![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 3 to 27 of 27. Go back in thread:
Posted by Cam W. on February 11, 2000, at 22:04:47
In reply to Feeling drugged, anxious, and a little depressed, posted by Noa on February 11, 2000, at 18:48:32
> I had been feeling increasingly better until last week. Have been at current dose of lithium for about 6 weeks. Suddenly I feel sleepy all the time, like a drugged feeling, hard to keep eyes open, etc. But, the anxious, jittery feeling is still there--my left leg is always shaking.
>
> And I am starting to feel somewhat depressed, not in the usual way, but overwhelmed because I cannot motivate myself or muster up any energy.
>
> Is it my meds? Can this suddenly happen?
>
> Despite fatigue, my sleep isn't the greatest. First of all, lots of interruptions to pee, from the lithium. But also, that jittery feeling makes me not want to go back to sleep.
>
> Have been using cafeine to try to counteract the tiredness, but it seems to make me even sleepier. I think I will stop cafeine again.
>
> About two weeks ago, I went to give blood at a work-based blood drive. My temp was 99.7 the first time, but the tech wanted to take it again, and the second time it was 99.4, which was acceptable (99.5 is the limit). Thing is, I usually run a low temp, altho maybe not with all these meds, esp. the thyroids. Could my sleepiness be related to that, even tho it was Jan. 24, which is almost two weeks ago? Could it be related to giving blood, which never bothered me before?
>
> Help. I feel lousy, and I don't know why.
>
> Fyi- my meds (in order of appearance in my life):
>
> effexor xr, 375
> cytomel, .0125
> synthroid, .025
> methylphenidate sr, 20 twice a day
> serzone, 225 at night
> lithium carbonate, 600 am and 600 pmNoa - I hope you will allow me to think out loud for the next little while as I try to review your med file. My books are at work, so I will have to restrict my comments to what I know. First, some questions.
1) Are you taking any herbs, nutraceuticals, large amounts of grapefruit juice, etc?
2) Have you changed your diet recently? (eg restricted salt, increased liquids greatly & such)
3) You said your body temperature was up; have you a fever, are your lips, nostrils (mucous membranes) dry?
4) Have you been sweating a lot?
5) Are the side effects like fatigue, dazed feeling, and restlessness worse approximately 2 to 3 hours after taking the lithium?
6) Have you had your lithium, electrolyte and thyroid levels done recently?
7) Are you taking the regular or XR version of Effexor?
Now to my wandering mind. The symptoms you are describing sound like they may be adrenergically mediated (caused by too much norepinephrine).They could also be due to the lithium (fatigue, dazed feeling, etc. sometimes coincide with peak blood levels). These can also be side effects of Effexor when doses are at or above 300mg/day.
Effexor also has a short half life (5 hr; active metabolite ODV = 11 hr). If you are taking the short acting you may be going into a mild withdrawl from Effexor every day. Withdrawl effects of Effexor can mimic depressive symptoms or flu-like symptoms (fatigue, malaise, etc.). This is probably not too likely, but your Effexor dose should be divided to at least twice (to three times) daily with the short acting formulation.
A minor side effect of Effexor, that has been reported in the literature, is hyponatremia (low body salt level). When taking lithium you need to eat a diet consistent in its level of salt (sodium) to keep your lithium levels within a therapeutic range. Checking lithium and electrolytes levels is an easy way to see if this is a problem.
Fever can lower body water levels, increasing lithium levels, as can crash diets and dehydration (sweating). Again a lithium level will show this.
Caffeine in the short-term can worsen lithium-induced tremor and long-term can lower lithium levels by inhibiting ADH (antidiuretic hormone) which your body uses to draw water back from your kidneys (concentrating urine). A similar inhibition of ADH occurs after 3 or 4 alcoholic beverages and your body starts excreting more water than it takes in. With caffeine or alcohol you can lower lithium levels by peeing it away (if you maintain adequate hydration) or raise lithium levels (if you dehydrate). In short - Stop the caffeine.
