Depends: First thing is be clear that you have panic disorder, versus panic attacks due to a medical cause. Next, the doctor needs to know that you do not have asthma or diabetes or any trouble with your heart ryhthm. When I use it with my patients, I sometimes start at a low dose twice per day. If one starts off with a large dose, it can cause slowed heart rate, low blood pressure, and fatigue.
Answered 6/20/2014
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