I assume I’ll get no response, but worth a shot.

I get episodes of depression and anxiety that leave me extremely tearful and anxious. I’m often unable to sleep beyond 4:30am and just immediately feel anxious with a fast heart rate , tearful, and hopeless. I get extreme separation anxiety from my mom as well but we live 3.5 hours apart.

It feels like PRNs barely help and nothing is ever going to change. I try to use coping skills but it’s hard when your heart keeps racing and everything feels so hopeless. My therapist and psychiatrist also find it odd because I’ll be in a bad state for days and then one day I wake up feeling totally fine and it’s over.

I currently take Effexor XR 300mg, Lamictal 25mg (titrating up), and Abilify 5mg (just started) daily. I have gabapentin 300mg PRN and clonidine 0.01mg PRN (just prescribed).

I take the PRNs right before bed and if I wake up at night but it feels like they don’t help.

Do I need a med chance? I’ve been on 300mg of Effexor for years.

Does anyone have any advice? Even if it’s just how to best utilize the PRNs to get through the day and sleep?