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Question

I’m on Anafranil 10mg a day for the past 10 year, maybe i had some uncomfortable days here and there during the past 10 years. 2 weeks ago I had very bad panic attack, I called 911 and they offer to take me the ER but they ensure me that I’m fin if I take one the xanex I have and I keep for this kind of day. After few hours my wife drove me to the urgent care, the doctor there gave me a shut to come down and wrote me Lorazipam 0.5 as need it and told me to keep taking my Anafranil 10mg one a day. I was ok after few days. But last week it started again and Saturday was very bad, I lift work and rush home to take Lorazipam. After a made few calls to friends and family members I stared double my dose of the Anafranil 10mg twice a day instead of only one. It has been only 3 days. I went to work today and after 3 hours it stated again, I try to mange it and finish my day but I couldn’t. I rush home and toke Lorazipam 0.5 I’m just wondering what happened to me, I was fin and very very good for the past 10 years., I didn’t change anything and I didn’t miss one dose of the Anafranil, my life is the same with maybe some improvements. Can anyone help me, and increased my dose of the Anafranil to 2x10mg a day is this a good step or not. Thanks

Submitted: 53 days and 13 hours ago.
Category: Mental Health
Value: $22
Status: CLOSED
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Optional Information

Gender: Male
Age: 40

Already Tried:
Anafranil 10mg twice a day and Lorazipam as needed

Posted by Dr Vikas 53 days and 13 hours ago.

Answer

Hello XXXXXXX,

Clomipramine (Anafranil) is a Tricyclic antidepressant which was earlier used for Anxiety disorders such as Panic disorder but the minimum dose start from 25 mg per day and reach up to 100 mg per day. Also Tricyclic antidepressants have a lot of associated side effects therefore not in much use these days.

Now days, drug of choice are SSRIs (Selective serotonin reuptake enhancer) such as Lexapro, Zoloft, Paxil, and Prozac. For treatment of Panic attacks and disorder they are given in combination depending on the clinical status with Benzodiazepines such as Ativan or Klonopin. Benzodiazepines are to be used for a shortest duration possible and after that can be used as needed basis while the SSRIs are continued.

So you may consult with your psychiatrist about the new treatment available which I have mentioned or there is a need to increase the dose of Anafranil. (Please do it only after consultation with your psychiatrist)

Other possible option is of Psychotherapy such as Cognitive and Behavior therapy.

You can find more details in this link given below.

Anxiety & Phobias


If you have any other query, please feel free to ask.

Regards

53 days and 13 hours ago.

Reply

Almost 13 years ago when this stated with me my doctor overseas stated with many different medications including Zoloft but none of them worked with me.

Only Anafranil was great.

How to find a Psychiatric in my area. And somebody will see me ASAP

Accepted Answer


OK, If Anafranil suits you, the dose need to be increased with the consent of your treating psychiatrist.

You can easily search for Psychiatrist near you by searching in Google for Psychiatrist in your area.

I am very sorry that I will not be able to assist you in finding a good psychiatrist who will see you ASAP as I am not from your place. I hope you understand my position.

Wishing you a early and speedy recovery.

Best wishes,

Vikas

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Expert: Dr Vikas
Pos. Feedback: 100.0 %
Accepts: 
Answered: 9/30/2009

Psychiatrist

MBBS ; M.D Psychiatry

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