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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by onegirlrhumba on October 10, 2003, at 21:51:34
help! i have never been a "morning person", if you will, but over the past 9 months or so, i find it nearly impossible to get myself out of bed. actually, it's been a problem (i guess) related to my depression for a few years, but lately it's gotten much worse. i'm on 10 mg of lexapro and 40 mg of adderall a day.
i feel like the lexapro hasn't been working very well anymore...when i get depressed it's like walking through a foot of snow all day. even the slightest physical exertion is almost painful. i can't understand how other people with depression and anxiety can function enough to even go to work on time anymore.
i have social anxiety, panic with agoraphobia, adhd and just plain old depression, i think. does anybody have any suggestions? should i ask about adding wellbutrin? i hate sleeping this much, i really do.
Posted by Zenclearer on October 10, 2003, at 22:15:36
In reply to i can't get out of bed!, posted by onegirlrhumba on October 10, 2003, at 21:51:34
It's probably the adderall causing the problems.
Posted by Mariposa on October 10, 2003, at 22:59:39
In reply to i can't get out of bed!, posted by onegirlrhumba on October 10, 2003, at 21:51:34
> help! i have never been a "morning person", if you will, but over the past 9 months or so, i find it nearly impossible to get myself out of bed. actually, it's been a problem (i guess) related to my depression for a few years, but lately it's gotten much worse. i'm on 10 mg of lexapro and 40 mg of adderall a day.
>
> i feel like the lexapro hasn't been working very well anymore...when i get depressed it's like walking through a foot of snow all day. even the slightest physical exertion is almost painful. i can't understand how other people with depression and anxiety can function enough to even go to work on time anymore.
>
> i have social anxiety, panic with agoraphobia, adhd and just plain old depression, i think. does anybody have any suggestions? should i ask about adding wellbutrin? i hate sleeping this much, i really do.Been there!!! Today I feel just like this!!! @ 20mg now for about a month, started Lex end of feb. All I take is Lexapro. Last time I got this way my pdoc raised me from 10mg to 20mg. It might be something to discuss w/your doc.
Best of luck!~~~8|8
Posted by EscherDementian on October 11, 2003, at 1:22:58
In reply to Re: i can't get out of bed! » onegirlrhumba, posted by Zenclearer on October 10, 2003, at 22:15:36
> It's probably the adderall causing the problems.
In what ways do you see the Adderall being responsible?
Posted by EscherDementian on October 11, 2003, at 1:40:35
In reply to i can't get out of bed!, posted by onegirlrhumba on October 10, 2003, at 21:51:34
I have a few questions--
How long have you been on the Lexapro?
How long at 40mg Adderall?
Ever take 2days break from it?
When do you take your first dose relative to getting out of bed?I have had some experience with Lexapro, Adderall, AND Wellbutrin. And with being too tired to get out of bed, too.
There may be other things going on besides the med. combo.
i'll see if i can help~
Escher
Posted by galkeepinon on October 11, 2003, at 2:10:29
In reply to i can't get out of bed!, posted by onegirlrhumba on October 10, 2003, at 21:51:34
When I first started Lexapro, I had the same problem. I was sleepy, tired, and had no motivation. It took about 1 month to pass. I hope it passes for you.
When did you start Lexparo? When do you take it?
I noticed when I took it at night, I could not sleep. If I take it in the early am, it works great and I sleep better at night.
Sometimes after a few weeks, I, and many people, found that they encountered a 'slump', but either it passed or they increased their dosage. I know Mariposa increased her dosage and felt much better.
If you hang in there with Lexapro and give it a fair chance, you may be pleasantly surprised:-)
Sometimes I wonder too how people with depression and anxiety can function enough to even go to work on time anymore, or school, or even out of the house. My schoolwork is still sitting on my desk way too much!
Talking to your prescribing doctor would be a good thing and I wish you the best!
Best wishes,
Kristen> help! i have never been a "morning person", if you will, but over the past 9 months or so, i find it nearly impossible to get myself out of bed. actually, it's been a problem (i guess) related to my depression for a few years, but lately it's gotten much worse. i'm on 10 mg of lexapro and 40 mg of adderall a day.
