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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Jeff on June 12, 1999, at 9:36:50
I had terrible anxiety-panic w/depression several years ago. Meds have relieved all of that..but of course with side effects that I must learn to tolerate. One of the S/E's are fatigue, lack of motivation/ sleepy / etc. I CANT STAND IT. I am in Sales, and my motivation is nil to none. . .deeply effecting my way of life via bills..etc.
Although the panic is gone (Anafranil 50mg x1 and Klonopin 1mg x1 at bedtime for 4 years) ...so is my energy and motivation...kinda dull blah bored etc.
Since I am on the meds..(I have tried ssri's with ill effects..serzone,paxil,Luvox,celexa,prozac,Wellbutrin etc) isnt there a little something..like a legal "speed" that I could take in the am to bring me some energy? Coffee works only temporary then crash.
Help...anyone? zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzJeffzzzzz
Posted by Judy on June 12, 1999, at 14:03:23
In reply to Low-No Energy on Meds, posted by Jeff on June 12, 1999, at 9:36:50
Jeff,
My daughter was prescribed Anafranil for OCD and walked around like a Zombie for over a year. She would come home from high school, do her homework, and then go to bed and sleep until morning. We assumed it was part of her condition, and only understood it was a side effect of Anafranil when she finally stopped taking it and her energy returned to normal.
She has since started taking Zoloft and is doing relatively well on it (Zoloft is not as effective for her OCD symptoms, but she's coping for the moment).
Since I am a total ignoramous regarding psychoparms compared to some of the other well-informed posters to this board, I can't tell you if there is something you can combine with Anafranil to offset the Zombie effect (maybe someone else here can).
You didn't mention the MAOI's in your list of 'tried-and-tossed' meds. They will certainly give you back your energy and I know at least Nardil is an excellent help for anxiety as well as depression.
Whether you find a combo that works for you or you decide to change meds, I wish you the best.
Judy
Posted by Peter on June 12, 1999, at 17:17:21
In reply to Low-No Energy on Meds, posted by Jeff on June 12, 1999, at 9:36:50
> I had terrible anxiety-panic w/depression several years ago. Meds have relieved all of that..but of course with side effects that I must learn to tolerate. One of the S/E's are fatigue, lack of motivation/ sleepy / etc. I CANT STAND IT. I am in Sales, and my motivation is nil to none. . .deeply effecting my way of life via bills..etc.
>
> Although the panic is gone (Anafranil 50mg x1 and Klonopin 1mg x1 at bedtime for 4 years) ...so is my energy and motivation...kinda dull blah bored etc.
>
> Since I am on the meds..(I have tried ssri's with ill effects..serzone,paxil,Luvox,celexa,prozac,Wellbutrin etc) isnt there a little something..like a legal "speed" that I could take in the am to bring me some energy? Coffee works only temporary then crash.
>
> Help...anyone? zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzJeffzzzzzYou might want to try to get your doc to presecribe Cylert or ritalin, stimulants which have been shown to augment the effects of anti-depressants. I personally have tried both but they have not really worked for me. All the ssri's induce fatigue which I have not been able to counteract. My doc is actually recommending Anafranil but your experience does not sound very promising. I wish you luck! Peter
Posted by W. Suggs on June 12, 1999, at 21:41:34
In reply to Re: Low-No Energy on Meds, posted by Peter on June 12, 1999, at 17:17:21
Jeff, I also am in sales and have gone through some of the similar experiences. Currently I am taking Wellbutrin SR bid (early am and at lunch), with moderate results. I have been through most of the ssri's w/limited success. One thing I know for sure is that a lot of these meds will decrease your REM sleeep resulting with your mentioned symptoms, grouped together in EDS (excessive daytime sleepiness). They lable this as Idiopathic Hypersomnolence - NO KIDDING!!! Just another fancy way to say that they do not know why you are sleepy. I took a sleep study and was removed from the effexor because it might interfer with my REM sleep. This did seem to help somewhat. I also know that some Dr's will prescribe cytomel (T3) as an adjunct or lithium 300 mg bid (worked wonders with me). Good luck!!
