Posted by bleauberry on February 6, 2010, at 9:10:37
In reply to mirtazapine side effects.. clue?, posted by viper1431 on February 5, 2010, at 21:44:15
You might want to do some google researching on "Chronic Fatigue Syndrome". It's hard to say on such a short description over the internet, and it is usually done on clinical evidence. Maybe your doctor doesn't know much about it and doesn't realize you might have it? As with depression itself, CFS is kind of a subjective diagnosis, at the mercy of the perception of whoever is looking at it. There is no lab test to say "you have depression" or "you have CFS".
Key word..."might". It fits the description.
But this gets into murky waters. Fatigue in the extremities, and the body overall, is one of the symptoms of depression. But are the fatigue and depression themselves symptoms and not diseases, symptoms of yet something else? Could be. In no way am I saying you have a bacterial infection, Lyme, or Candida, but they do look exactly the same as what you describe. So you see what I mean about things getting murky. It's hard to know what's causing what, what came first, whether to treat a disease on a hunch based on clinical presentation, or whether to just confine your treatments to alleviating symptoms as best as possible.
That said, remeron is probably not a good choice for someone whos baseline is fatigue. If it were to be used at all, it would probably need to be at least 30mg-45mg (where stimulation is more prominent than sedation), or in combination with something stimulating.
Low dose Savella.
Ritalin (brand, not generic).
Prozac+Ritalin (both brand, not generic).
Wellbutrin brand (not generic).
Low dose Abilify (1mg-5mg).
Parnate.
Nortriptyline.Those are things that could be on your radar screen. Some could be monotherapy and some could be combined.
If you need sedation assistance and remeron is your choice, 7.5mg is much more than you need. Believe me. Try cutting that 7.5mg in half or even quarters. I found that even doses as small as about 3mg were even more sedating than 7.5mg, but didn't have as much of the strong hangover into the next day. Even 1mg, mere crumbs, can pack a punch at bedtime.
Other options for sleep:
Low dose Nortriptyline (5mg-10mg)
LunestaSeroquel or Trazodone are both popular choices for sleep, but I personally do not favor those approaches. They are however good candidates in the sleep department.
Chronic Fatigue Syndrome is usually treated with stimulating antidepressants and stimulants. To get to the root cause of it, most success stories involved the use of antibiotics and/or antifungals, indicating an unsuspected undiagnosable infectious pathogenic cause. Those success stories abound all over the worldwide web, forums, and youtube, but most could not be reliably diagnosed by labs, and were instead attacked on the preponderance of evidence...basically blind trials that ended up being bullseye correct. CFS can be helped by antidepressants and stimulants, but the cures are usually antibiotics. Much research is needed, so we have to go on anecdotal evidence, which points the way to infectious diseases. Most of those will not show up relaibly in blood tests, which is why people who get chronic fatigue still have it decades later...doctor's view lab tests are perfect, but they are far from it.
On a 1-10 scale, food choices alone can make a difference of 2 or 3 points on the scale in terms of the fatigue you feel. It basically entails an entirely new approach to eating...eat for health, not for pleasure. That too is a another story, but basically we're talking heavy on veggies and fruits, lean meats, the good fats (olive oil, avocado, nuts of all kinds, fish), very low sugars, frequent small meals, and avoiding most things that are white (white bread, white grains), and doing self-tests to see how you feel after not eating gluten for 2 weeks, and another to see how you feel not consuming any cow dairy for 2 weeks. These kinds of things can improve your energy scores all by themselves without any meds. Probably sleep better too.
poster:bleauberry
thread:936087
URL: http://www.dr-bob.org/babble/20100204/msgs/936125.html