It would be interesting for you to ask your psychiatrist to tell you more about her reasoning in suggesting this particular combination of drugs, one which I have never come across before, and I don't really understanding the logic behind it. I would have thought there was more good evidence in favour of changing to an SSRI antidepressant being effective in this combination of problems, and I'd have thought one of these more likely to help the panic attacks. In my experience, Effexor is less useful in reducing anxiety symptoms. But I don't have her advantage of knowing whatever history you may have of the use of other ADs.
With all drugs, the side-effects tend to be most noticeable in the first couple of weeks.
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