The Serzone dose is at a sub-therapeutic level for antidepressant activity. Serzone absorption is weird, as low doses are not absorbed well. Are you sensitive to the ADs like Paxil or Prozac? If so, you could be a slow metabolizer of the cytochrome P450-2D6 system. In people who are slow metabolizers of this system, a minor metabolite of Serzone (mCPP) can cause increased anxiety and worsen sleep patterns (opposite of what Serzone does). Large amounts of grapefruit juice can also raise mCPP levels.
Conclusion - One or more of these mechanisms MAY be causing some of your problems, but then again, MAYBE NOT. These are just flowings from an overactive mind. Maybe others can add to this or subtract from it. I hope it helps a little. Take care and good luck (hope you feel better soon) - Cam W.
Posted by Abby on February 11, 2000, at 22:15:54
In reply to Feeling drugged, anxious, and a little depressed, posted by Noa on February 11, 2000, at 18:48:32
> I had been feeling increasingly better until last week. Have been at current dose of lithium for about 6 weeks. Suddenly I feel sleepy all the time, like a drugged feeling, hard to keep eyes open, etc. But, the anxious, jittery feeling is still there--my left leg is always shaking.
>
> And I am starting to feel somewhat depressed, not in the usual way, but overwhelmed because I cannot motivate myself or muster up any energy.
>
> Is it my meds? Can this suddenly happen?
>
> Despite fatigue, my sleep isn't the greatest. First of all, lots of interruptions to pee, from the lithium. But also, that jittery feeling makes me not want to go back to sleep.
>
Noa--I'm so sorry to hear it. When's your next appointment with a psychiatrist? You mentioned something about apnea in another post. Could that be affecting your sleep, making you tired and feeling lousy. Could you have some kind of mild flu-like infection--thus the higher temperature. I doubt giving blood did anything. Did you ever think of trying an atypical neuroleptic like risperidone in micro doses?Abby
Posted by Cindy W on February 11, 2000, at 22:18:31
In reply to Re: Feeling drugged, anxious, and a little depressed, posted by Abby on February 11, 2000, at 22:15:54
> > I had been feeling increasingly better until last week. Have been at current dose of lithium for about 6 weeks. Suddenly I feel sleepy all the time, like a drugged feeling, hard to keep eyes open, etc. But, the anxious, jittery feeling is still there--my left leg is always shaking.
> >
> > And I am starting to feel somewhat depressed, not in the usual way, but overwhelmed because I cannot motivate myself or muster up any energy.
> >
> > Is it my meds? Can this suddenly happen?
> >
> > Despite fatigue, my sleep isn't the greatest. First of all, lots of interruptions to pee, from the lithium. But also, that jittery feeling makes me not want to go back to sleep.
> >
> Noa--I'm so sorry to hear it. When's your next appointment with a psychiatrist? You mentioned something about apnea in another post. Could that be affecting your sleep, making you tired and feeling lousy. Could you have some kind of mild flu-like infection--thus the higher temperature. I doubt giving blood did anything. Did you ever think of trying an atypical neuroleptic like risperidone in micro doses?
>
> AbbyNoa, I hope you're feeling better soon. You have given others so much support and inspiration I hate to hear you're feeling bad.--Cindy W
Posted by torchgrl on February 11, 2000, at 23:52:13
In reply to Re: Feeling drugged, anxious, and a little depressed, posted by Cindy W on February 11, 2000, at 22:18:31
Noa,
Sorry to hear things aren't going so well right now. And I guess the more meds you take, the more possibilities there are for culprits... It *does* sound like there's some kind of noradrenergic component, causing the anxiety, not being able to go back to sleep when you wake up in the middle of the night. I don't remember much about my Serzone trial, but when I was discussing it with my doctor the other day, she went over her notes on it and remarked that at first it made me tired, then I started feeling speedy/anxious--perhaps you're following a similar route with it.
Posted by Renee N on February 12, 2000, at 1:24:33
In reply to Feeling drugged, anxious, and a little depressed, posted by Noa on February 11, 2000, at 18:48:32
> I had been feeling increasingly better until last week. Have been at current dose of lithium for about 6 weeks. Suddenly I feel sleepy all the time, like a drugged feeling, hard to keep eyes open, etc. But, the anxious, jittery feeling is still there--my left leg is always shaking.
