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A 34-year-old female asked about a 37-year-old male:

Dr prescribed amitryptaline in addition to lexapro (escitalopram) to treat anxiety. have been taking lexapro (escitalopram) for years but still having panic attacks and insomnia.

2 doctor answers6 doctors weighed in
Dr. Dariush Saghafi
Neurology 34 years experience
When Rx'ed Amitripty: If you just got the script for amitryptiline today then, we're way to early to conclude anything. If you have already been on that combo for at least 2-3 weeks and no change in your symptoms then, you should call your doctor. Do your panic attacks stem from PTSD, nightmares, abuse, or other forms of trauma? Unless you address such issues DIRECTLY, no amount of medication is likely to work well.
Dr. Joyce Pastore
Internal Medicine 30 years experience
Insomnia: Amitryptaline is effective for depressive symptoms and to help you sleep. It is not the best treatment for anxiety. I would give it a couple of weeks to see if it at least helps the insomnia. If no improvement, see your doctor for alternative meds. Cognitive behavioral psychotherapy is very effective for anxiety in conjunction with short term meds.
Dr. Adam Lewis
Dr. Adam Lewis commented
Neurosurgery 36 years experience
Excellent answer. Cognitive therapy is an excellent option for the long run. A medication to treat anxiety with low risk for addiction is a good option in the short run.
Aug 9, 2014

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