Our expert says:
Yes, there can indeed be such a chain of events - but panic disorder is, for good reasons, not recognized as a CAUSE of agoraphobia ( and why agoraphobia rather than other phobias ? ) - and emphasizing the supposed connection isn't especially USEFUL.
The chemical impact of the antidepressants is horribly complex. Because, for instance, even where we know that drug X predominantly impacts on brain chemical Y, that is only an initial part of it, as raising or lowering one brain chemical usually variably raises or lowers others as the brain tries to balance things out.
I don't see any reason at all why a once-a-day med which you find is as a side-effect causing you to feel drowsy, should be taken in the morning - it'd be well worth trying instead to take it at night, where the drowsiness would be welcome and useful.
With most drugs, most side-effects are most troublesome in the first few weeks on the drug, and tend to reduce or go away. I'm not at all convinced that Duloxetine has "a better side effect profile" than others like SSRI's" - this is the claim EVERY drug company makes for EVERY new and expensive drug, and with time more side-effects are recognized. I've not been especially impressed that Duloxetine has great advantages.
The newer antidepressant Agomelatine does seem, with a distinct chemical profile, to have less impact on sexual functions.
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