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OK, You want to stop Effexor because you are much concerned about its effect on Blood pressure?
because it is very true that Hypertension should be controlled prior to initiation of Venlafaxine (Effexor) and should be monitored regularly during treatment. It has a dose dependent effect on increasing blood pressure.
OK, see in your case there is a simple solution for this problem. It is true that Effexor affect blood pressure and it is comparatively difficult to taper it down when compared to other antidepressant.
Your doctor can simply shift you over to a SSRI antidepressant Fluoxetine (Prozac) which is a very effective medicine for controlling panic disorder.
In patients who are experiencing difficulty in tapering down Venlafaxine (Effexor) we simply switch the on Fluoxetine which has a long half life and can be easily taper down later on.
In your case, there will be dual advantage of doing this. First of all you will be able to taper down Effexor and secondly Prozac can effectively control your panic attacks without affecting blood pressure.
Your doctor will follow the method of cross tapering in which he will slowly reduce the dose of Effexor and will gradually increase the dose of Prozac.
No, it is a SSRI antidepressant which are the first line medicines for treating Panic disorder.
and I personally prefer SSRI antidepressants over Venlafaxine for controlling Panic disorder.
Yes, with MAO inhibitors one should be very careful.
Cross tapering is a frequently used method while switching over from one to another antidepressant.
the rate of tapering varies from patient to patient and there is no clear cut guideline for it.
Clonazepam can be taken on as and when needed basis, specially the mouth dissolving preparation which bypass gastric metabolism and can bring very quick relief.
Prozac may initially slightly worsen anxiety just like all other SSRI antidepressant so during the initiation of treatment it is a good idea to continue Clonazepam by your doctor.
for few weeks, then it can be used as and when needed.
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