Hi guys,
After three years of relative stability, my panic disorder has returned aggressively. Since 2008 I've been on 100mg imipramine (an older tricyclic) and 20mg Lexapro. The combo seemed to work okay, except that using the two togther exaggerated some of the imipramine's side effects, like sedation. Now I'm seeing a different psychiatrist, and consulted independently with a third, who both expressed concern that my former doctor had me in a tricyclic and an SSRI simultaneously; and both recommended strongly that I get off imipramine and switch to another SSRI for therapeutic relief. The plan with my new doctor is to eliminate imipramine (I'm now down to 25mg/nightly and experiencing unpleasant withdrawal symptoms, despite tapering my dose gradually over a month) and swapping Zoloft for Lexapro. So here are my two questions, and I'd be very grateful for any advice or feedback:
1. Does anyone know how common or uncommon it is to receive treatment for panic disorder and GAD (mine's pretty bad right now) with an SSRI and a TCA? When my first doctor put me on them three years ago, I didn't know anything and had no reason to worry. I also checked with a couple of pharmacists, none of whom expressed concern. But both my new doctor and the guy I consulted emphatically did NOT want me on the TCA. But I also suffer chronic migraines, and the TCA is useful for those, so I'd like to hang on to it, if possible, or switch to another TCA.
2. Anyone had any experience "swapping" one SSRI for another? My psychiatrist assures me that, because they belong to the same class, I won't suffer withdrawal symptoms from quitting the Lexapro. Still, I didn't know swapping was an option, as I also believed that tapering is preferred, even in cases on switching between drugs within a single class.
Sorry for the long post. Feeling quite confused and stressed over this transition. Thanks for support, guys.
Nick
