Brief Answer: Your condition will improve,need to change dosage. Detailed Answer: Hi, Pristiq (Desvenlafaxine) is a serotonin-norepinephrine reuptake inhibitor (SNRI) which might cause drowsiness as side effect. Remeron (Mirtazapine) is improving the natural neurotransmitters in the brain. It has also drowsiness as side effect. Requip (ropinirole) drug action is achieved by restoring of the natural balance of dopamin in the brain. Drowsiness is one of its side effects. As you may see, all the drugs you are taking are helping you not to have panic attack anymore. They are constituting the natural balance of neurotrasmittitors in your brain. Their effect is associated with a general sleepy feeling. As you are saying, you responding well to the treatment because you have less panic attack. I am glad to hear that for you. So, it is time now to talk with your doctor to reduce the dose of the drugs you are taking until not taking them anymore gradually. With regards to nebivolol, I'd suggest to keep on using it with a reduced dose. I would also ask to monitor your blood pressure and heart rate and record them for future reference. This medicine is a beta-blockers and beta-blockers are known to cause impotence in some people on prolonged use. Oscillations in blood pressure and heart rate can also cause sleepiness to you. Once again, talk to your doctor to start changing the doses as soon as possible. All the best! Dr.Alba Feel free to ask me other questions you might have! If you are satisfied with my answer, please close this thread and kindly rate my answer! Thank you

---

Brief Answer: Report side effects to your doctor... Detailed Answer: Hi again, Thank you for sending in more of your medical data. You are taking 3 drugs which are helping you to get off the panic attacks. One of them was started 2 months ago, 1 other 10 days, while the third just 2 days ago. So, they have started working giving you the sensation of sleepiness. That is great for your brain, which needs to be relaxed and "cleaned" from anxiety. On the other hand, this feeling sleepy would interfere with your daily activities. So, at this point, I'd ask to discuss again with the doctor who prescribed these drugs to you to start reducing their dose. I do not recommend to do it on your own as you need medical assistance and guidance to have the desired results. Sometimes, reducing doses roughly or cut off the drug at a glance would give negative effects on your body. With regards to tachycardia, it is common for patients with anxiety to experience that. So, you should continue taking nebivolol which can help stabilize your heart rates. Now, if the tachycardia started when you first took remeron, I'd suggest to report this to your doctor for further evaluation or alternate treatment. Wish you health! Dr.Alba If you are satisfied with my answer, please close this thread and kindly rate my answer. Thank you!

---