Well the pdoc I was seeing wanted me to stop smoking because he thought it was contributing to my anxiety (and believe me, I've had panic attacks with it before, but that's because I didn't know my limits and smoked a bit too much for one sitting). And no, I don't need to smoke to function on a basic level, just for sleep. I love the fact that I was 2 months into taking Trileptal when he decided to tell me this. Anyway, I'm trying to decide whether to find a new pdoc and tryout that effexor/wellbutrin and remeron combo or take a break for awhile and see what happens. I'll still hold on to klonopin which I'll take on a per need basis, but I won't be taking anything with that. Has anyone here taken a break from medications for awhile with mixed or positive results?