Has anyone just developed panic attacks out of nowhere?

[Stellakacz]

I have anxiety. Recently, I had what I would call a pseudo attack on a plane. My symptoms were that I felt very hot, I felt out of my skin with nausea and stomachache. As soon as I got of the place I felt fine. However, on the next flight I took I was afraid this would happen again. Of course it did but to a much lesser extent.
I have been on 300 my Wellbutrin XL for about 8 months. I went back to tell my doctor what happened. I was thinking maybe I could pretreat myself with Xanax. He had no problem with the idea. But he also suggested something else. He told me that many people do well on Wellbutrin and a SSRI. He suggested I add 20mg of Prozac and drop the Wellbutrin to 150mg. I never had any drug reactions in the past so I took his advice. About 6 days in to the therapy I had a panic attack at a restaurant. Day 7 I had another one at home. My mind was racing and my anxiety was off the charts. I had never experienced anything like that in my entire life. It was terrifying.
I called the doc and he stopped the Prozac. I was told that I could do a taper but I was only on the med for 1 week. They did call in 10mg tabs but I never used them. Let's just say the next 10 days were unbearable. I still went to work and did what I needed to do but I was going crazy in side. It was the most challenging thing I ever went through.
I went back to the doc and he was surprised by my symptoms. He was so sure it was the Wellbutrin even though I never had an issue with that before. He told me to drop the Wellbutrin to 150mg and use Xanax 0.25 as needed. Well...that's not really helping. I do feel less anxiety day to day but it is moving at a snails pace. I hate the Xanac. It makes me dry heave. He called in Klonopin which works a little better but isn't fixing the problem. I see a psychiatrist this week because I feel that she will be better equipped to handle my medication. I just don't understand why my symptoms persist. It's been 15 days of hell!!

[Paxiled]

I would just say, again, that the snri category of meds, such as Effexor and Cymbalta, are more for depression than for anxiety as they are very stimulating (wellbutrin is the most stimulating, but snris target norepinephrine as well as serotonin, and the former is basically adrenaline, the very thing we're trying not to excrete when we get anxious).  That's why ssris are used first for anxiety (along with tricyclics) because they tend to be less stimulating, but then they can also lower metabolism which explains the weight gain and can also lead to sexual dysfunction, but so can the ssris as they also target serotonin more heavily than wellbutrin does.  And ssris aren't used because depression is an underlying issue -- all these drugs other than benzos are antidepressants and that's how they were tested and approved, but it turned out they were also effective for anxiety and most of them got additional approval from FDA to be used for that as well.  Hope you solve this.

[Stellakacz]

Thanks! It is nice to know that someone else has experienced what you are experiencing. I think I need something like Effexor or cymbalta. Probably should drop the Wellbutrin. For know I'm on 0.25 Klonopin and 150 mg XL Wellbutrin. I will know more when I see the psychiatrist this week. It's hard when your life gets turned upside down but I'm trying to keep things in perspective.

[Pollas]

I've suffered from social anxiety for years.  Even though I would get really anxious about things such as speaking in front of people, I never had panic attacks. I was on Effexor for several years and recently had to go off it for health reasons.  Now after being off it for a short bit I have suddenly had a few panic attacks along with anxious feelings.  My psychiatrist prescribed me Xanax but only for a short time as it can be addictive.  The Xanax is working some but I am still having at least one attack a day.  I am seeing my doctor in a few days and will try to come up with a new plan.  Anxiety can make you miserable.  I hope you can get help.

[Stellakacz]

Oh and what I have read says that if you have anxiety you may have underlying depression. That's why the SSRI's are used. But no, depression wasn't a symptom.

[Paxiled]

Most likely you went into withdrawal because of the sudden drop in your dosage of wellbutrin.  You have to taper off these meds as slowly as you need to, as individuals differ, and wellbutrin isn't as hard to stop as other ADs, but sudden changes such as the one you did usually bring on some kind of problem for the brain in adapting.  The other thing is, why were you on wellbutrin?  That's for depression, not anxiety, so I'm assuming you're being treated for depression and the anxiety is more recent?  Is that true?  Because wellbutrin is the most stimulating of the ADs and can be very hard on anxiety sufferers.  Prozac is the most stimulating for most people of the ssris, but is also the safest to take as it's the easiest to stop taking.  But the only reason I know of docs combine the two is if you're on an ssri and you're suffering the side effects of weight gain and/or sexual dysfunction.  Adding some wellbutrin to that can help diminish the ssri side effects.  So here's what I think happened, though there's no way I can know for sure obviously:  the sudden decrease in your wellbutrin caused a withdrawal reaction, which manifested in increased anxiety, a common withdrawal symptom.  Adding Prozac made that worse, as it's another stimulating AD.  So I think you've learned why we have psychiatrists and why regular docs are bad at this, but don't expect all psychiatrists to be any better -- that's up to you to judge by doing your homework.  My own experience is, if they take insurance, they probably aren't very good, but you draw your own conclusions.  And you don't mention therapy -- are you in therapy to see if you can get past this?

[Stellakacz]

Thanks for the response. I was never depressed. I did have some components of OCD and was on Prozac and Lexapro in the past. I never had any symptoms while on those medications. Well anxiety wise. I had the night sweats and the sexual side effects. I didn't have weight gain but my weight just stayed the same despite exercise. He thought Wellbutrin would help so I did it without a wean from the Lexapro and did get nausea and brain zaps. I never had any panic attacks or increased anxiety. I didn't have those symptoms until the Wellbutrin and Prozac were combined.
I'm anxious. I know that. I worry. But look, I go to work, I take a class, I teach, I work out, I go out for dinner etc. In my mind, I have anxiety yes but it's managed. When those drugs were combined I didn't think I could leave my house!! It really altered my life dramatically.
I have never went to therapy but a colleague has talked about CBT. The psychiatrist I see this week offers thoses services in addition to medication management at the office. So I'm definitely interested in finding a way  either without medication or with medication to help cope with the anxiety long term.