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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by metamorphosis on January 12, 2010, at 17:00:59
I am stuck in a rut.I have no energy. I just had a physical and everything is fine. it's frustrating because last summer I was biking around 300 miles a week. Now I barely get through work without half assing it.Albiet my jojb is physically demanding but it was last summer too.
So I'm hoping for some input on these meds possibly causing apathy. I take Leaxapro 10mg,Lamictal 200mg,Wellbutrin 150mg. Anyone have any idea of which could be the culprit? i thought Wellbutrin would offset the Leaxapro but maybe the dose is to low? I'm not sure if fatigue is a common side effect of Lamictal. Any input would be appreciated.
Posted by janejane on January 12, 2010, at 17:08:38
In reply to Tired of being tired, posted by metamorphosis on January 12, 2010, at 17:00:59
I think increasing the wellbutrin dose might be worth a shot, if you can tolerate it. I felt less tired when I took more.
Posted by janejane on January 12, 2010, at 17:26:14
In reply to Tired of being tired, posted by metamorphosis on January 12, 2010, at 17:00:59
Forgot to say, seems like lowering the lexapro might help too, if you think you're developing apathy. You could try increasing the dose to see if it gets worse, then you know its the culprit. Or decrease and see if it gets better. I don't know about the lamictal.
Posted by polarbear206 on January 12, 2010, at 22:27:11
In reply to Tired of being tired, posted by metamorphosis on January 12, 2010, at 17:00:59
> I am stuck in a rut.I have no energy. I just had a physical and everything is fine. it's frustrating because last summer I was biking around 300 miles a week. Now I barely get through work without half assing it.Albiet my jojb is physically demanding but it was last summer too.
> So I'm hoping for some input on these meds possibly causing apathy. I take Leaxapro 10mg,Lamictal 200mg,Wellbutrin 150mg. Anyone have any idea of which could be the culprit? i thought Wellbutrin would offset the Leaxapro but maybe the dose is to low? I'm not sure if fatigue is a common side effect of Lamictal. Any input would be appreciated.Some people have to increase their AD doses in the winter months due to SAD. Light therapy also helps. How long have you been on these meds and current doses? Was one recently been added?
Posted by Phillipa on January 12, 2010, at 22:28:35
In reply to Re: Tired of being tired, posted by polarbear206 on January 12, 2010, at 22:27:11
How's your thyroid? Phillipa
Posted by metamorphosis on January 13, 2010, at 9:18:27
In reply to Re: Tired of being tired, posted by Phillipa on January 12, 2010, at 22:28:35
I had my Thyroid checked years ago and it was okay. That may be something I need to do again. Which may be a problblem as i don't have insurance. As far as adding meds.;I was on Klonopin,Lamictal,Provigil,and Wellbutrin.That was last summer when my energy and attitude was at a high. I'm not sure if I was taking Lexapro on a regular basis. Also, the Lamictal could have been at a lower dose 100mg.
Posted by janejane on January 13, 2010, at 9:29:30
In reply to Re: Tired of being tired, posted by metamorphosis on January 13, 2010, at 9:18:27
Maybe dropping the provigil has something to do with it.
Posted by metamorphosis on January 14, 2010, at 4:30:12
In reply to Re: Tired of being tired » metamorphosis, posted by janejane on January 13, 2010, at 9:29:30
I'm back on the Provigil. I originally thought that was the problem.
Posted by detroitpistons on January 14, 2010, at 19:49:50
In reply to Re: Tired of being tired, posted by metamorphosis on January 14, 2010, at 4:30:12
> I'm back on the Provigil. I originally thought that was the problem.
I'm confused here. If this is the case, then the fatigue is almost definitely due to quitting Provigil, which is a stimulant. Any time I've ever stopped taking a stimulant, I've felt fatigued for a while. I'd say that's pretty normal, but the question is how long have you been off of it and how long were you on it before?
Posted by delna on January 15, 2010, at 10:07:12
In reply to Tired of being tired, posted by metamorphosis on January 12, 2010, at 17:00:59
> I am stuck in a rut.I have no energy. I just had a physical and everything is fine. it's frustrating because last summer I was biking around 300 miles a week. Now I barely get through work without half assing it.Albiet my jojb is physically demanding but it was last summer too.
> So I'm hoping for some input on these meds possibly causing apathy. I take Leaxapro 10mg,Lamictal 200mg,Wellbutrin 150mg. Anyone have any idea of which could be the culprit? i thought Wellbutrin would offset the Leaxapro but maybe the dose is to low? I'm not sure if fatigue is a common side effect of Lamictal. Any input would be appreciated.Hi,
I too am very tired all the time- a few weeks ago i couldn't even sit up .Like you, I have also just had all my physical checkups done and nothing huge turned up (just a few vitamin deficiencies which cannot explain the tiredness)
I take Lamictal but I do not find it sedating at all. I have also been on Lexapro and again I feel it is not sedating. Taking it at night may help if you fear they are the culprits.
Anyway, this is the combination that has helped me:
Ritalin 40mg
Provigil 400mg
Wellbutrin 450mg
I also take lamictal 200mg and prozac 20mg.
