Hi Holly,
I know what you mean about the doctors not knowing as much as we do. I have been on numerous medicatons over the years for both depression and anxiety, and now ADD as well. My therapist believes that ADD has been the primary issue all these years -- it leads to stress and anxiety and feeling like a failure, which leads to depression and fatigue -- a viscious circle.
Anyway, I wanted to chime in here since I have been through the ringer on these meds. I have tried almost all of the SSRIs, the SNRIs (like Effexor and Cymbalta), the stimulants, some anti-psychotics as "boosters" to the SSRIs that never worked for me on their own, etc. I am still on a mixture of medications that serve only as a safety net. Sometimes when I start a medication it takes awhile to adjust, and then I feel great for a couple months, but then everything goes back to the way it was.
That's why this program is so valuable. I finished the program with a coach a couple months ago, and felt better going through the program than I ever felt on medication or even in therapy. I had a relapse when the program was over, and I am trying to get back into it again, hoping to find support and comaraderie on this forum.
After all of that background (sorry for rambling!) is your dr. wanting to put you on an ssri for panic disorder alone? Or do you have depression too? Usually the SSRIs are for anxiety with some component of depression.
Everyone is different in how they react to meds, but I am VERY med sensitive and have a hard time with almost every med I try. I have found that I need to start with 1/4 of the smallest dose available. I literally took 2.5 mg. of Prozac, when the therapeutic dose is 20 mg. I have gotten to the point where, if the dr. tells me to start with a certain dose, I automatically cut it into quarters and work my way up. It is worth a shot, if you are up for trying another ssri ... just try to take a micro-dose and start from there (telling your dr. about it first. If he says something like, "oh that amount won't do anything," then believe me, he is not educated about med-sensitive people).
For me, Lexapro and Prozac are the best tolerated, but at low doses. And the effects don't last long for me. For a couple months I will be depression-free, stres-free, etc., but that always ends. Increasing the dose never helps, because the side-effects are too bad. Still, I need to stay on them or I do hit a rock bottom.
I hope to wean off some things, slowly, as I go through the program again (and again and again!). Right now I know I need the medication. I have tried to go med-free a few times, and I always hit a bottom I didn't even know could get so low. However, with the skills and I am learning and the hope I am growing, there might be a chance I can get off of them someday.
That is awesome that you don't need Ativan during the day anymore! Congratulations

. I take Klonapin at night for sleep ... I am the same way you are when it comes to needing sleep, and the Klonapin stops my brain from speeding around in circles.
Well, I wanted to share all of that in case you have any questions for me about any different meds and side effects ... i will be happy to answer any quesitons, and be a cheerleader for you, whether you decide to try another ssri or go without. It is a hard decision! hang in there, and keep us posted ...
Take care,
Maureen