>
> And I am starting to feel somewhat depressed, not in the usual way, Ibut overwhelmed because cannot motivate myself or muster up any energy.
>Noa,
I felt that way all the time when I started on Effexor XR. I still do, but I have slightly more energy. Seems I use it all up at work.> Is it my meds? Can this suddenly happen?
>
> Despite fatigue, my sleep isn't the greatest. First of all, lots of interruptions to pee, from the lithium. But also, that jittery feeling makes me not want to go back to sleep.
>
> Have been using cafeine to try to counteract the tiredness, but it seems to make me even sleepier. I think I will stop cafeine again.
>The caffeine doesn't do much for me. I stay up way too late, usually because I can't break away from here...
> About two weeks ago, I went to give blood at a work-based blood drive. My temp was 99.7 the first time, but the tech wanted to take it again, and the second time it was 99.4, which was acceptable (99.5 is the limit). Thing is, I usually run a low temp, altho maybe not with all these meds, esp. the thyroids. Could my sleepiness be related to that, even tho it was Jan. 24, which is almost two weeks ago? Could it be related to giving blood, which never bothered me before?
>
> Help. I feel lousy, and I don't know why.
>
> Fyi- my meds (in order of appearance in my life):
>
> effexor xr, 375
> cytomel, .0125
> synthroid, .025
> methylphenidate sr, 20 twice a day
> serzone, 225 at night
> lithium carbonate, 600 am and 600 pm
I don't know enough about your meds to be of any help in this regard. For someone who feels so down, it's amazing how much energy and thought you give to others feeling down. This gift you have should should be cherished and nourished. I think I can safely speak for all of us here to say we think you are wonderful...intelligent, caring, funny, perceptive, open...I could go on, but I see I've already got you blushing! Renee N
Posted by Alice on February 12, 2000, at 2:41:41
In reply to Feeling drugged, anxious, and a little depressed, posted by Noa on February 11, 2000, at 18:48:32
> I had been feeling increasingly better until last week. Have been at current dose of lithium for about 6 weeks. Suddenly I feel sleepy all the time, like a drugged feeling, hard to keep eyes open, etc. But, the anxious, jittery feeling is still there--my left leg is always shaking.
>
> And I am starting to feel somewhat depressed, not in the usual way, but overwhelmed because I cannot motivate myself or muster up any energy.
>
> Is it my meds? Can this suddenly happen?
>
> Despite fatigue, my sleep isn't the greatest. First of all, lots of interruptions to pee, from the lithium. But also, that jittery feeling makes me not want to go back to sleep.
>
> Have been using cafeine to try to counteract the tiredness, but it seems to make me even sleepier. I think I will stop cafeine again.
>
> About two weeks ago, I went to give blood at a work-based blood drive. My temp was 99.7 the first time, but the tech wanted to take it again, and the second time it was 99.4, which was acceptable (99.5 is the limit). Thing is, I usually run a low temp, altho maybe not with all these meds, esp. the thyroids. Could my sleepiness be related to that, even tho it was Jan. 24, which is almost two weeks ago? Could it be related to giving blood, which never bothered me before?
>
> Help. I feel lousy, and I don't know why.
>
> Fyi- my meds (in order of appearance in my life):
>
> effexor xr, 375
> cytomel, .0125
> synthroid, .025
> methylphenidate sr, 20 twice a day
> serzone, 225 at night
> lithium carbonate, 600 am and 600 pmHi Noa, this might be a little off the subject, but I didn't know you could give blood while on antidepressants! My mother always told me I couldn't. So it's ok? Also, I was on Lithium back when I was 13. It started off helping me, but when the dose was increased, I started having excruciating stomach pains (and even horrible diarrhea--yuck!) Then I just started getting really depressed again, so they took me off of it. I recently started taking Topomax, which really seems to help without stomach aches. Do you know, or does anyone who is reading this know, if that Topomax is the same type of drug as Lithium, or if it is prescribed for the same reasons?
