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Re: Best antipsychotic to augment SSRI for panic?

Posted by doxogenic boy on March 24, 2014, at 13:15:49

In reply to Best antipsychotic to augment SSRI for panic?, posted by SpratNZ on March 23, 2014, at 4:16:07

> Hi
>
> I've had agoraphobia with panic attacks for 25 years now - SSRI's worked beautifully at first, but had a tendancy to poop out after about 3 years. Now I've been through them all - pdoc has me back on Paxil but it's only working at about 50%. I'm taking 1mg of clonazepam at the same time but still get panic attacks. I'm not keen to go long term on the clonazepam because the amount I need practically knocks me out. My Pdoc is keen to augment the Paxil with an antipsychotic - while this makes me quite nervous, I fear I've run out of other options. Is there any particular antipsychotic that would be suited for panic disorder?


Seroquel (quetiapine) may help against panic disorder with agoraphobia:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2993527/

Excerpt from the link above:
"In this case report, low-dose quetiapine (Seroquel®) effectively treated panic disorder with agoraphobia (PDA) and obsessive-compulsive disorder (OCD) in a patient with bipolar depression."
End quote.

See also case report below about quetiapine + SSRI. Seroquel has helped against my servere generalized anxiety disorder and treatment resistant depression (see my medication in my signature) and there are lots of people (but not everybody) who are satisfied with Seroquel. It is important to take it at bedtime, to avoid being tired during the day.

http://www.sciencedirect.com/science/article/pii/S1876201812000275
Quote from the link above:
Efficacy of quetiapine in treatment-resistant panic disorder: A case report

William Pitchot
Marc Ansseau

Highlights

Some patients with panic disorder fail to respond to standard treatments. Some studies have suggested that atypical antipsychotics in association with an SSRI could be an option for treatment-refractory panic disorder. Efficacy of low doses of quetiapine in addition to an antidepressant in a patient suffering from treatment-resistant panic disorder.
End quote.

- doxogenic


Earlier TRD/anxiety
300 mg tianeptine, 6 X 50 mg successfully since Oct 2009
20 mcg liothyronine
40 mg escitalopram
100 mg trimipramine
50 mg agomelatine
600 mg quetiapine


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