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Chronic fatigue, lack of concentration, depression, quivering of heart. Elevated liver enzymes. Taking Citalopram, Methylphenidate. Advice?

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Practicing since : 2005
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Hi I'm 48 male 5'10" 175# i've suffered depression for about 15 years
I have chronic fatigue bad concentration lack of motivation I take40 mg
citalopram 300mg buprppion 20mg methylphenidate x4 latley I decided to get my testastorne checked it was normal but I have elavated liver enzymes mostley what I drink is diet mt dew 4 to 8 a day and some milk Igo back in for more blood work tomorrow any ideas or questions I should ask also lately I've had strange feelinig what I think would be slightley lower and to the left of my heart mabey a slight quiver, thanks XXXXXXX
Posted Thu, 3 May 2012 in Depression
Answered by Dr. Mitaly 3 hours later

Thanks for posting your query.

Your symptoms as fatigue, lack of motivation, heart palpitations and concentration issues could be suggestive of anxiety disorder along with depression.

It must be recognized that the problems you are having are not pathological.
Treatment may include supportive therapy, such as changes in lifestyle and behavior, psychotherapy, complementary therapies, and if required change in the medication.

Some simple measures that can help you include-
1. Practice relaxation exercises like yoga, XXXXXXX breathing exercises.

2. Do a regular workout or exercise, morning walk.

3. Decrease sugar intake in your diet.

4. Indulge in some interesting hobbies.

5. Listen to music, XXXXXXX friends.

Beverages and soft drinks can also contribute to feeling of quivering in the heart. You need to reduce the intake of carbonated beverages. Instead opt for fresh juices, fruits.

Regarding the elevated liver enzymes I would like to explain you that if there are no symptoms as fever, bloating, yellowish discoloration of eyes and the levels are not more than three times the baseline values then it is considered normal.

For that you need to have healthy balanced diet.
Avoid oily and food XXXXXXX in saturated food which can raise the enzyme level.
Have high fiber diet.

Hope this answers your query. Please accept the answer in case you do not have follow up query.

Above answer was peer-reviewed by
Follow-up: Chronic fatigue, lack of concentration, depression, quivering of heart. Elevated liver enzymes. Taking Citalopram, Methylphenidate. Advice? 1 hour later
wil anxiety cause sweating, hands shaking, nervessness,not being able to think of words when talking or not fully understanding simple instructions and finaly does it come and go
Answered by Dr. Mitaly 38 minutes later

Thanks for the follow up.

Yes, anxiety can present with symptoms as sweating, hand shaking or to do even simple daily activities without this thing being on your mind.

It can increase at times when you are under any stress or apprehension and you might feel better when relaxed.

I hope, this helps to solve your query. Please accept my answer in case you have no follow up queries.

Wishing you Good health!

Above answer was peer-reviewed by
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