Posted by JohnL on February 12, 2000, at 4:24:56
In reply to Feeling drugged, anxious, and a little depressed, posted by Noa on February 11, 2000, at 18:48:32
> I had been feeling increasingly better until last week. Have been at current dose of lithium for about 6 weeks. Suddenly I feel sleepy all the time, like a drugged feeling, hard to keep eyes open, etc. But, the anxious, jittery feeling is still there--my left leg is always shaking.
>
> And I am starting to feel somewhat depressed, not in the usual way, but overwhelmed because I cannot motivate myself or muster up any energy.> Help. I feel lousy, and I don't know why.
>
> Fyi- my meds (in order of appearance in my life):
>
> effexor xr, 375
> cytomel, .0125
> synthroid, .025
> methylphenidate sr, 20 twice a day
> serzone, 225 at night
> lithium carbonate, 600 am and 600 pmSorry it's not working better Noa. I hate to suggest it, but it doesn't seem to me Lithium is the one you were hoping for. Granted it can take longer than six weeks to help with some people. But still, at 6 weeks I would expect more obvious positive results if it was the right one. Sure Lithium works with a lot of people, and a survey of pdocs showed it was a top choice for augmentation, but with you it doesn't seem to be targeting whatever underlying problem exists. If it was, results would be better than they are by now. With some people Lithium works as fast as 48 hours. In those cases it is clearly hitting the nail on the head. In other cases when it misses the target, we have to wait for a trickle down effect that may or may not ever work.
Where to go from here? In your shoes I would discuss the following with my doctor:
1)Mark two weeks on the calendar and begin weening off Lithium if you haven't seen a dramatic improvement by then. Not a so-so improvement. If it's just so-so, forget it. It's not targeting the problem, and we're subjecting the body to unneeded drugs and side effects.
2)Try two or three antipsychotics, two weeks each, with a day or two washout inbetween. Try to get a prescription for short trials of all three in one visit. The idea is to look for a rapid improvement with one of them. That would indicate we're on-target. Up to now we're not on target. So it makes sense to me to look elsewhere. You haven't tried this class of drugs yet, and to me it has become a top priority to do so. Just as a sidenote, I read in a pharmacology book that a psychostimulant combined with a low dose antipsychotic is a wonderful combination when antidepressants aren't doing the trick. Your Ritalin will increase NE/dopamine function in parts of the brain where it's needed, but will also affect other parts where it's not needed. The antipsychotic will counterbalance this.
3)Try a two week trial of each of two other mood stabilizers. If the target is being hit, you'll know inside of two weeks. The longer the wait, the farther we are from the real underlying biological problem.And one final comment. I've mentioned this before, but I'm still suspect of the Serzone in your mix. When Serzone has adverse reactions in some people (including me), the description of those adverse effects sound exactly like what you are describing. Hopefully there might be some ideas here to help you. I sure feel for you. Talk about frustration. I am cheering for you! :) JohnL
Ditch the Lithium. Try antipsychotics.
Posted by Janet from Brazil on February 12, 2000, at 4:34:47
In reply to Feeling drugged, anxious, and a little depressed, posted by Noa on February 11, 2000, at 18:48:32
> I had been feeling increasingly better until last week. Have been at current dose of lithium for about 6 weeks. Suddenly I feel sleepy all the time, like a drugged feeling, hard to keep eyes open, etc. But, the anxious, jittery feeling is still there--my left leg is always shaking.
>
> And I am starting to feel somewhat depressed, not in the usual way, but overwhelmed because I cannot motivate myself or muster up any energy.
>
> Is it my meds? Can this suddenly happen?
>
> Despite fatigue, my sleep isn't the greatest. First of all, lots of interruptions to pee, from the lithium. But also, that jittery feeling makes me not want to go back to sleep.
>
> Have been using cafeine to try to counteract the tiredness, but it seems to make me even sleepier. I think I will stop cafeine again.
>
> About two weeks ago, I went to give blood at a work-based blood drive. My temp was 99.7 the first time, but the tech wanted to take it again, and the second time it was 99.4, which was acceptable (99.5 is the limit). Thing is, I usually run a low temp, altho maybe not with all these meds, esp. the thyroids. Could my sleepiness be related to that, even tho it was Jan. 24, which is almost two weeks ago? Could it be related to giving blood, which never bothered me before?
