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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by cellocarly on May 16, 2001, at 16:37:37
I cannot get my psychiatrist or GP to listen to me when I say how incredibly tired I have been the past few years. I excercise on a regular basis and eat a healthy vegan diet and am under 30 yrs of age. I am on lithium (1200 mg/day) and effesor sr (300 mg/day.
I am just so tired - how can I get them, especially my psychiatrist to take me seriously and listen to me when I say the meds must be causing it.
Does anyone else have problems with being ridiculously tired? I am ready to start taking caffeine pills so that I can function for a full day. This has been going on for so long and I thought these side effects would go away or lessen. Any thoughts would be appreciated.
colleen
Posted by SalArmy4me on May 16, 2001, at 16:47:40
In reply to so tired, posted by cellocarly on May 16, 2001, at 16:37:37
You can take all your Effexor XR at bedtime to minimize daytime sedation...
If you're doing that already and that doesn't work, you might ask your doctor for a stimulant like Provigil or Cylert.
Posted by cellocarly on May 16, 2001, at 18:08:00
In reply to Re: so tired, posted by SalArmy4me on May 16, 2001, at 16:47:40
> Thank you for the info - I will definately ask about those stimulants rather than try the caffeine route.
You can take all your Effexor XR at bedtime to minimize daytime sedation...
>
> If you're doing that already and that doesn't work, you might ask your doctor for a stimulant like Provigil or Cylert.
Posted by sl on May 16, 2001, at 21:05:21
In reply to so tired, posted by cellocarly on May 16, 2001, at 16:37:37
> Does anyone else have problems with being ridiculously tired?*nudgenudge* Yes, absolutely. Someone suggested I double my ineffective dose of Effexor and I was like "NO WAY, I'd never wake up to find out if it had any effect!".
>I am ready to start taking caffeine pills so that I can function for a full day.
Yup. I suggest diet Dr Pepper. ;)
Hang in there, you'll figure it out. :)
sl
Posted by Sunnely on May 16, 2001, at 21:22:00
In reply to so tired, posted by cellocarly on May 16, 2001, at 16:37:37
Hi Colleen,
Here's my own 2 cents.
How's your lithium levels been? Although 1200 mg/day of Lithium is an average dose for most healthy people, some are more sensitive than the others with regard to the side effects such as tiredness, easy fatigability, even lethargy. If you exercise and sweat considerably, your lithium level may increase. Also, if you restrict your salt intake, your lithium level may rise. You should also be aware that there are several drugs that can interact with lithium leading to an increase in lithium level. Notorius are the diuretics, the ACE inhibitors (for high blood pressure such as Vasotec, Zestril, etc.) and the NSAIDs (e.g., ibuprofen, naproxen, piroxicam, etc.). Incidentally, caffeine intake will lead to a decrease in lithium level which can lead to manic relapse. On the other hand, if you have been consuming caffeine regularly with a stable lithium level then decide to stop caffeine, your lithium level will rise.
There have been case reports of lithium toxicity in combination with the SSRIs (especially Prozac). The exact mechanism is unknown but may have something to do with the SSRIs' effect on the kidneys. In your case, I'm not sure if the Effexor may be causing your lithium level to rise. Nonetheless, it's clinically prudent to have a periodic lithium levels while on these antidepressants.
How's your thyroid doing? Lithium can induce hypothyroidism which can be manifested as tiredness and lack of energy or motivation. While on lithium, thyroid function tests should be performed every 6-12 months.
How's your parathyroid gland doing? There have been case reports of lithium causing parathyroid tumor leading to such symptoms as tiredness, lack of energy, and even depression. If it occurs, it usually occurs after a few years of lithium therapy. If your calcium level is high (which should also be checked periodically while on lithium), this may indicate that your parathyroid is affected. A parathyroid hormone level (parathorhome) should then be checked.
Finally, "therapeutic" lithium levels are merely guidelines. They are not etched in stone. The clinical picture remains the best parameter as to whether one is experiencing lithium side effects or toxicity. One person may not have an iota of side effects with a lithium level ranging from 0.8 - 1.2 while another individual, of similar age and health profile, may already feel lethargic at this range.
++++++++++++++++++++++++++++++
> I cannot get my psychiatrist or GP to listen to me when I say how incredibly tired I have been the past few years. I excercise on a regular basis and eat a healthy vegan diet and am under 30 yrs of age. I am on lithium (1200 mg/day) and effesor sr (300 mg/day.
> I am just so tired - how can I get them, especially my psychiatrist to take me seriously and listen to me when I say the meds must be causing it.
> Does anyone else have problems with being ridiculously tired? I am ready to start taking caffeine pills so that I can function for a full day. This has been going on for so long and I thought these side effects would go away or lessen. Any thoughts would be appreciated.
> colleen
Posted by cellocarly on May 17, 2001, at 14:08:02
In reply to Re: so tired » cellocarly, posted by Sunnely on May 16, 2001, at 21:22:00
> Sunnely and all,
Great suggestions and ideas about the tired thing. I totally did not know that you needed salt intake. I also didn't know that caffeine lowers lithium level. This is bad, but I haven't had a level done since october!! I am going this saturday do take care of it.
Thanks again!
Cellocarly
Hi Colleen,
>
> Here's my own 2 cents.