>
> i feel like the lexapro hasn't been working very well anymore...when i get depressed it's like walking through a foot of snow all day. even the slightest physical exertion is almost painful. i can't understand how other people with depression and anxiety can function enough to even go to work on time anymore.
>
> i have social anxiety, panic with agoraphobia, adhd and just plain old depression, i think. does anybody have any suggestions? should i ask about adding wellbutrin? i hate sleeping this much, i really do.
Posted by Zenclearer on October 11, 2003, at 15:26:13
In reply to Re: i can't get out of bed! » Zenclearer, posted by EscherDementian on October 11, 2003, at 1:22:58
There's a point for many adults on adderall when physical fatigue becomes overwhelming. It can feel like adrenal exhaustion. Seemingly paradoxical.
> > It's probably the adderall causing the problems.
>
> In what ways do you see the Adderall being responsible?
Posted by EscherDementian on October 11, 2003, at 17:33:17
In reply to Re: i can't get out of bed! » EscherDementian, posted by Zenclearer on October 11, 2003, at 15:26:13
> There's a point for many adults on adderall when physical fatigue becomes overwhelming. It can feel like adrenal exhaustion. Seemingly paradoxical.
> >
Ah!so. Yes, i wasn't sure if you were just an Adderall 'naysayer', or were referring to something specific.
Adrenal exhaustion can definately be a concern.
i've added Pantothenic Acid to my daily suppliments for adrenal support because of this.
Am also remembering L-Phenylalanine or DL-(same) for dopamine production. A depletion causes a lower back/spine ache, no?It might be something that Onegirlrhumba might consider.
Girlrhumba? Wish i knew more about your morning tiredness. I've learned much about this through my own experience with it, Adderall, and Lexapro.
DSCH also has some insight about tiredness; different source and remedy.Escher
Posted by Zenclearer on October 11, 2003, at 21:36:02
In reply to Re: i can't get out of bed!, posted by EscherDementian on October 11, 2003, at 17:33:17
Do you find that dl-phen or tyrosine supplements cause any water retention?
I do find a small dose of tyrosine helpful (I've only taken intermitantly, not daily). But I also feel an unpleasant let-down a day or so later, when the high level depletes again. And I don't enjoy taking it every day due to the water retention effects.
If this happens to you, does it resolve over time? And do you feel any crash, however subtle, a few days after your supplement depletes?
Over time, I have experimented with amino supplements, and while they certainly help in the short term, I feel overall more up-and-downs. So I've found that there may not be a net gain for me.
Am I the only person with this issue?
And this is a medication-related topic, so I hopw it stays on this board vs getting transferred over to the alternative board. I am talking about the use of aminos to counter the negative side effects of stims (not as alternative treatment modality).
Posted by onegirlrhumba on October 13, 2003, at 5:49:12
In reply to Re: i can't get out of bed! » EscherDementian, posted by Zenclearer on October 11, 2003, at 21:36:02
hey, thank you for your input.
i've been on the lexapro for about 8 months, i think.
i may be confusing the side effects of my meds with untreated symptoms of depression. i'm not sure if i can't wake up because i'm still depressed or because something "isn't working" correctly.
as for the adderall, if i can wake up and manage to TAKE IT in the morning, things are much better. the problem is that i wake up and refuse to take it because i know i won't be able to fall back asleep. i mean, i can sleep on it, but not for several hours, and that's all i want to do. just sleep.
i'll see what the doc says this week.
Posted by EscherDementian on October 14, 2003, at 6:20:27
In reply to Re: i can't get out of bed!, posted by onegirlrhumba on October 13, 2003, at 5:49:12
Hi Onegirlrhumba,
What did your pdoc say? Any useful info. to share?