>
> Help. I feel lousy, and I don't know why.
>
> Fyi- my meds (in order of appearance in my life):
>
> effexor xr, 375
> cytomel, .0125
> synthroid, .025
> methylphenidate sr, 20 twice a day
> serzone, 225 at night
> lithium carbonate, 600 am and 600 pmDear Noa, Can't help with the meds. Just to say my thoughts are with you. Good Luck, Jan.
Posted by Noa on February 12, 2000, at 5:36:52
In reply to Re: Feeling drugged, anxious, and a little depressed, posted by JohnL on February 12, 2000, at 4:24:56
Thing is, John, I DO think the lithium has worked. In the weeks I have been on it, I have definitely seen a lot of improvement. It's just that suddenly I am feeling drugged/sleepy/sedated all the time.
As for the anxiety, I was tolerating it ok as long as my energy was coming back and I was feelign better. But with the onset of this drugged feeling, the anxiety is harder to take.
I also think some of the anxiety is psychological, having to do with my fear/panic about investing hope in the improvement only to be whallopped again by another major depressive episode, as I have so many times.
At the moment, a lot of my anxiety is about something similar--feeling discouraged about this loss of energy all of a sudden and feeling tired/sedated and not doing good work at my job. Also, some of the jitteriness seems to be a way of bringing in extra stimulation to my brain just to stay awake.
I really do need to stop the cafeine. I started a bad habit in past few weeks of drinking a lot of coca cola. As you know, I am thirsty all the time from the lithium, so you can imagine how much coke I can drink, where I used to stick exclusivelywith water. I have also started drinking different bottle juices, all of which have too much sugar. So my first step is to cut those out and see if it helps, and to cut out the coffee, too, which I had only started back on in the past 2 weeks. It is a bit of a chicken and egg question, but it is worth a try.
I also started lowering my serzone dose, although I need to tell my pdoc that. I usually don't make changes without consulting him first, but I really wanted to try this. I cut back just a tad--from 225 to 187.5. Although, I probably should try one change at a time, ie, wait till I get used to no cafeine again, and then decide if the decrease in serzone is warranted.
Another thing is, my pdoc did mention there is something I can take to prevent having to wake up to pee. I might ask him about this. I really miss the uninterrupted sleep, which I had only started having since starting apnea treatment in fall of 98. I really liked it--sleep had finally become satisfying.
Finally, I know I should start doing some exercise.
Posted by Phil on February 12, 2000, at 7:59:05
In reply to Re: Feeling drugged, anxious, and a little depressed, posted by Noa on February 12, 2000, at 5:36:52
Noa, No suggestions on meds but wanted you to know that I'm pulling for you, too.
I feel really angry at this disease and even more so about the hell we all have to endure to find the right mix of these hideous chemicals to feel better.
Phil
Posted by Noa on February 12, 2000, at 8:29:40
In reply to Re: Feeling drugged, anxious, and a little depressed, posted by Phil on February 12, 2000, at 7:59:05
Thanks to all for your support. I don't know what this sudden sleepiness is about, but the support I get here has been and continues to be a life saver for me, perhaps one of the important pillars of my treatment plan.
> I feel really angry at this disease and even more so about the hell we all have to endure to find the right mix of these hideous chemicals to feel better.
>
> PhilI agree, Phil. These meds are life savers, and I am so thankful for them, but they are a pain in the ass, too. Advanced as medicine is today, in a way we are in the same place humanity was centuries ago: the treatments themselves are toxic.
Posted by JohnL on February 12, 2000, at 10:31:14
In reply to Re: Feeling drugged, anxious, and a little depressed, posted by Noa on February 12, 2000, at 5:36:52
> Thing is, John, I DO think the lithium has worked. In the weeks I have been on it, I have definitely seen a lot of improvement. It's just that suddenly I am feeling drugged/sleepy/sedated all the time.
