I've been taking amitriptine with propranolol for over 2 months now for panic attacks and sleep problems. Initially, I took 10 mg of propranol 3 times a day, but I had to reduce propranolol to only once or twice a day because I have low blood pressure. The doctor said I don't have to take it every day if I feel like it lowers my blood pressure. He said that if I feel my heart beating faster and I'm nervous, I should take it. After a month, the doctor additionally prescribed amitriptilin 10mg before bedtime, as I continued to have panic attacks. I have the impression that since taking amitriptilin, my hands are shaking terribly, my voice trembles when I am talking to someone, I feel like I am shaking from the inside. The muscles also tremble, especially in the legs. He has a profession in which his hands cannot tremble, which causes even greater anxiety. For about 3 weeks I had to increase the dose of propranolol to 20 mg 3 times a day because I was shaking even when I wasn't stressed. I've read that it could be serotonin syndrome