Our expert says:
The thing with drugs like Cilift and indeed any antidepressant, and many other drugs is that either one takes them at the recommended dose every day, and they produce the effects we want, or don't take them. taking them now andn then doesn't allow them to produce the desirable effects, though they can still cause unwelcome side-effects. A door should be either open or shut, and one should either be on the drug or off it ( unless one is tapering off to come off it ).
Sounds like good advice to go back on the cilift for the time being. I'm not certain of the Rivotril at night in the treatment of panic attacks. I gather you had no erectile problems on the Cilift on its own, but these problems only arose ( or didn't arise, as it were ) after starting the Rivotril ? If the latter, I'd question whether the Rivotril is really necessary. If the erectile problems started while on the Cilift, it might be worth considering using a different antidepressant, as though a few guys get this sort of problem on most of them, nobody gets the problem on all of them, and another may suit you better. Alsdo, Wellbutrin, though not as thoroughly tested in Panic Disorder, doesn't seem to cause sexual side-effects.
Anyhow, the good news is that these drugs do not causedamage, let alone permanent damage --- the effect is a nuisance, caused chemically and temporary, and not permanent.
I don't think I know the doctor you mention, but he sounds usefully concerned with helping you
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