>Noa,
Sounds a little more complicated than I assumed. One has to hesitate about considering adding yet another drug, huh? Based on everything you've said so far, I think my vote now would be to keep the Lithium on board but ditch the Serzone. If nothing else, just to see how it goes. You can always get back on it if you discover it was doing something helpful. I've been suspect of it in your case all along though. Could be wrong, but there's only one way to find out. I wonder what your doc would think of lowering the Lithium a notch?
Posted by CG on February 12, 2000, at 10:46:25
In reply to Re: Feeling drugged, anxious, and a little depressed, posted by JohnL on February 12, 2000, at 10:31:14
Noa, the number of posts you have received certainly attests to your kindness and willigness to help others. Apparently you have touched many of our lives. I too hope the very best for you. Just ain't fair, is it???? It seems like I have read that folks with ADD respond to caffeine differently that others. It tends to sedate them. Probably too simplistic, but certainly worth a thought. I have never been dx'd with ADD, but I know that caffeine doesn't stimulate me, but rather slows me down. Also, I am with JohnL about the Serzone. It SUCKS! Here's hoping for quick resolve...CG
Posted by kelly on February 12, 2000, at 12:11:13
In reply to Feeling drugged, anxious, and a little depressed, posted by Noa on February 11, 2000, at 18:48:32
> I had been feeling increasingly better until last week. Have been at current dose of lithium for about 6 weeks. Suddenly I feel sleepy all the time, like a drugged feeling, hard to keep eyes open, etc. But, the anxious, jittery feeling is still there--my left leg is always shaking.
>
> And I am starting to feel somewhat depressed, not in the usual way, but overwhelmed because I cannot motivate myself or muster up any energy.
>
> Is it my meds? Can this suddenly happen?
>
> Despite fatigue, my sleep isn't the greatest. First of all, lots of interruptions to pee, from the lithium. But also, that jittery feeling makes me not want to go back to sleep.
>
> Have been using cafeine to try to counteract the tiredness, but it seems to make me even sleepier. I think I will stop cafeine again.
>
> About two weeks ago, I went to give blood at a work-based blood drive. My temp was 99.7 the first time, but the tech wanted to take it again, and the second time it was 99.4, which was acceptable (99.5 is the limit). Thing is, I usually run a low temp, altho maybe not with all these meds, esp. the thyroids. Could my sleepiness be related to that, even tho it was Jan. 24, which is almost two weeks ago? Could it be related to giving blood, which never bothered me before?
>
> Help. I feel lousy, and I don't know why.
>
> Fyi- my meds (in order of appearance in my life):
>
> effexor xr, 375
> cytomel, .0125
> synthroid, .025
> methylphenidate sr, 20 twice a day
> serzone, 225 at night
> lithium carbonate, 600 am and 600 pmI'm sorry to here that your down,&hope that you feel better soon.When i was on lithium it made me very jittery,& drugged up feeling but not at first.Lithium is successful w/ 60 to 70 prercent of the patients taking it,I wasn't one of them. Cafeine sounds like it could be the problem,or changing or diet.Good luck
Posted by CarolAnn on February 12, 2000, at 14:07:57
In reply to Feeling drugged, anxious, and a little depressed, posted by Noa on February 11, 2000, at 18:48:32
Noa, I'm so sorry you are feeling this way. I wonder, how long has it been since you had a complete physical? One of your other posts, in this thread, mentioned a lot of coke and sugary juices in the last couple weeks. Have you considered that maybe your problem is a blood sugar thing? The symptoms sound a bit like Adult Onset Diabetes. Or you could have developed chronic low-blood sugar. I don't know, it's just that I was struck by the fact that in the past couple of weeks your diet has included a lot of extra sugar, and now, lately, you are feeling so poorly. Just a thought. Good luck!CarolAnn
Posted by Noa on February 12, 2000, at 14:58:25
In reply to Re: Feeling drugged, anxious, and a little depressed, posted by CarolAnn on February 12, 2000, at 14:07:57
Thanks, everyone.
