Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Increased Lethargy While On Epilim, Sertraline, Clopidogrel And Simvastatin?
Question: Hi I'm currently taking epilm 600 mg at night for JME and also take 100mg sertraline for aniexty and dreppresion. My epilepsy is well controlled no seizure for about 7 years. I have recurrent epsiodes of dreppresion and have had one episode of psychosis. My depression is currently manageable but I do feel very lathargic a lot of the time which affect my quality of life. This could be a side effect of the medication or symptom of the illness not sure which. What can I do to improve this?
For info I also take 75mg clopidogrel for a recent TIA and 40mg simvastatin for high cholesterol.
For info I also take 75mg clopidogrel for a recent TIA and 40mg simvastatin for high cholesterol.
Brief Answer:
Serum Vitamin B12 level and thyroid should be checked
Detailed Answer:
Hello,
Thanks for writing to us.
Almost 20-50% of the patients of epilepsy suffered form depression.
Lethargy is one of the vegetative symptoms of depression. If your other symptoms of depression are responding well to sertraline than we need to check your serum vitamin B12 level and thyroid hormone profile as they are frequently low in patients with depression. If any of them comes low, supplement can help to improve your symptom of lethargy.
If reports come normal, there is need of increasing the dose of sertraline or another medicine like duloxetine can be added.
It is not likely side effect of medicine as you are taking them since long without any other problem.
However even after changing antidepressant medicines lethargy continues and EEG comes normal we can check by reducing dose of epilm that it is causing lethargy or not.
In any case if you BMI( body mass index is high) you need to reduce weight. Regular exercise, diet modifications and healthy lifestyle will help.
Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.
Serum Vitamin B12 level and thyroid should be checked
Detailed Answer:
Hello,
Thanks for writing to us.
Almost 20-50% of the patients of epilepsy suffered form depression.
Lethargy is one of the vegetative symptoms of depression. If your other symptoms of depression are responding well to sertraline than we need to check your serum vitamin B12 level and thyroid hormone profile as they are frequently low in patients with depression. If any of them comes low, supplement can help to improve your symptom of lethargy.
If reports come normal, there is need of increasing the dose of sertraline or another medicine like duloxetine can be added.
It is not likely side effect of medicine as you are taking them since long without any other problem.
However even after changing antidepressant medicines lethargy continues and EEG comes normal we can check by reducing dose of epilm that it is causing lethargy or not.
In any case if you BMI( body mass index is high) you need to reduce weight. Regular exercise, diet modifications and healthy lifestyle will help.
Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.
Above answer was peer-reviewed by :
Dr. Prasad
Thank you for your answer.
Thyroid hormone levels were checked about 10 months ago, I don't know the exact results however I was told they were normal. I don't know about serum vitamin B12 specifically but I assume this would have been checked. I will make an appointment with my GP to get this checked again to be sure.
I am currently waiting for an appointment to see a psychiatrist so I can discuss increasing or changing medication if this is required.
I would be happy to consider reducing epilepsy dosage as my epilepsy has been stable for a long time. However I will probably need to see a neurologist for this.
BMI is currently 28.8 a little high, however I am taking steps to reduce this. I have started a 5:2 diet plan and do 2-3 hours cycling a week.
Thyroid hormone levels were checked about 10 months ago, I don't know the exact results however I was told they were normal. I don't know about serum vitamin B12 specifically but I assume this would have been checked. I will make an appointment with my GP to get this checked again to be sure.
I am currently waiting for an appointment to see a psychiatrist so I can discuss increasing or changing medication if this is required.
I would be happy to consider reducing epilepsy dosage as my epilepsy has been stable for a long time. However I will probably need to see a neurologist for this.
BMI is currently 28.8 a little high, however I am taking steps to reduce this. I have started a 5:2 diet plan and do 2-3 hours cycling a week.
Brief Answer:
Yes you are following right approach all the best
Detailed Answer:
Hi,
Thanks for follow up and sorry for delayed response.
Consulting psychiatrist and neurologist will help to change your medicines according to need for better health.
All the best for your efforts to reduce weight.
Wish you good health.
You can close the query with rating if no more question.
Take care.
Yes you are following right approach all the best
Detailed Answer:
Hi,
Thanks for follow up and sorry for delayed response.
Consulting psychiatrist and neurologist will help to change your medicines according to need for better health.
All the best for your efforts to reduce weight.
Wish you good health.
You can close the query with rating if no more question.
Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
