Question:
I recently have been in contact with the list about my ‘flare up’ in panic attacks and my associated driving problems. I just wanted to touch base with the list on my condition. I have noticed a great deal of improvement as the Imipramine takes effect. (It was replaced with Zoloft which seemed to be related to the ‘flare up’). I am now driving again with much less anxiety and recently visited a new Panic & Phobia Clinic in my area. My new Psyc. told me that the Xanax I am taking (and having been taking for ~ 8 years) has likely become less effective which he said often occurs with long term use of Xanax. He also indicated to me he has had the greatest success treating panic disorder with Imipramine and MAO inhibitors. I will be trying to slowly (very slowly) ween myself off the Xanax entirely. RegardsJMB
Response:
I recently have been in contact with the list about my ‘flare up’ in panic attacks and my associated driving problems. I just wanted to touch base with the list on my condition. I have noticed a great deal of improvement as the Imipramine takes effect. (It was replaced with Zoloft which seemed to be related to the ‘flare up’). I am now driving again with much less anxiety and recently visited a new Panic & Phobia Clinic in my area. My new Psyc. told me that the Xanax I am taking (and having been taking for ~ 8 years) has likely become less effective which he said often occurs with long term use of Xanax. He also indicated to me he has had the greatest success treating panic disorder with Imipramine and MAO inhibitors. I will be trying to slowly (very slowly) ween myself off the Xanax entirely. RegardsJMB
There is no indication in research that Xanax becomes less effective over time AFAIK. Imipramine and Xanax make a nice combo (it happens to be the one I’m on 
) MAOI’s are probably the most effective meds but many don’t want to take/prescribe them because of side effects and dietary restrictions. I can’t remember if you told us why imipramine was first replaced by Zoloft. But if it works, it works and why change a winning team? It may be a good idea to try and see if you can do without Xanax -0 the less medication the better of course – but if you get anxious from that (even if tapered off very slowly) it’s that old PD again telling you that you still need Xanax. I hope you won’t. Philip
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