I don't know why I have been craving the sugary drinks lately. I did have my blood sugar checked right before starting lithium, which was December. It was normal. I had told my doc I was worried about diabetes because of all the weight I have put on over the years, especially the past few years. My weight is up real high, so it would be natural to worry about diabetes, but the blood test came back ok.
Still, I think I will first try to cut out the cafeine and cut down on the sugar. Then, I'll cut back more on the serzone if needed. I also need to look into checking if I am having any apnea events at the current air pressure. It is possible, with weight gain, that I need a slightly higher pressure to keep my airway open. I guess it is even possible that some of my meds are affecting muscle tone, which can affect apnea.
Why is everything so much work?
Posted by Noa on February 12, 2000, at 15:12:45
In reply to Re: Feeling drugged, anxious, and a little depressed, posted by JohnL on February 12, 2000, at 10:31:14
John, Serzone is a relatively minor player in my cocktail, certainly as an AD. It replaced trazodone as a sleep aid (because of the activation of the effexor) when the trazodone started to lose its effectiveness. My pdoc thought it would do both the sleep aid thing and add some AD effect as an adjunct to the effexor xr. It has worked fairly well for sleep, and definiely has calmed the myoclonus almost completely. Before the lithium, I was sleeping well, except when in a depressed episode.
Since the lithium, it is the peeing that wakes me up so much.
But why would I SUDDENLy start feeling this fatigue and drowsiness, after a number of good weeks? Do you think it could be the cafeine and sugar?
Posted by torchgrl on February 12, 2000, at 19:08:47
In reply to Re: Feeling drugged, anxious, and a little depressed, posted by Noa on February 12, 2000, at 15:12:45
> John, Serzone is a relatively minor player in my cocktail, certainly as an AD. It replaced trazodone as a sleep aid (because of the activation of the effexor) when the trazodone started to lose its effectiveness. My pdoc thought it would do both the sleep aid thing and add some AD effect as an adjunct to the effexor xr. It has worked fairly well for sleep, and definiely has calmed the myoclonus almost completely. Before the lithium, I was sleeping well, except when in a depressed episode.
>
> Since the lithium, it is the peeing that wakes me up so much.
>
> But why would I SUDDENLy start feeling this fatigue and drowsiness, after a number of good weeks? Do you think it could be the cafeine and sugar?I notice that, since I don't usually consume a lot of sugar, when I go on a binge (which for me would just be eating/drinking sugary stuff regularly for a bit), it really affects me. I have to make sure not to have any anywhere near bedtime, or it really affects my sleep. Caffeine also hits harder when I've been off it for awhile, but it feels like the sugar really does a number on me, so that could indeed be the culprit. Plus, it probably throws your blood-sugar levels all over the place, which could induce fatigue, I'd imagine. Why don't you just try eliminating most if not all of the sugary stuff and see if that helps, before making adjustments to an until-now effective meds regime? Although, as I mentioned before, Serzone seems to be able to go from sedating to activating in some people, so... If it's not serving as an AD, maybe you could try Ambien or Sonata to help with sleep...
More brainstorming.
Posted by Deb R on February 13, 2000, at 0:45:58
In reply to Re: Feeling drugged, anxious, and a little depressed, posted by Noa on February 12, 2000, at 15:12:45
> But why would I SUDDENLy start feeling this fatigue and drowsiness, after a number of good weeks? Do you think it could be the cafeine and sugar?Hey Noa,
Your symptoms of fatigue and drowsiness sound just like I get when my iron levels fall through the floor (as they regularly do). High caffeine doses stop the body absorbing iron, maybe you have an iron deficiency...sounds like a full blood test may be a good move (you said you had one before the starting the lithium, so it would be interesting to compare then and now.)
Donating blood as you did will also deplete your body a bit, so if your iron levels are low, that could bring on the fatigue. The leg jitters are what stick out in my mind though - the iron 'thing' is probably way off the mark, but I thought it was worth a post. Have you experienced leg jitters with any other meds you have taken in the past?
Anyway, you are a fantastic person and it saddens me to think you are having a rough trot at the moment. Hope things look up soon...best wishesDeb.