Posted by Wayne R. on June 13, 1999, at 6:58:11
In reply to Low-No Energy on Meds, posted by Jeff on June 12, 1999, at 9:36:50
Jeff, I too have experienced the apathy that can result from some of these meds. Naltrexone has worked very well for me as an augmentation. Here are some links for your reference:
Augmentation of Antidepressants with Naltrexone
http://www.dr-bob.org/tips/split/Aug-antidep-with-naltrex.html
SSRI's and Apathy
http://www.dr-bob.org/tips/split/SSRIs-and-apathy.html
In corresponding with Dr Dante (who posted in the above links) I discovered that he had obtained a patent with the intent of establishing some credibility for the augmentation. He has been trying to initiate some interest in controlled studies that might lead to approval of Naltrexone as an augmentation. If you review the patent be sure to view all of the claims.US Patent 5512593: Composition and method of treating depression using natoxone or naltrexone in combination with a serotonin reuptake inhibitor.
http://www.patents.ibm.com/details?pn10=US05512593
Best regards... Wayne
Posted by JohnB on June 13, 1999, at 13:49:41
In reply to Re: Low-No Energy on Meds, posted by Peter on June 12, 1999, at 17:17:21
I would advise against the traditional stimulants as augmentation meds. A far better choice would be a fantastic new med recently approved for narcolepsy called Modafinil. It appears to enhance wakefulness and vigilance without the nervous jitters that accompany the stimulants. The addition of Wellbutrin would also be a reasonable option. I happen to know exactly how you feel! Good luck.
Posted by Peter on June 14, 1999, at 21:25:45
In reply to Re: Low-No Energy on Meds, posted by JohnB on June 13, 1999, at 13:49:41
> I would advise against the traditional stimulants as augmentation meds. A far better choice would be a fantastic new med recently approved for narcolepsy called Modafinil. It appears to enhance wakefulness and vigilance without the nervous jitters that accompany the stimulants. The addition of Wellbutrin would also be a reasonable option. I happen to know exactly how you feel! Good luck.
John; has modafinil been approved in the U.S? Do you know expensive it is? Any info would be greatly appreciated. Thanks! Peter
Posted by claudeah on June 19, 1999, at 0:05:39
In reply to Re: Low-No Energy on Meds, posted by Peter on June 14, 1999, at 21:25:45
It seems that no matter what drug I've been on---prozac, zoloft, wellbutrin, litium, tegretal, clorazapate and klonopin---have all made me feel like I am on a constant dose of Nyquil. And they all make me gain weight...so my docs want me to exercize, but who has the energy. It takes everything just to stay awake at work. I told him between the sleepiness and the weight gain what I am currently on is totally unacceptable. He wants to put me on Lamictal and Neurontin. Anyone have any luck with that combination?
Otherwise I feel like going off of everything, because the last time I did I lost 10 lbs. in 10 days! Went on the litium, klonopin and the clorazepate and gained it back in a couple of days.....it is so discouraging. My doc is researching the drugs out there though to try to find a combo that doesn't--if he finds one I'll let ya'll know.
Help!!
Posted by JohnL on June 19, 1999, at 3:53:47
In reply to Re: Low-No Energy on Meds, posted by claudeah on June 19, 1999, at 0:05:39
> It seems that no matter what drug I've been on---prozac, zoloft, wellbutrin, litium, tegretal, clorazapate and klonopin---have all made me feel like I am on a constant dose of Nyquil. And they all make me gain weight...so my docs want me to exercize, but who has the energy. It takes everything just to stay awake at work. I told him between the sleepiness and the weight gain what I am currently on is totally unacceptable. He wants to put me on Lamictal and Neurontin. Anyone have any luck with that combination?
>
> Otherwise I feel like going off of everything, because the last time I did I lost 10 lbs. in 10 days! Went on the litium, klonopin and the clorazepate and gained it back in a couple of days.....it is so discouraging. My doc is researching the drugs out there though to try to find a combo that doesn't--if he finds one I'll let ya'll know.