Adding the Ritalin has *really* helped with the tiredness and apathy.
I personally feel that some people need higher doses of Provigil etc to feel better. I don't know if your doctor is open to raising the doses.
I am also taking T3. My thyroid levels all fall in range but my doctor decided to try it anyway (since T3 is often used to augment ADs). I do feel that it has improved energy levels (but not mood)
I hope you find some relief. Tiredness is so disabling.
Take Care
D
Posted by bleauberry on January 15, 2010, at 18:18:08
In reply to Tired of being tired, posted by metamorphosis on January 12, 2010, at 17:00:59
I wish I had medication to suggest that hasn't already been mentioned. But clearly, if fatigue is the issue and we are not going to explore what is behind it, then symptom improvement will be within the stimulant category...Ritalin or Adderall primarily. Modafinil maybe.
I feel it is a very common misconception to get a full physical and "they found nothing wrong". Well, did they check your saliva cortisol four times throughout a 24 hour period to see what was happening? No. Did they check your free T3, T4, and thyroid antibodies? Most likely no. Did they look at the color of your tongue? Did they ask if you ever feel cold when other people are not cold? Did they look at your teeth for silver fillings or ask if you ever had any?
As was stated already, thyroid augmentation in psychiatry is customary practice, even when lab values appear normal. Keep in mind, each lab has their own interpretation of what a normal range is, and those ranges are so wide that illness symptoms can happen even within that normal range. We can measure thyroid in the blood, but we cannot see what is going on at the receptor level. Sometimes we just need more.
It would be interesting to test your temperature. With an accurate thermomemter, take your temp as soon as you wake in the morning, again around noon, and again in the evening. Keep a log of these readings for two weeks. Look for patterns...lows, highs. If your waking temp is below 97.6, or if your averaged temperatures are around 98 - 98.2, then that is a good hint there is a real problem in the thyroid/cortisol circuits. You need not test these things because you would probably be given the wrong tests anyway, or they would be interpreted through narrow views, or they just plain wouldn't be helpful unless they were grossly out of line. The better thing to do is try pro-cortisol stuff and pro-thyroid stuff to see if your temps change and your energy changes.
I would not really suspect any of your current meds causing the degree of difficulty you are feeling. There is something else going on. My feelings anyway. There are various causes of chronic fatigue.
Posted by Phillipa on January 15, 2010, at 19:22:44
In reply to Re: Tired of being tired » metamorphosis, posted by delna on January 15, 2010, at 10:07:12
Delna your're better now? Love Phillipa
Posted by annabamma on January 19, 2010, at 18:17:48
In reply to Re: Tired of being tired » delna, posted by Phillipa on January 15, 2010, at 19:22:44
Boy, I can relate- "Tired of Being Tired" could be one of the subtitles of my life! Blueberry makes some good points! Make sure your doctors is not still using the "old-range" thyroid scale. My doctor is pretty good,but come to find out I'd been hypothyroid for a couple of years because the lab was using the old range thyroid numbers= anything under 5 is okay.The newer thinking is most people feel good about 2 OR LESS. I've convinced my doctor to treat me by symptoms and not numbers(within reason) For people who feel like the walking dead =tired, NO energy, motivation,etc. it's worth checking into. Like a lot of these tests, KNOW YOUR NUMBERS, don't just take your doctor's word that you're in some vague "okay-range". And this can happen where ever you go! I live in a town with a world-class university and excellent hospitals and good doctors. You've just got to be your own advocate. Excuse my little jog off the subject! Bottom line=meds won't work if your thyroid / adrenal systems are out of whack.
Posted by Phillipa on January 19, 2010, at 20:42:02
In reply to Re: Tired of being tired, posted by annabamma on January 19, 2010, at 18:17:48
Yup I keep copies of all my labs latest 1. something in range still tired and yest Free T4 also in new ranges. My endo lectures at a University. I do think somehow there's more to it. Don't know what just do. Phillipa
Posted by meltingpot on January 20, 2010, at 10:17:48
In reply to Tired of being tired, posted by metamorphosis on January 12, 2010, at 17:00:59
Hi,
In my experience when a medication stops working properly then you experience tiredness instead of energy, apathy where before there was motivation. Anxiety where before there was peace.
When the Paxil was working for me, I had a lot of energy, on one occasion I stayed up all night without feeling that bad. Now I'm tired and sleepy all day even after getting loads of sleep.
I've added Wellbutrin and have been on it for about 3 weeks but it doesn't seem to be doing a lot.
I know that Lamictal can make you very tired too.
If you find something that helps, please let me know.
Denise
Posted by annabamma on January 20, 2010, at 14:08:26
In reply to Re: Tired of being tired » annabamma, posted by Phillipa on January 19, 2010, at 20:42:02
Yes,I think there's more to it, too! After years of body/brain chemical upheaval, I'm sure I've burned out some kind of adrenal/thyroid balance! Going through anxiety/panic spells in sure hard on your body and mind!
This is the end of the thread.
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