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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Amigan on February 25, 2008, at 11:36:13
Hi. I have a question:
Which of these medications do you think that it is the most effective for chronic fatigue (withOUT fibromialgia or other pain disorders) and also low motivation?:
Selegiline (l-deprenyl), Bupropion (wellbutrin) or Venlafaxin (effexor)?
I DO know that there are better meds for these conditions by far, (ritalin, provigil, etc) but please, restrict the debate to the above 3.
Thank you.
Posted by dbc on February 25, 2008, at 17:42:31
In reply to Which of these meds for chronic fatigue/Low motiv., posted by Amigan on February 25, 2008, at 11:36:13
I'd go with the first two, effexor is just to much of a hassle. Wellbutrin probably has the lowest side effect profile of any of them.
Posted by bleauberry on February 25, 2008, at 19:55:02
In reply to Which of these meds for chronic fatigue/Low motiv., posted by Amigan on February 25, 2008, at 11:36:13
Wellbutrin first. Selegiline second. If condisering effexor it might be anticipated that the withdrawals could be a difficult period if the med doesn't work out.
Wellbutrin is energy to me, though I've never taken it at therapeutic doses or for more than a few days. Even just 75mg has a decent subtle energy kick that might be good for chronic fatigue.
Selegiline was similar, except came with irritation agitation. That was at 3mg a day for a week.
I wish there was more research on chronic fatigue so we could fix the cause rather than artificially take something stimulatory to balance it out. Much of the reading I've done says it has something to do with one or a combination of these, perhaps one causing another:
Food intolerances or sensitivities (lab testing available for about $300 to identify the offending foods)
Immune system gone haywire, basically a form of autoimmune disease. There are some autoimmune tests available and hints of it in routine blood test numbers.
Adrenal fatigue. $100 lab test will measure 24 hour cortisol in 4 saliva samples.
Hypothyroid, regardless if the numbers look good on a test. Some doctors give T3 even if tests look good because there is considerable anecdotal evidence that it often works, due to an unseen defect in the thyroid system (not the glandular output) that is not evident by reading hormone levels. For example if the receiving thyroid receptors are clogged up by faulty conversion of T4 to excess rT3, or if mercury or lead have found a home there, it will take more T3 to overcome those things.
Heavy metal toxicity. Mercury and/or lead more common than is given credit these days. Mercury has no mercy on the entire biochemistry of the body. This is harder to test for, but can usually be confirmed with 95% accuracy with a combination of symtpoms, hair analysis, and specific lab tests. Basically, the more tests that are deviant from normal the more conclusive the diagnosis. This is a complicated tricky topic and needs the book Amalgam Illness to explain it all in detail and what tests to get and how to interpret them.
If any of the above conditions exist...food intolerance, autoimmune disease, hidden hypothyroid, adrenal fatigue, longterm low level mercury accumulation...chronic fatigue is expected. At other forums I visit where the focus is on chelation of heavy metals, nearly 100% of them have chronic fatigue, and mercury also directly caused the other above mentioned things as well on top of it all.
As a disclaimer, chronic fatigue is probably not well understood and most of what is in this post is personal opinion based on tons of research. There could be endless causes of chronic fatigue, but the ones I listed here are the top ones in my own opinion, with metal toxicity being the most likely culprit in far more people than anyone remotely suspects or even considers.
Posted by yxibow on February 26, 2008, at 5:32:37
In reply to Which of these meds for chronic fatigue/Low motiv., posted by Amigan on February 25, 2008, at 11:36:13
> Hi. I have a question:
> Which of these medications do you think that it is the most effective for chronic fatigue (withOUT fibromialgia or other pain disorders) and also low motivation?:
> Selegiline (l-deprenyl), Bupropion (wellbutrin) or Venlafaxin (effexor)?
> I DO know that there are better meds for these conditions by far, (ritalin, provigil, etc) but please, restrict the debate to the above 3.
> Thank you.
>Well selegeline at low doses is a MAO-B, in its EMSAM formulation it can have dietary MAOI restrictions at higher formulations because it becomes MAO-A as well.
I would probably say that Wellbutrin is much less of a hassle. Effexor for people who don't have a lot of anxiety can in general be rather stimulating so that is worth a try as well. I know I can't take Effexor, its like caffeine squared in the anxiety sense.
Posted by mav27 on February 26, 2008, at 6:30:03
In reply to Re: Which of these meds for chronic fatigue/Low mo » Amigan, posted by yxibow on February 26, 2008, at 5:32:37
> > Hi. I have a question:
> > Which of these medications do you think that it is the most effective for chronic fatigue (withOUT fibromialgia or other pain disorders) and also low motivation?:
> > Selegiline (l-deprenyl), Bupropion (wellbutrin) or Venlafaxin (effexor)?
> > I DO know that there are better meds for these conditions by far, (ritalin, provigil, etc) but please, restrict the debate to the above 3.
> > Thank you.
> >
>
> Well selegeline at low doses is a MAO-B, in its EMSAM formulation it can have dietary MAOI restrictions at higher formulations because it becomes MAO-A as well.
>
> I would probably say that Wellbutrin is much less of a hassle. Effexor for people who don't have a lot of anxiety can in general be rather stimulating so that is worth a try as well. I know I can't take Effexor, its like caffeine squared in the anxiety sense.I'm like the total opposite. Effexor was the only one that worked for me, but i couldn't stand a couple side effects. Wellbutrin has made my anxiety worse, i'm very irritable and is making me drowsy. Havn't tried selegaline.
Posted by Phillipa on February 26, 2008, at 13:13:43
In reply to Re: Which of these meds for chronic fatigue/Low mo » yxibow, posted by mav27 on February 26, 2008, at 6:30:03
Same here hospital for me one week of wellbtrin l50mg but then couldn't tolerate effexor either. Ad's don't seem to work for me. Gotta lie down again said answer one post and it was three. Phillipa
Posted by cindy lou on February 26, 2008, at 16:12:25
In reply to Re: Which of these meds for chronic fatigue/Low motiv., posted by bleauberry on February 25, 2008, at 19:55:02
Where would I get a lab test for adrenal fatigue? Do I need a prescription or can I just go into any lab and ask to be tested?
Thanks,
cindy> Adrenal fatigue. $100 lab test will measure 24 hour cortisol in 4 saliva samples.
>
Posted by bleauberry on February 26, 2008, at 19:21:37
In reply to Re: Which of these meds for chronic fatigue/Low motiv. » bleauberry, posted by cindy lou on February 26, 2008, at 16:12:25
They can be ordered from labs online without a prescription. They will send you the kit and instructions and you mail back the saliva test tubes. Just type in a google search "adrenal stress index" or "adrenal saliva test" or "adrenal lab tests without prescription" and you will find sources. Doctor's Data and Great Smokies are two of the labs used a lot by doctors.
> Where would I get a lab test for adrenal fatigue? Do I need a prescription or can I just go into any lab and ask to be tested?
>
> Thanks,
> cindy
>
> > Adrenal fatigue. $100 lab test will measure 24 hour cortisol in 4 saliva samples.
> >
>
This is the end of the thread.
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