>
> How's your lithium levels been? Although 1200 mg/day of Lithium is an average dose for most healthy people, some are more sensitive than the others with regard to the side effects such as tiredness, easy fatigability, even lethargy. If you exercise and sweat considerably, your lithium level may increase. Also, if you restrict your salt intake, your lithium level may rise. You should also be aware that there are several drugs that can interact with lithium leading to an increase in lithium level. Notorius are the diuretics, the ACE inhibitors (for high blood pressure such as Vasotec, Zestril, etc.) and the NSAIDs (e.g., ibuprofen, naproxen, piroxicam, etc.). Incidentally, caffeine intake will lead to a decrease in lithium level which can lead to manic relapse. On the other hand, if you have been consuming caffeine regularly with a stable lithium level then decide to stop caffeine, your lithium level will rise.
>
> There have been case reports of lithium toxicity in combination with the SSRIs (especially Prozac). The exact mechanism is unknown but may have something to do with the SSRIs' effect on the kidneys. In your case, I'm not sure if the Effexor may be causing your lithium level to rise. Nonetheless, it's clinically prudent to have a periodic lithium levels while on these antidepressants.
>
> How's your thyroid doing? Lithium can induce hypothyroidism which can be manifested as tiredness and lack of energy or motivation. While on lithium, thyroid function tests should be performed every 6-12 months.
>
> How's your parathyroid gland doing? There have been case reports of lithium causing parathyroid tumor leading to such symptoms as tiredness, lack of energy, and even depression. If it occurs, it usually occurs after a few years of lithium therapy. If your calcium level is high (which should also be checked periodically while on lithium), this may indicate that your parathyroid is affected. A parathyroid hormone level (parathorhome) should then be checked.
>
> Finally, "therapeutic" lithium levels are merely guidelines. They are not etched in stone. The clinical picture remains the best parameter as to whether one is experiencing lithium side effects or toxicity. One person may not have an iota of side effects with a lithium level ranging from 0.8 - 1.2 while another individual, of similar age and health profile, may already feel lethargic at this range.
>
> ++++++++++++++++++++++++++++++
>
> > I cannot get my psychiatrist or GP to listen to me when I say how incredibly tired I have been the past few years. I excercise on a regular basis and eat a healthy vegan diet and am under 30 yrs of age. I am on lithium (1200 mg/day) and effesor sr (300 mg/day.
> > I am just so tired - how can I get them, especially my psychiatrist to take me seriously and listen to me when I say the meds must be causing it.
> > Does anyone else have problems with being ridiculously tired? I am ready to start taking caffeine pills so that I can function for a full day. This has been going on for so long and I thought these side effects would go away or lessen. Any thoughts would be appreciated.
> > colleen
Posted by Bill L on May 18, 2001, at 14:57:34
In reply to so tired, posted by cellocarly on May 16, 2001, at 16:37:37
I have had more energy since taking Ginkgo Biloba (60 mg twice a day). It also counteracts negative sexual side effects of AD's for some people. Talk to your doctor first since you may want to avoid it if you have any sort of bleeding problems.
> I cannot get my psychiatrist or GP to listen to me when I say how incredibly tired I have been the past few years. I excercise on a regular basis and eat a healthy vegan diet and am under 30 yrs of age. I am on lithium (1200 mg/day) and effesor sr (300 mg/day.
> I am just so tired - how can I get them, especially my psychiatrist to take me seriously and listen to me when I say the meds must be causing it.
> Does anyone else have problems with being ridiculously tired? I am ready to start taking caffeine pills so that I can function for a full day. This has been going on for so long and I thought these side effects would go away or lessen. Any thoughts would be appreciated.
> colleen
Posted by Noa on May 18, 2001, at 16:23:46
In reply to Re: so tired, posted by Bill L on May 18, 2001, at 14:57:34
I have to second some of the things already said and add some:
How are your lithium blood levels? Are you getting enough salt, because lithium replaces salt in the cells of the body if there isn't enough salt, and that can cause you to have too much lithium in your body.
Check out the thyroid angle. Lithium induced hypothyroidism is not uncommon, I think.
If you are a vegan, do you take B12 supplements? B12 is only available in animal products, so if you are a vegan, you are not getting any from your diet, and need supplements. You should have your B12 level checked. My sister went from being vegetarian to vegan and became deficient in B12. She was tired all the time. She is now receiving B12 injections.
Have you ruled out a sleep disorder, such as apnea or Periodic limb movement disorder?
Posted by niss on May 18, 2001, at 22:17:33
In reply to so tired, posted by cellocarly on May 16, 2001, at 16:37:37
Actually, this used to happen to me quite a bit.
Increase the amount of protein in your diet. Even if it means drinking a protein shake. This will help termendously...you should have no less than 80 mgs of protein on a daily basis. More if you are exercising.> I cannot get my psychiatrist or GP to listen to me when I say how incredibly tired I have been the past few years. I excercise on a regular basis and eat a healthy vegan diet and am under 30 yrs of age. I am on lithium (1200 mg/day) and effesor sr (300 mg/day.
> I am just so tired - how can I get them, especially my psychiatrist to take me seriously and listen to me when I say the meds must be causing it.
> Does anyone else have problems with being ridiculously tired? I am ready to start taking caffeine pills so that I can function for a full day. This has been going on for so long and I thought these side effects would go away or lessen. Any thoughts would be appreciated.
> colleen
This is the end of the thread.
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