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Relapse in the first weeks of antidepressant treatment

Dear expert,

I was admitted to a clinic about three weeks ago due to anxiety and panic attacks, and was prescribed Amioxid neuraxpharm (30mg in the morning, 60mg in the evening). This (rather unusual) medication was chosen because I had previously had good success with Equilibin and did not tolerate SSRI.

The effects of the medication started to work "by the book" (despite doubts, so it couldn't have been a placebo effect), initially sedating and then increasing drive and mood. Last week, in the third week, I was almost back to my old self and happy about it.

However, for the past three days, I have experienced a strong relapse into panic, possibly due to additional stress. As a result, after three weeks, I am once again dependent on my emergency medications (Atosil, Tavor). What does this mean? Is this a common occurrence, or should I question the medication already (which I honestly do in my panic, and now fear being back at square one)?
I have a lot of respect for Tavor and fear dependence, but in the last few days, I have not been able to cope without it, which I initially tried in my hope for Amioxid. Is it possible that it is still too early for me to achieve a "stable condition"? I have read different time frames in various sources, 6-8 weeks in the package insert. What is your experience? Is it possible to experience such a setback after an initial improvement in the first few weeks? How long can I use Tavor without having to fear dependence (currently taking 1 tablet daily, rarely 2 in a dosage of 1.0)?
I must also mention that before being switched to Amioxid in the clinic, I was taking Opipramol 50 for 4 months (1-1-0), which was abruptly stopped and replaced with Amioxid, which I found rather concerning.

Thank you very much!

Dr. med. Frauke Gehring

Good day,

Since Amoxid and Opipramol are similar substances, the abrupt switch was not a problem. However, the mood improvement you noticed happened so early that it is unlikely to be due to the Amoxid. It actually takes six weeks to notice a noticeable, stable improvement in mood. So you can assume it was a natural mood fluctuation and confidently hope that it will get significantly better again.
There is no period of time in which you can use Tavor without fear of dependence. It can develop very quickly or very slowly. Therefore, you should try to take it as little as possible and as infrequently as possible. It is only for a foreseeable time.

All the best!

Sincerely, Dr. Höllering

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Experte für Neurology

Dr. med. Frauke Gehring

Dr. med. Frauke Gehring

Arnsberg

Staatsexamen 1984 in Kiel, seit 1992 in eigener Praxis niedergelassen. Onlineberatung seit 2001 bei Almeda, Focus (als ärztliche Leiterin), Onmeda, Bild der Frau. Moderatorin, Dozentin für medizinische Themen.

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