Well, I went to the doctor yesterday with chest pains, jaw pain, upper back pain and heart palpitations, convinced I was having a massive heart attack. He did an EKG and turns out everything is fine with my heart, it was just a massive panic attack. I left with a prescription for Pamelor, 25 mg to take at night for sleep, klonopin .25 mg twice a day for anxiety, and the name of a clinical psychologist. I am so confused. If you may remember, I am in the process of tapering off Paxil after many years of use, as it is not working for me at ALL any more. I am down to 7mg, going very slowly with the liquid form. I know alot of these symptoms are withdrawal, but also this started before I started tapering, so that's how I know the Paxil just "pooped out" on me (I've taken it for 14 years!) I tried Effexor back a couple of months ago, and that was a major disaster! I was only on it 3 weeks and quit and had horrible withdrawal effects! I would love to be anti-depressant free, but things don't seem to be working out well. I am stressed to the max, hair falling out, having major anxiety and panic attacks all day long. Also having periods of major depression and lethargy and no energy. I can barely function. Is it safe to mix Pamelor with Paxil, as I continue to taper the Paxil? I think the Pamelor he gave me is a relatively low dose (25mg at bedtime), more for sleep than depression per se. I am just SOOOO scared to start another AD after my experience with Effexor!!! Yeaaaahhh!!!! I am leaning toward trying the klonopin first, and seeing if it helps my anxiety enough. I hate to add 2 new meds at the same time - it would be hard to tell what was causing what if I start to have side effects. I also plan to call the psychologist, as I really need someone to talk to. I am just having such a hard time right now. Thanks if you've stayed with me this far! I know it's a long post.