Posted by Zeke on January 3, 2000, at 23:52:09
In reply to Re: Tired ALL the Time, posted by Sassy on January 3, 2000, at 20:32:24
Of course fatigue concurrent with a viral infection such as Epstein Barr can also be an autoimmune reaction -- your immune system attacking your nervous system. This is similar to the role of elevated cortisol levels 'attacking' (effecting) the CNS in depression. But that's not really practical here, and I'm not aware of any meds that are effective against the Epstein Barr virus either.
If no physical causes are found (low grade chronic infection, apnea) there are several medical options...
Antidepressants which are energizing include protryptline (Vivactil), Wellbutrin, and the MAO inhibitors. Of those, only Wellbutrin could (should) be added to an SSRI.
Someone suggested having thyroid levels checked. (A good idea.) But even if they are in the normal range -- as you say they are -- thyroid hormone could be added and should have an energizing effect.
Lastly, a stimulant such as Ritalin, Dexedrine or Adderall could be added. An online chapter from a psychopharmcology textbook states, "Stimulants have been used to counteract anergia secondary to SSRI therapy in depression." (http://www.appi.org/books/schatze/as08.html) Whether your doctor is willing to do this -- or willing to use a sufficient dose -- is another matter. However, this would likely be the safest, fastest method to counteract anergia either from depression or antidepressants. Indeed the afore mentioned article also says, "Stimulants also have a place in the crisis management of individuals whose functioning is impaired by depression and whose life situation will deteriorate rapidly if they are not able to resume functioning within a few days. In such situations a trial of methylphenidate, D-amphetamine, or magnesium pemoline is worth initiating to attempt to get a patient through a crisis where failure to function might result in getting fired from a job or flunking out of college."
If your doc is closed to these options, you should get a second opinion.
As for college, let your instructors know what your situation is, and that you might need some accomodations. You should also provide some documentation to your college's disabilities coordinator (your responsibility under the Americans with Disabilities Act). Depression is certainly covered under ADA.
Just out of curiosity, does your depression and anergia become worse in the winter months? (Right now we are in the period of shortest daylight.) If so, you might have Seasonal Affective Disorder. SAD is often responsive to light therapy.
poster:Zeke
thread:17870
URL: http://www.dr-bob.org/babble/20000101/msgs/17946.html