ( extended release ) from the current xanax ( plain ) , this will ensure better control of anxiety and panicity while it works together with pristiq . Also, the dose of xanax xr needs to be twice a day instead of current 3 times a day dose ,and as far as the dose is concerned it can be increased to 1 mg at night and 0.5 mg in morning ... so in all , ask your doctor to shift you on xanax xr from xanax , and instead of three times a day dose , keep wo times a day dose of xanax xr , while you continue on pristiq at 50 mg dose / day .. And you should contine on this combination of pristiq and xanax xr for atleast 1 month and see for the improvement of your condition , and if after 1 month of being on this drug combination , there is no significant control over panic attacks then you shall ask your doctor to further increase the dose of pristiq to 100 mg / day while continuing on xanax xr in the same doses.. You see in treating a psychiatry condition , the clinician has to dwell on various combinations in order to find the correct combination that works best for the patient..
I hope this helps..
I wish you all the best...
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