Posted by Noa on February 13, 2000, at 8:04:57
In reply to Re: Feeling drugged, anxious, and a little depressed, posted by Deb R on February 13, 2000, at 0:45:58
Deb, thanks. I think a blood test is in order. My friend suggested I might be hypothyroid because of the lithium. The last time my thyroid was checked it was good but that was immediately before starting lithium, which is known to cause hypothyroid. So, maybe my t3 and t4 doses aren't sufficient now? I'll have the iron checked, too. When I went to give blood, I noticed in the iron test that my droplet sank extremely slowly.
Posted by torchgrl on February 13, 2000, at 14:57:11
In reply to Re: Feeling drugged, anxious, and a little depressed, posted by Noa on February 13, 2000, at 8:04:57
> Deb, thanks. I think a blood test is in order. My friend suggested I might be hypothyroid because of the lithium. The last time my thyroid was checked it was good but that was immediately before starting lithium, which is known to cause hypothyroid. So, maybe my t3 and t4 doses aren't sufficient now? I'll have the iron checked, too. When I went to give blood, I noticed in the iron test that my droplet sank extremely slowly.
Noa,
I was just thinking of suggesting the thyroid test, after reading something about lithium affecting thyroid, particularly in women, on another board. That could be the answer!Re: iron deficiency, would that cause your blood to come out slowly? When I was participating in the rebox. study, I had to have several blood tests, and the 2 things that were notable were that it was difficult to find a vein, and that it took FOREVER to accumulate all the blood necessary for the tests. I have pretty low blood-pressure (about 94/60), so I kind of attributed it to that, but perhaps I should be thinking about iron, too...
Posted by Noa on February 13, 2000, at 19:33:21
In reply to Re: Feeling drugged, anxious, and a little depressed, posted by torchgrl on February 13, 2000, at 14:57:11
Don't know what happened to my post from a while ago...here is the gist:
Torchgirl, I think bp is related to the speed of the flow of blood when donating. It is not about iron.
I was refering to the iron test they do, in which they drop a droplet of blood into a blue solution and if it sinks, it has enough iron, if it floats, it doesn't. Mine eventually sank, but it took a long time.
Posted by Noa on February 14, 2000, at 19:29:40
In reply to Re: Feeling drugged, anxious, and a little depressed, posted by Noa on February 13, 2000, at 19:33:21
Just talked to my pdoc, who agrees that a test of thyroid is in order. He is faxing the order to the lab, so I'll go tomorrow.
The weekend was a total bust with me hibernating in my pjs. Then, I couldn't get myself up for work today, either. I just feel like a rag doll, no energy, no interest, no will. Just totally enervated and blah.
I am going to try to get myself to work tomorrow. We'll see....
Posted by Cindy W on February 14, 2000, at 20:32:58
In reply to Re: Feeling drugged, anxious, and a little depressed, posted by Noa on February 14, 2000, at 19:29:40
> Just talked to my pdoc, who agrees that a test of thyroid is in order. He is faxing the order to the lab, so I'll go tomorrow.
>
> The weekend was a total bust with me hibernating in my pjs. Then, I couldn't get myself up for work today, either. I just feel like a rag doll, no energy, no interest, no will. Just totally enervated and blah.
>
> I am going to try to get myself to work tomorrow. We'll see....
Noa, hope you have more energy soon, and that your pdoc is able to find out what is keeping you so low in energy. Hang in there!--Cindy W
Posted by dove on February 14, 2000, at 20:40:07
In reply to Re: Feeling drugged, anxious, and a little depressed, posted by Noa on February 13, 2000, at 8:04:57
Dear Noa, first I am pleased to see everyone supporting you here in babbleland. I know it is hard to tell if you're up or down, or for that matter, inside right versus inside out. You are so caring and thoughtful on a longterm daily basis. You're pretty amazing and I hope those labs get proccessed swiftly and You get a second wind, or is it the first wind we're still looking for... My best wishes to you, and thank you so much for all the time you put into babble, reaching out to all us lost souls, being a true friend. I will keep you in my prayers and in my thoughts. Here's hoping it's something simple like thyroid.
Lots of hope and good vibes going your way Noa.dove
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