>
> Help!!Strange, even Wellbutrin? Oh well. For what it's worth, Lamactil is supposed to be the more stimulating of the two, while some describe neurontin as being very sedating. But there is also debate, because some people get stimulated on one but not the other. And some get sedated with either. Considering your quirkiness to side effects (me too, you're not alone) you should try one at a time to avoid confusing the issue. It's funny, in the medicine of herbs, they treat "like with like". That would mean, theoretically, if you have sedation problems try something rather sedating to become stimulated and vica-versa. Doesn't make sense to me, but that's the way they treat, and it's fuel for thought. Anyway, I don't see mention of stimulants in your post. You know, some heavy-hitter doctors out there use these a lot because they not only relieve depression quickly (days, not weeks), but they might be just what you need to counteract sedation and weight gain. They are given along with antidepressants frequently. Ask your doc about it. There are several with different characteristics to choose from. The most common seems to be Ritalin, but there are others. Worth a try. Best wishes. JohnL
Posted by claudeah on June 19, 1999, at 23:09:49
In reply to Re: Low-No Energy on Meds, posted by JohnL on June 19, 1999, at 3:53:47
> Strange, even Wellbutrin? Oh well. For what it's worth, Lamactil is supposed to be the more stimulating of the two, while some describe neurontin as being very sedating. But there is also debate, because some people get stimulated on one but not the other. And some get sedated with either. Considering your quirkiness to side effects (me too, you're not alone) you should try one at a time to avoid confusing the issue. It's funny, in the medicine of herbs, they treat "like with like". That would mean, theoretically, if you have sedation problems try something rather sedating to become stimulated and vica-versa. Doesn't make sense to me, but that's the way they treat, and it's fuel for thought. Anyway, I don't see mention of stimulants in your post. You know, some heavy-hitter doctors out there use these a lot because they not only relieve depression quickly (days, not weeks), but they might be just what you need to counteract sedation and weight gain. They are given along with antidepressants frequently. Ask your doc about it. There are several with different characteristics to choose from. The most common seems to be Ritalin, but there are others. Worth a try. Best wishes. JohnL
John--I should say that while on tegretal, wellbutrin, and lithium (yes combined) my weight stayed the same, but I was tired all the time (for about 4 years) until January. Then I started going a little bit (is there such a thing) manic. Spent a lot of $$$ on things like buying a ticket to Paris on Tuesday and leaving on Thursday---at least when I went to Rome I had two weeks notice. Was really starting to get out of control. The one at a time thing hasn't seemed to work for me because if I don't have something for the mania or the depression I get hit by the one I don't have the medication for.
But I'm not giving up. I suppose I would rather be fat, stable and employed than trim, unstable and unemployed. Sigh--I guess that's why I'll keep giving money for research. Somebody has got to get it right!
Thanks,
And good luck to everyone!
Claudea
Posted by Barbara on June 23, 1999, at 18:36:10
In reply to Re: Low-No Energy on Meds, posted by JohnL on June 19, 1999, at 3:53:47
> > It seems that no matter what drug I've been on---prozac, zoloft, wellbutrin, litium, tegretal, clorazapate and klonopin---have all made me feel like I am on a constant dose of Nyquil. And they all make me gain weight...so my docs want me to exercize, but who has the energy. It takes everything just to stay awake at work. I told him between the sleepiness and the weight gain what I am currently on is totally unacceptable. He wants to put me on Lamictal and Neurontin. Anyone have any luck with that combination?
> >
> > Otherwise I feel like going off of everything, because the last time I did I lost 10 lbs. in 10 days! Went on the litium, klonopin and the clorazepate and gained it back in a couple of days.....it is so discouraging. My doc is researching the drugs out there though to try to find a combo that doesn't--if he finds one I'll let ya'll know.
> >
> > Help!!
>
> Strange, even Wellbutrin? Oh well. For what it's worth, Lamactil is supposed to be the more stimulating of the two, while some describe neurontin as being very sedating. But there is also debate, because some people get stimulated on one but not the other. And some get sedated with either. Considering your quirkiness to side effects (me too, you're not alone) you should try one at a time to avoid confusing the issue. It's funny, in the medicine of herbs, they treat "like with like". That would mean, theoretically, if you have sedation problems try something rather sedating to become stimulated and vica-versa. Doesn't make sense to me, but that's the way they treat, and it's fuel for thought. Anyway, I don't see mention of stimulants in your post. You know, some heavy-hitter doctors out there use these a lot because they not only relieve depression quickly (days, not weeks), but they might be just what you need to counteract sedation and weight gain. They are given along with antidepressants frequently. Ask your doc about it. There are several with different characteristics to choose from. The most common seems to be Ritalin, but there are others. Worth a try. Best wishes. JohnLJohn,
Have you any experience with successfully defeating the lethargy monster?
I was on Prozac for three or so years and it seems
the sleepiness got worse as time went on.
(sexual side effects were defeated within the first six months naturally).
My Psy suggested a change to Effexor which I have
been on for a month or so (150mg daily).
I am not falling asleep at my desk anymore but still
combat fatigue and the desire to sleep as well as
a lack of energy and some weight gain.
I had an opportunity to try dexedrine which seemed
a dream come true initially but later it seemed
the sleep monster had been hibernating and attacked
immediately after the dexedrine wore off.Your input would be appreciated.
Thanks,
Barbara
suggested a stimulant
This is the end of the thread.
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