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Suggest Treatment For Extreme Fatigue

Posted on Fri, 2 May 2014

Question: i feel like i have been hit by a train every night after work. i started taking tylenol and coffee. seems to help my concentration. wanted to know if i can try pregabalin. get too tired cuz i try so hard during the day. just want to be able to think. history venlafaxine 150 mg. concerta. adderall. buspar. bupropion. trying self cbt to relax.

Answered by Dr. Surendiran Gaj (58 minutes later)

Brief Answer: Probable anti depressant side effect. Detailed Answer: Hello there, Welcome to HCM, Thanks for writing to us, I have gone through your query, I just came to know that you are on ANTI DEPRESSANTS (venlafaxine and bupropion), ADHD (attention deficit hyperactivity disorder) medications [concerta and adderall] and anxiolytic (buspar). The extreme tiredness you are experiencing might be the side effect of anti-depressants you are using like venlafaxine and bupropion. I just want to know how long you are using this drugs, as the side effects fades gradually in months after starting the drugs, so no need to pause the drugs. Sometimes, dose dependent toxicity(venlafaxine 75mg instead of 150mg) also results in this kind of symptoms, in that situation reducing the dosage helps in decreasing the symptoms. PREGABALIN is a wonder drug in availing neuropathic related pain, but I don’t suggest you to take it unless you are cleared that your symptoms are not from your prescribed drugs. Am glad your symptoms are relieved by Tylenol (acetaminophen) and caffeine (coffee), but it is just a temporary remedy. Yes, of course COGNITIVE BEHAVIOURAL THERAPHY (CBT) excellently helps in relieving stress and keep your mind fresh,in good concentration and healthy and its the best treatment of choice for ADHD. Do not change the drugs by yourself, Consult your treating psychiatrist for further assistance whether to reduce the dosage or changing the drug as per your condition after proper examination. Take care. Dr.surendiran.g

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Surendiran Gaj (39 hours later)

i stopped antidepressants 2 years ago and since tried only adderall 20 mg more or less per day - better than nothing but too much weakness and anxiety. i did try buspar and bupropione for about 1 month over 9 months ago but got tinnitis. not likely any side effects now from those meds now causing weakness. i tried 5 mg adderall this afternoon and it really helped organize my thinking. might try combo adderall 5 mg and tylenol 500 mg and caffeine tomorrow. another pain med might work better like an opioid or ketamine. i read about ketamine just now for depression. just need something to consistently help. need help desparately. very disorganized thinking. almost schizoid like i guess. very disorganized which wears me out trying to just keep kind of organized. and that makes me tired. and depressed when it takes so long to do something simple or remember anything cuz its all jumbled. i wish i could show you my notes. i try to skip and abreviate but then miss things.horrible. takes so long to organize. is that add or depression or schizo? and just absolutely no energy. very depressing.

Answered by Dr. Surendiran Gaj (15 hours later)

Brief Answer: ATTENTION DEFICIT DISORDER. try CBT Detailed Answer: Hello there, Nice to see you again, I understand your circumstances completely, the symptoms you are experiencing like disorganised thought, mood swing, over frustration, easy distraction are classical of ADHD/ADD. [attention deficit disorder]. I too suggest to continue adderall 5 mg on daily basis as this drug works well. You can use Tylenol 500mg and caffeine along with another analgesics (NSAID) like ibuprofen if you are in need to reduce your pain. I suggest not to use opioid and ketamine as they have the tendency to develop into dependence and making it as an addiction. As I said already, have a word about CBT [COGNITIVE BEHAVIOURAL THERAPHY] with your treating psychiatrist, as it is best mode of non-medical treatment in ADD. Try to meditate and yoga, which is proved to reduce stress and helps to organise the thought. Develop healthy food habits and learn to relax at leisure times. Hope helped you. Take care. Dr.surendiran.g MBBS,PGD[Geriatric medicine]

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Above answer was peer-reviewed by : Dr. Yogesh D