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What Causes Excessive Tiredness While On Dexedrine And Cymbalta?

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Posted on Tue, 1 Dec 2015
Question: Thank you for your answers, Dr. Sheppe; I just have one more.
I am a Court Reporter and I am behind with my work. I am so tired I just want to lay in bed all day which of course is very stressful with not getting anything done. I have been tired since last XXXXXXX which is why my doctor put me on Dexedrine. I have been off Dexedrine for five days now, take 5-30 milligrams of Cymbalta at night with half a milligram of Zoplicone for sleep. How long will this tiredness last, it is making me more depressed and it's impossible to function. What do you suggest?
Thank you again
doctor
Answered by Dr. Alexander H. Sheppe (12 minutes later)
Brief Answer:
Consultation

Detailed Answer:
Good to hear from you again. As always, I am most happy to answer any questions you have at any time. I appreciate the chance to get to know you and be involved in your care.

I really believe after considering your unique case that fatigue for you is a symptom of a major depressive episode. The treatment for this is an antidepressant, and I believe Cymbalta is the correct choice for you at this time. Keep in mind that antidepressants can take 6-8 weeks to achieve full effect, so it may take this long on the maximum dose of Cymbalta (120mg) to see your fatigue melt away.

Dexedrine was a good idea by your doctor to perk you up during the day, but you appear to have had side effects from it. I would definitely mention this to your doctor, as there are other stimulants to consider (Adderall, Ritalin, Vyvanse) that may not give you those same side effects, but instead might perk you up during the day.

Until then, it is important you are at least getting a full 8 hours of sleep a night. Hopefully the low dose of Zopiclone is helping with this. Maintain good sleep hygiene and a routine that helps.

The bottom line is that we are still waiting for Cymbalta to kick in. Until then, consider another stimulant such as Adderall to help combat the fatigue of depression. Let me know how if goes, or if you have further questions about this.

Dr. Sheppe
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Alexander H. Sheppe (25 hours later)
Hi Doctor Sheppe:

Thank you so much for your replies. I wish I had started the Cymbalta for my fatigue before now, as I want to lay in bed all day but I can't sleep. I am more depressed because I can't get the transcripts for court completed which is causing me undue stress as I have headlines to meet. I have been on this high dose of Cymbalta for a week now and I am still fatigued all day and can't get anything done. Every morning when I get up I hope to feel less fatigued but as you say it takes time. But I'm hoping every day I can function better. I called my doctor this morning about this and may ask him for Adderall, although when I took Dexedine I had terrible heart flutters and was very anxious. I live alone and it's very difficult when you don't feel well. Every day I pray I will feel better but it certainly has been a struggle. I want to thank you for your reply.
Sincerely XXXX
doctor
Answered by Dr. Alexander H. Sheppe (37 minutes later)
Brief Answer:
Followup

Detailed Answer:
Ms. XXXX, it's my pleasure to work with you. I know things are very, very difficult when you are living alone and depressed. But you are doing everything you can to get better, and should be applauded for that. You're taking medicine that will eventually help you, you're trying to stay engaged at work, and you're involved with your doctors. These are all good signs that point to the fact that you will get better.

Please don't hesitate to reach out with further questions.

Dr. Sheppe
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
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Dr. Alexander H. Sheppe

Psychiatrist

Practicing since :2014

Answered : 2236 Questions

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What Causes Excessive Tiredness While On Dexedrine And Cymbalta?

Brief Answer: Consultation Detailed Answer: Good to hear from you again. As always, I am most happy to answer any questions you have at any time. I appreciate the chance to get to know you and be involved in your care. I really believe after considering your unique case that fatigue for you is a symptom of a major depressive episode. The treatment for this is an antidepressant, and I believe Cymbalta is the correct choice for you at this time. Keep in mind that antidepressants can take 6-8 weeks to achieve full effect, so it may take this long on the maximum dose of Cymbalta (120mg) to see your fatigue melt away. Dexedrine was a good idea by your doctor to perk you up during the day, but you appear to have had side effects from it. I would definitely mention this to your doctor, as there are other stimulants to consider (Adderall, Ritalin, Vyvanse) that may not give you those same side effects, but instead might perk you up during the day. Until then, it is important you are at least getting a full 8 hours of sleep a night. Hopefully the low dose of Zopiclone is helping with this. Maintain good sleep hygiene and a routine that helps. The bottom line is that we are still waiting for Cymbalta to kick in. Until then, consider another stimulant such as Adderall to help combat the fatigue of depression. Let me know how if goes, or if you have further questions about this. Dr. Sheppe