My supposition is that 8months is too soon for a 'poop out' on the Lexapro. And too established to suddenly feel tired from it.Something helpful that i've become in the habit of, is putting my morning dose of Adderall on my bedside table in easy reach. The first time i awake (or at clock bell) i will put it in my mouth without even getting up, and sometimes even sleep 20-30mins more. My next waking feels almost like those childhood mornings when awaking was an encouraged feeling. Also, i re-arranged my dosage schedule from 3 equal mgs x daily, to taking a larger portion in the AM- then receeding lower until the last dose at the end of the day is the smallest. The time difference between doses also increases as the succession in the day advances.
(e.g. 40mgs @ 8am, 20mgs @ lunch, 10mgs @ 6pm)You may already be doing this. If not, experiment, but keep in mind that too large a dose might 'calm and quiet' you too much, if you are ADD/ADHD. That's not what you want first thing in the morning... And too much Adderall in the longrun can make you tired/depressed if you get adrenal exhausted or dopamine depleted.
Also have your morning blood sugar checked, and your thyroid. For me, i found out iodized salt of all things, lift me from depression. There is another thing you may consider, and that is HPA-axis dysfunction. DSCH can tell you more about that.
i have also found that specific nutritional suppliments with my last food before i sleep helped FAR more than Wellbutrin. (Many of us can share which suppliments if you're interested :)
The mood lift was seamless, and Wellbutrin mixed with Lexapro gave me ear-screeeeeeing side-effects.
Oh- and this may sound impossible if you're an insomniac/day sleeper like me, but direct sunlight- (only 10min at least still works) -at some point during the day or week has an unbelievably remarkable effect on my tiredness (or not) upon waking.i, too, had a TERRIBLE time feeling too depressed/tired upon waking (i used to ask myself, "Ughh. Are you still here?") and pull the covers over my head. i'd continue sleeping as long as i could, without any benefit of feeling refreshed or regenerated. My depression/sleep would keep me from taking morning Adderall and SSRI. i found that adding additional different meds (up to 4 x daily) basically gave me more SEs but not more true benefits, IMHO. The key for me was going back through a basics checklist. But that's just me- there may be many here on PB that have different solution successes.
I'm looking forward to knowing theirs, too~ :)Escher
~An eyefull.
Posted by EscherDementian on October 14, 2003, at 7:06:27
In reply to Re: i can't get out of bed! » EscherDementian, posted by Zenclearer on October 11, 2003, at 21:36:02
> Do you find that dl-phen or tyrosine supplements cause any water retention?
> I do find a small dose of tyrosine helpful (I've only taken intermitantly, not daily). But I also feel an unpleasant let-down a day or so later, when the high level depletes again. And I don't enjoy taking it every day due to the water retention effects.
>Wow. That sounds tough, Zenclearer. I wish i could be more helpful here... i have never noticed water retention. Only occasionally in a female-lunar-cycle sort of way ;)
> If this happens to you, does it resolve over time? And do you feel any crash, however subtle, a few days after your supplement depletes?
> Over time, I have experimented with amino supplements, and while they certainly help in the short term, I feel overall more up-and-downs. So I've found that there may not be a net gain for me.
>My experience is that i continue steady-state until i go for too long WITHOUT my suppliments.
UNLESS i am eating what/how i should, and getting the exercise and sleep i should, etc.etc. then i have no up-downs. But really, WHO does that consistently?(not me, anyway) So i suppliment with those suppliments.
> Am I the only person with this issue?
>
> And this is a medication-related topic, so I hopw it stays on this board vs getting transferred over to the alternative board. I am talking about the use of aminos to counter the negative side effects of stims (not as alternative treatment modality).
Hear-Hear!
~let's find out about that water retention, no?Escher
Posted by EscherDementian on October 14, 2003, at 7:08:15
In reply to Re: i can't get out of bed! » onegirlrhumba, posted by EscherDementian on October 14, 2003, at 6:20:27
Posted by Zenclearer on October 14, 2003, at 7:19:18
In reply to Re: i can't get out of bed!, posted by EscherDementian on October 14, 2003, at 7:06:27
Wow. It sounds like your routine/regimen really works for you. That's great.
What supplements do you take?
