Question:

Hello — I’ve been on imipramine (25 mgs) for two months now.  No question that it has stopped the anx./panic attacks dead in the water, but it’s having another effect also.  This is hard to describe, but increasingly I am feeling that I am not me — that whatever makes me me is disappearing.  The dr. maintains that it can’t be the imipramine, but I am wondering why these new problems just happen to coincide with my taking it? Isn’t there somewhere out there a medication that one can take only when one is having the attacks instead of all the time? Also, does anyone know if the effects of the imipramine are permanent, or would I return to being the old me if I stop taking it (which, do not worry, I would not do all of a sudden)? Thanks to anyone who has any answers. L.

Response:

– Hide quoted text — Show quoted text – Hello — I’ve been on imipramine (25 mgs) for two months now.  No question that it has stopped the anx./panic attacks dead in the water, but it’s having another effect also.  This is hard to describe, but increasingly I am feeling that I am not me — that whatever makes me me is disappearing.  The dr. maintains that it can’t be the imipramine, but I am wondering why these new problems just happen to coincide with my taking it? Isn’t there somewhere out there a medication that one can take only when one is having the attacks instead of all the time? Also, does anyone know if the effects of the imipramine are permanent, or would I return to being the old me if I stop taking it (which, do not worry, I would not do all of a sudden)? Thanks to anyone who has any answers. L.

25 mgs of imipramine is next to nothing. It’s hardly possible that this did away with your PAD and also caused this *derealization* you’re talking about. But by now nothing surprises me anymore. and placebo effects (if that’s what it is) are effects too.To answer your question: you can  rather easily stop imipramine and you will not have changed. The meds that can be taken *as needed* when you feel an attack coming on are benzos: Xanax or Ativan. Generally .5 mg or 1 mg of Xanax will kill a PA in 10-20 minutes for most people. I hope your doctor will prescribe Xanax because some don’t as they mistakenly believe iot is addictive. Addictive it is not, but you may become dependent on it which means that it should be stopped very slowly to avoid withdrawal symptoms. But with Xanax used only *as needed* the chance of dependency is very slim. Philip – Hide quoted text — Show quoted text –

Response:

Hi L, wlcome to ASAP, I’ve been on imipramine (25 mgs) for two months now.  No question that it has stopped the anx./panic attacks dead in the water, but it’s having another effect also.  This is hard to describe, but increasingly I am feeling that I am not me — that whatever makes me me is disappearing.  The dr. maintains that it can’t be the imipramine, but I am wondering why these new problems just happen to coincide with my taking it?

I tend to agree with your doctor. 25mg is such a small amount (the therapeudic dose is 150mg+) that it shouldn’t be causing the depersonalization you seem to be experiencing. It could be a further manifestation of the disorder. I would suggest you discuss this with a psychiatrist or psychologist. Isn’t there somewhere out there a medication that one can take only when one is having the attacks instead of all the time?

Yep, benzodiazepines like Ativan, Klonopin, Valium and Xanax. Also, does anyone know if the effects of the imipramine are permanent, or would I return to being the old me if I stop taking it (which, do not worry, I would not do all of a sudden)?

Given the small size of 25mg pills you may not have any choice (check before trying to cut them – they have a very thick coating which may be there for a reason). However, this is such a small amount you should be able to stop without problems. Thanks to anyone who has any answers. L.

Ian Phobias:  Hoplophobia- Fear of firearms.

Response:

Hello — I’ve been on imipramine (25 mgs) for two months now.  No question that it has stopped the anx./panic attacks dead in the water, but it’s having another effect also.  This is hard to describe, but increasingly I am feeling that I am not me — that whatever makes me me is disappearing.  The dr. maintains that it can’t be the imipramine, but I am wondering why these new problems just happen to coincide with my taking it?

I would tend to agree with your doctor but keep in mind that all of us are different. 25 MG/day is considered a very small dose. However, I receive a theraputic response from 5-10 MG/day and I can assure you that this isn’t a placebo effect.  Imipramine is available in 10 MG tabs. Isn’t there somewhere out there a medication that one can take only when one is having the attacks instead of all the time?

Almost any of the benzodiazepines would work. The quickest acting and arguably, the most popular for PAs is Xanax. However, Ativan is good and longer acting benzodiazepines like Klonopin and Valium work well too. Also, does anyone know if the effects of the imipramine are permanent, or would I return to being the old me if I stop taking it (which, do not worry, I would not do all of a sudden)?

Not to worry. The effects imipramine simply wear off within a few days and since it’s available in 10 MG tabs, you could "wean" yourself rather easily… with your doctors permission of course.

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