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I have panic disorder.  I have tried Buspar and Xanax, and Ativan.  Also have been on beta blockers, but I am so sensitive to the medication and side effects.  I am now on 6.25 mg of Zoloft per day. I started on 25mg but could not take the side effects.  This small amount has stopped the spontaneous panic attacks and taken the edge off of the anxiety.  I have been on it for a month now and I am also using a light box for 1 hour a day.  I know that Zoloft has to build up in your body.  Will this small dose eventually build up to a level that will stop the panic and anxiety?  I know it will take longer probably to hit a good level because of the small dose.

Answer
Georgina

On such a low dose, I suspect it very unlikely that you will have significant accumulation or side effects. If you are finding benefit from the dose, that is good but I would doubt whether there would be continuous, progressive improvement even at a slow rate.

That said, I do wonder whether the side effects you experience to medication may, at least be in part be due to the anxiety problem itself. You already have anxiety, and adding in a drug with the potential for side effects, only serves to feed the anxiety as you now worry about the development of side effects, or focus on symptoms that might otherwise go unnoticed.

It may be worth discussing with your doctor whether some non-drug, behavioural or mood therapy might be useful. As it's drug free, the anxiety of side effects wouldn't apply and you may find a variety of ways to manage or control your anxiety.

I hope this helps.

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Nigel Simmons

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I am happy to answer general questions on medicines and hospital care. If possible, please use approved / chemical names rather than brands which are not internationally recognised. Like all health professionals I am bound by a duty of care which prevents me giving detailed information about medication or treatment of people other than the questioner. I will endeavour to help wherever possible or point towards more appropriate advice. If however your question crosses too far into patient confidentiality, I hope you will understand why I cannot answer your question. Consider.. would you want me to discuss your care with a friend or relative without your knowledge?

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