I see you take about 80 mg/day Adderall. I assume you don't have any problems with rapid heart beat etc on that? I take a low dose of dex, 12 mg/day. I used to take Adderall, but now with the almost-transparent effects of dex, when I take Adderall, it feels irritating, with mood effects.
However, the dex often leaves me somewhat wasted, with less physical initiative.
Thusly the discussion on tyrosine.
I, too, take my dex before waking.
Posted by Patient on October 14, 2003, at 13:49:03
In reply to i can't get out of bed!, posted by onegirlrhumba on October 10, 2003, at 21:51:34
I understand the sleepy feeling.
I've never taken Adderall, but I've taken 20mg Celexa daily-it made me sleep too good-slept in real late and would end up taking a nap during the day. I forgot to mention to another poster concerning augmenting Wellbutrin with Lexapro, that I did have Wellbutrin SR 150mg added to the daily Celexa to counteract the loss of libido side effect. It didn't help in that respect, but there's more to my loss of libido than just medications. Anyway, it did help bring me back to life in that I no longer napped and felt very relaxed while on the combo. Don't ask me why I stopped this combo-I tend to fiddle with medicine changes too much, thinking some other drug will work better-I have borderline personality disorder, that includes depression, anxiety, and anger control problems.
Right now I'm taking Lexapro 5mg daily. I take it in mid-afternoon. It too made me sleepy, especially at the start, but didn't seem as severe as on Celexa. I think what adds to the sleepiness is what I've eaten that day-if I load up on a simple carbohydrate breakfast-it's guaranteed I'll be a walking zombie in an hour or two. I try to eat more protein than carbohydrates to make sure I don't get a food coma. I've also taken carbamazepine (Tegretol), which off-label use is a mood stabiliser. This was added to help with my high irritability/anger problem and was started when I first started Lex. back in Feb. This combination was helpful a bit, for my irritability, but I was even more tired during the day and would end up needing a nap. I haven't been taking Tegretol for this reason. In the past week, having some leftover Wellbutrin SR, I started to take one 150mg tablet first thing in the morning, and Lex. in mid-afternoon. I was so glad I did for I no longer experience daytime sleepiness, and I feel more relaxed from the Wellbutrin. It also removed the ulcer-like false hunger pangs I was experiencing in different degrees on the Lexapro. Wellbutrin can act as an appetite suppressant, and I think this is why it has helped with my stomach problem. It also acts, in general, as a stimulant (hey-no wonder I felt better!). I really thought that the Wellbutrin would make me anxious, but it didn't-the relaxed feeling was very welcome. It can cause insomnia at bedtime, so I suggest to anyone adding it to an SSRI is start with the slowest dose and take it as early in the morning as you can, and to avoid caffeine. There is regular form of Wellbutrin in 75mg and 100mg, and if you start on this, then I'd suggest the 75mg. (Maybe it only comes in 100mgs.) I take Wellbutrin SR (sustained-release) in it's lowest dosage of 150mg. It is usually taken twice a day as mono-therapy. The latest form of Wellb. is Wellbutrin XL (extra-long, I guess?) and this is a once daily version, which I wouldn't recommend since it would be the most likely form to cause insomnia.
And, must add that a few people that add Wellbutrin to an SSRI end up feeling even more tired-depends on the person and what SSRI they are taking.
I have had one night of mild insomnia so far with this mix. I took the older antidepressant trazodone (Desyrel) 12.5mg at bedtime and it helped me sleep fine-trazodone is commonly used as a sleep aid for insomnia caused by certain antidepressants.
Hope this helps. I like the sun on the face idea-first thing in the morning helps get your sleep cycle back to normal by telling your brain, via the retina, when to halt the release of melatonin in the morning, and to release it at the proper time at night to help you sleep.
