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Over Medicating

Sep 23, 2003

Hi, I recently submitted a question about my psychological medications for anxiety/panic. History: my doc initially put me on Zoloft (50mg)plus Xanax for anxiety. Then took me off the Zoloft and switched it with Lexapro (10mg) still along with an increased dose of Xanax to 4mg/day.

Now he put me back on Zoloft with the Lexapro and Xanax. My symptoms are continuing to intensify and my shaking/trembling/fears are not subsiding.

Do you think there's a possibility I'm being over-medicated? My gut feeling is that so many medication switches in such a short time frame (i.e., 3 months) isn't good for the system.


Response from Dr. Horwath

Both Zoloft and Xanax are excellent medications for the treatment of panic disorder. For people with panic disorder, Zoloft generally needs to be started at low doses (25- 50 mg) and increased slowly in order to avoid side effects. The benefits are not seen immediately; it may require several weeks. The anti-anxiety effects of Xanax are immediate.

I'm not sure of the reason for the switching between Zolft and Lexapro. Lexapro does not yet have an FDA indication for panic disorder, and it has not been extensively studied for panic. Moreover, there is no good reason for using Zoloft and Lexapro at the same time.

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