I am not sure from your post if your panic attacks come early in the morning eg 2.00 am, 3.00 am etc or later in the morning, 9.00 am, 10.00 am etc
People can be woken from sleep with a nocturnal panic attack with symptoms that can include a burning tingling heat. Some people also report night sweats with these panic attacks.
People can also experience this type of panic attack during the day, but the nocturnal attacks can be particularly frightening when woken from sleep with one.
Panic attacks can mimic a number of physical conditions and so I am not able to say if your symptoms are a sign of perimenopause. You will need to ask your doctor about this.
In regards to your medication, some people can still have panic attacks, and other anxiety symptoms while using medication. You may wish to speak with your doctor about this also. They may want to review your medication.
It is very important that you don't stop taking your medication. Any withdrawal from any of the medications prescribed for anxiety disorders needs to be done very slowly under medical supervision. This includes Effexor and the other SSRI group of anti depressants.
If your doctor reconfirms your diagnosis of panic disorder, you may wish to consider seeing a cognitive behavioural therapist (CBT). CBT is the most effective therapy in the long term for anxiety disorders.
You can read about this on our web site
And you can find a CBT therapist in your area by visiting our world wide referral pages
Power Surge Anxiety-Panic Expert
Founder of The Panic Anxiety Hub
Online Panic Anxiety Management Program
E.mail Bronwyn Fox
Author of Power Over Panic: Freedom From Panic/Anxiety Related Disorders"
Power Over Panic (2nd Edition)
and Bronwyn's audio cassette,
Taking Back The Power