Just another update, I have been better since I added on the 5 mg of Lexapro to the 50 pristiq and 7.5 remeron. Still taking 1 mg klonopin in divided doses as before. Today I did feel a bit downish, but not enough to stop me from doing some work until it got too hot and I came inside. Last week I remember a day where I felt so "normal" it was almost scary. I really savored that day. The other days weren't as stellar but not bad at all, well within "normal" actually. I think what got me today was the fact that I had a palp or something while out with some friends yesterday, it was hot, and while standing outside I felt not the typical flipped PVC feeling but just a moment where I felt like I was sinking or something and couldn't move/breathe whatever, it passed quickly. I really couldn't say if I felt anything in my chest, it was more of a head feeling, but I didn't black out or anything. Maybe it was some other weird body thing, but it upset me a bit because throughout this long illness (year and a half so far this time) I have been spared palps or similar stuff for the most part till recently. However I did a treadmill test last week and it was fine, the cardiologist said no problems I can exercise. I am trying to rationalize my fears away, mainly with the idea that whatever it was, it didn't harm me and really no matter what I cannot control everything about my body or my life, as my therapist has pointed out we have less control over our lives than we like to think that we do. Worrying does not help a situation like this, I got checked out, even if they missed something (oh how we anxiety sufferers tend to go there) worrying will not fix it, and only takes away from the possible pleasure one can have in that moment instead. Also my back pain has improved since I last wrote, while I did have some joint/back pain today from some hard digging in the garden, it was not nearly as bad as a few weeks ago. I will see the pdoc next week, I am a bit concerned that she will be away for 3 weeks without a pdoc backup (there is a PA who can write prescriptions I think) but even that worry is illogical because why should anything happen then that hasn't already happened, and I can always go to a regular doc or emergency room (not that the latter is particularly useful in my experience anyway) if I have a problem. I guess we anxious folks like to know our security blanket is always there, but docs and therapists have lives too. I can always call my therapist as well if I have a bad experience or day. Overall I am trending better, the bad days are not as bad and farther and fewer than before, and the good days can be really good. I am less afraid of being by myself (and I have to be alone a lot during the summer months), and the agoraphobia is so much better than a year ago, if I feel any its small and I can fight it. I am checking my bp/pulse less often, going days without doing either, but today I did check and even not feeling stellar at the moment the bp was low and pulse in the mid 80s, nothing to worry about. I did get the weird top of the arm burning feeling today, thought maybe I had sunburn but it has calmed down by now so I think it was just some residual anxiety. At some point in the future I will want to get off Pristiq since it has no official way of going down or up in increments (Ian I did read the fruit juice idea, it could work I guess but the time release factor would probably be compromised), if I am truly lucky Lexapro might work again (there seems to be no studies on whether a med can work a second time if it worked fully for years, then didn't work fully, and is tried again) though I have heard of a case through someone I know of paxil pooping out and then working again after a few months on another AD that didn't work so well. It would be good if the drug companies would do this kind of research (it wouldn't be hard, all you would need is a questionnaire, access to a large body of patients/former patients, and access to a computer for statistical analysis) but they have no incentive to do so, long term studies that might involve other meds they don't sell don't seem to matter to them. But it sure would be useful for patients.