Posted by onegirlrhumba on October 14, 2003, at 18:10:34
In reply to Re: LexaproAdderall-i can't get out of bed!, posted by Patient on October 14, 2003, at 13:49:03
thanks, i will definitely try taking my adderall first thing apon waking...i've found that it's much easier to wake up once it's started working also.
i realized that i've been more depressed than usual for the past two weeks...and the only change i made two weeks ago was that i started taking something for acid reflux disease...i forget the name, starts with a p? prevacid maybe?
anyway, i'm wondering now if anybody knows if that may have interfered with my lexapro. now that i think about it, it really feels like i've been going through AD withdrawl...maybe that could be the problem? i stopped taking it yesterday to find out. i would much rather have heartburn than be depressed.
but does anybody know what i could take for heartburn that won't affect my other meds? maybe it has to do with the time i take them? cuz i take my heartburn med and antidepressant at the same time of day.
also, can somebody recommend a good supplement or two that might help with anxiety and general feeling of melancholy, etc? and where can i get this stuff?
Posted by Patient on October 15, 2003, at 16:06:40
In reply to Re: LexaproAdderall-i can't get out of bed!, posted by onegirlrhumba on October 14, 2003, at 18:10:34
> thanks, i will definitely try taking my adderall first thing apon waking...i've found that it's much easier to wake up once it's started working also.
>
> i realized that i've been more depressed than usual for the past two weeks...and the only change i made two weeks ago was that i started taking something for acid reflux disease...i forget the name, starts with a p? prevacid maybe?
>
> anyway, i'm wondering now if anybody knows if that may have interfered with my lexapro. now that i think about it, it really feels like i've been going through AD withdrawl...maybe that could be the problem? i stopped taking it yesterday to find out. i would much rather have heartburn than be depressed.
>
> but does anybody know what i could take for heartburn that won't affect my other meds? maybe it has to do with the time i take them? cuz i take my heartburn med and antidepressant at the same time of day.
>
> also, can somebody recommend a good supplement or two that might help with anxiety and general feeling of melancholy, etc? and where can i get this stuff?Hi,
That's interesting, because for the past month or two I have had varying degrees of ulcer-type false hunger pangs while taking Lexapro. I've taken Lexapro as 5mg a day, and for a period I was taking 5mg once in morning and once in evening. I couldn't handle 10mg at once-made me a bit anxious. Anyway, after adding the Wellbutrin to the 5mg Lexapro, the pangs went away. It wasn't exactly acid reflux, though as you say, but someone else on this board mentioned Celexa causing this. I must mention that for years I was bulimic, and this probably has negatively affected my stomach for good, though I've never experienced these sensations while taking Zoloft, Prozac, or Celexa in the past.
I checked out the drug info for Prevacid and it doesn't mention any interactions with SSRI's, but that doesn't mean it doesn't happen, and there may be documentation about it through medical resources not on the internet. Tell your doctor. I'd suggest taking the two medicines at least 3 hours apart. If you stop the proton-pump inhibitor medicine, Prevacid, and the symptoms go away, then I would suspect a drug interaction occuring.
For nutritional supplements to treat depression and anxiety, I could go on and on, but I'll mention a good book "Prescription for Nutritional Healing" by Balch-it contains chapters on both disorders and nutritional suggestions. I always suggest a high-potency quality multi-vitamin/mineral supplement and B-complex. I go to my local health food store, or shop on line. www.VitaminShoppe.com as well as www.Vitacost.com. There are others out there.
Sounds like you'll have to set you're alarm to take the Adderall ; )
Posted by galkeepinon on October 15, 2003, at 18:50:12
In reply to Re: LexaproAdderall-i can't get out of bed!, posted by onegirlrhumba on October 14, 2003, at 18:10:34
I'm sorry to hear you're not feeling well, and hope you can get all this straightened out for yourself:-)
I have taken Prevacid for 4 years with my antidepressants, actually with Seroquel, Klonopin, Lamictal, Effexor (when I was on it), and now with my Lexapro~with no problems.
Prevacid has actually helped *coat* my tummy for the psych meds I take now. Prevacid is a pretty good drug IMHO, maybe talk to your doctor so you can be on your way to feeling better.
Best wishes.>>>>>but does anybody know what i could take for heartburn that won't affect my other meds? maybe it has to do with the time i take them? cuz i take my heartburn med and antidepressant at the same time of day.
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