###Human: Is it advisable to take Buspar to cope with serotonin depletion? ###Assistant: Hello. You have provided a helpful insightful summary of your problems. As you rightly identified, your difficulties appear to be related to excessive anxiety. Panic attacks, obsessive preoccupation about breathing, fatigue and sleep disturbance appear to be related to high anxiety levels. I note that you responded very well to Paroxetine 20 mg for more than two decades but did not tolerate the increased dose recently and 20 mg is no longer effective. This is noticed commonly clinically due to various reasons. Just wanted to clarify whether in addition to medication, have you received any psychological therapy like CBT for management of your anxiety. CBT is highly effective in anxiety and will be very useful for the symptoms you describe. Kindly discuss with your doctor about CBT input. Even if you had CBT before, it will be worthwhile having it again to gain an additional perspective. Regarding medication change, switching to another SSRI like Sertraline should be considered first before SNRIs or TCAs or augmentation strategies. Benzo can be continued for short periods. Kindly discuss with your doctor as you will need to be monitored during the switching period. Also, I just wanted to highlight other additional strategies that help to decrease anxiety levels. Try progressive muscle relaxation exercises at least twice daily. Avoid alcohol, caffeinated drinks, it will worsen anxiety. Regular walking or exercise helps. To sum up, medication helps but also consider CBT and non-pharmacological measures in addition to medication as there is good evidence that they help with anxiety.