Q. Need second opinion on Celexa and Buspar for severe anxiety/panic attacks
Dear Doctor, I am a 24 year old female, was prescribed with Celexa 20mg  once daily and Buspar 5mg twice daily for severe anxiety/panic attacks. Both of these medicines are SSRIs though, and I read about it online that everyone/every source says never to take them at the same time due to risk of serotonin syndrome. Today, after taking the Buspar, I felt cold and shivered constantly. I could not get warm and I was very sleepy. Now I am scared to take the night time dose of Buspar and Celexa. I would like to have a second opinion on the safety of taking these medications together. If it is not safe, can I take only one instead? Which one would you recommend, the Buspar or the Celexa? Thank you in advance.
Hi. You are not on too high a dose of celexa or buspar. However serotonin syndrome is not always dose dependant. I feel just the chills and sedation are too general to be indicative of serotonin syndrome. You should have some level of muscle rigidity, high fever, muscular contractions (myoclonus) to suggest that. In my professional opinion I do not have much faith in Buspar.  Celexa is good enough as an antidepressant (SSRI) to eventually help you have a full remission of depression, anxiety and panic attacks. If I was your treating psychiatrist, I would have supplemented the celexa with clonazepam (Klonopin) on a as needed basis, between 0.5 and 1mg every 8 hours PRN anxiety. If you are feeling cold and shivering constantly you might need to see your PCP (Primary Care Physician) to urgently address if you have an active urinary tract infection and also have him check your thyroid function. In effect, I advise you to stop the Buspar for now. Hope it helps. Get back to a psychiatrist online for further help -->