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TherapistMarryAnn, Therapist
Category: Mental Health
Satisfied Customers: 5822
Experience:  Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
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I have suffered with depression and anxiety since I was

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Hi there
I have suffered with depression and anxiety since I was sixteen, and am now 56, but a very young type of 56 (most of my colleagues think I am in my thirties). I am a midwife and am good at my job, but my depression is out of control. I have taken clomipramine since I had my second baby at 28, but now have a right bundle branch block probably caused by the med, and can only take 50mg at night. My doctor has added sertraline 50mg in the morning as I keep thinking about breathing and how it is going to stop and I am going to die. This is making life so difficult. I still have a 13 (just) year old daughter who needs my support, as well as four other more grown up children (one grown up daughter, married, one grown up son, model maker and special effects, one 19 year old daughter at Uni, one son, 18, going to Uni in September). Please advise if these meds are a good combination, and are they safe for my heart? I have no happiness in my life, I feel it is finished at my age, and old age and death is all that is ahead

Hi, I'd like to help you with your question.

It sounds like you may benefit greatly from therapy. Medications are meant to help you cope until you can go through therapy and resolve your issues, or at least get to the point that you feel you can cope without them.

The symptoms you describe sound like panic disorder and depression to me. Has your doctor, or anyone, done a full psych eval for you and determined your diagnosis? This is an important first step to being treated appropriately.

Cognative Behavioral therapy (CBT) has proven to be very effective with anxiety treatment. If your doctor can refer you to a therapist, see if you can find one with experience with CBT, although any therapist will have a way to treat your symptoms.

You may also want to see a psychiatrist and get your mediations straightened out. There are many options for people who deal with anxiety and depression. Paxil and Ativan may be good solutions for your situation, but check with your doctor about whether or not you can take those medications.

There is a book that may help you get started. It is called The Anxiety and Phobia Workbook by Edmund Bourne. It is an excellent book on how to deal with symptoms like trouble breathing with anxiety. has the book or your local library may as well.

I hope this has helped you,

Customer: replied 6 years ago.
Hi Kate
Thank you for your reply.
I still feel that I need my question answered regarding the safety of Clomipramine 50mg and Sertraline (Zoloft in USA)50mg taken together regarding my Right Bundle Branch Block.
I have found all types of therapy non effective over the years. It just upsets me to go into depth about my problems, and I have always practised a form of CBT myself anyway, reassuring myself and being logical about things, but I feel the perimenopause is making things much worse at the moment.


I am sorry, I was not clear on what you had asked originally. Thank you for the clarification.

I spoke with a colleague of mine who agreed with me. We both recommend a complete medical re evaluation.

The medication you are originally taking is a trycyclic anti depressant. These are considered a much older class of medications and are typically (although it is possible) not prescribed in combination with the serotonin enhancing medications of which Zoloft is. In most cases, especially with the type of symptoms you are experiencing, a singular use of an SSRI medication combined with an anti anxiety medication such as Alprazolam is used. My colleague indicated that it sounds like your prescribing doctor may be older as this combination has not been used for quite a while. It is never a bad idea to have a second opinion on these medications as the reaction I received when I asked for the consult was one of surprise.

I hope this answers your question,


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