Posted by SLS on May 17, 2012, at 6:32:23
In reply to Re: What will work for my panic disorder + MDD??, posted by gilmourr on May 16, 2012, at 22:30:38
> I would've liked to go on effexor longer, but I tried it for 10-11 days, and my BP was already up to 160/110 on 150 mg, and I was having tremendous chest pain. Like burning chest pain, and pretty harsh prolonged pain for hours at times.
> Do you think I should've just stuck with it? Because I didn't want my BP to go into stage 3 hypertension and my chest hurt too much
If it were me, I don't think I would have continued taking Effexor. If you are looking to try a SNRI-type drug, I would consider going with Cymbalta (duloxetine) first before trying Savella (milnacipran). Perhaps the most efficacious SNRI out there is Anafranil (clomipramine), a tricyclic antidepressant. However, it comes with a side effect burden that is predominantly anticholinergic in nature. With its additional NE effects, this would include an elevated heart rate. There would actually be a slight decrease in blood pressure (due to NE alpha-1a receptor blockade). Orthostatic hypotension can occur. One thing about tricyclics is that they are often effective for panic disorder. Imipramine has been studied most for this indication. However, the few investigations of clomipramine have suggested that it is more effective than impramine.
Nardil, a monoamine oxidase inhibitor (MAOI) is also good for panic disorder.
Some see things as they are and ask why.
I dream of things that never were and ask why not.
- George Bernard Shaw