[Laurenbean]

Hey guys, I’m a new cat to this forum. I’m feeling down and hopeless with doctors and medications and I know many of you feel similar.

Diagnoses: major depression, GAD, panic disorder, ADD (by another doc?). I’ve been seeing my current psychiatrist for about a year and a half and I feel frustrated. Over the course of 8 years I’ve tried the following SSRI’s: Paxil, Zoloft, cymbalta, Prozac, Wellbutrin and I’m currently on Lexeoro 30mg, abilify, ambien, and just added Modafinil. Has anyone had a similar combination to the one I’m on? My doctor just added Modanifil and got rid of the Wellbutrin (450mg) due to the fatigue I can’t seem to shake (I thinks it’s SSRI induced and maybe ADD related?) has anyone been on modafinil and an SSRI? Anyone feel ssri’s are too sedating? Any recommendations for medications to combat the fatigue. He wants me to check my thyroid and even asked if I’ve ever seen a neurologist....I was kind of offended as if he wrote off how I feel as not possible bc I seem treatment resistant. Maybe I’m just being over sensitive. Thanks to everyone who reads this or has any insight. I appreciate it more than you know

[zoiecat]

I don't know about the rest but I get terrible fatigue from SSRI's. When I was on Lexapro and or Zoloft years ago my doc gave me Wellbutrin to counteract the fatigue. I later learned the Wellbutrin was what gave me horrible vivid nightmares. Recently I was on Lexapro and Rexulti. The fatigue was so bad I quit the Rexulti a couple months ago and I have since quit the Lexapro as well. So far so good. I take one about every 5 days. I fear the SI will come back eventually and I will have to go back on but it is so nice to have a bit more energy. That is not to say I don't feel exhausted all the time just from the depression alone but it is still better. I hate the meds. I would be interested in something that would help as well. You said you have ADD, my friend gave me half an ADD pill for a few days when I started my meds and it really helped give me more energy. Are you on something for the ADD? I would think it would help as they are just basically uppers. I wish my doc would subscribe something like that. I just might go back on the Lexapro if she did. She does not yet know I quit the Lexapro. I don't' see her again until December. My T is aware though. Good luck to you.

[still_crazy]

Modafanil does help people in a number of psychiatric indications, or at least it seems to, based on limited research. Its been used for patients on stable tranquilizer treatment in psychotic disorders (helps apathy, fatigue, concentration; less risk of causing psychosis than Ritalin or amphetamines, less likely to see drug abuse, too...), and it can help with some problems people have both from depression and the drugs used to treat depression.

The downside is that such use is "off label" and the drug is more expensive than most of the more traditional stimulants (ritalin, focalin, the various amphetamines, etc.).

Some doctors are tightening down on their controlled substance prescribing. Others still regard Adult ADD/ADHD as a problem that responds best to the older stimulants (they do have more solid data behind them). Some doctors still use Ritalin and the amphetamines in some people w/ a diagnosis of depression ("uppers" were once the primary drugs for depression).

All I can say is...if you're having lots of difficulties with the psych drugs and you're not getting the results you're after, I would -personally- think about looking for a different doctor.

Hope this helps. I also hope things get better in your world.

[WildcatVet]

I never had a problem with sedation when I was taking antidepressants...just the opposite...they made me hypomanic. But when I started my BP meds I was extremely depressed...fatigued constantly...so my pdoc added Provigil and then Nuvigil (because he was giving me samples...these two drugs are $$$$$ and often not covered by Medicare or private insurance).
I loved the stuff! Gave me all day energy...without the jitters and racing heart rate... Hopefully it will do the same for you.
P.S. I also found out I was hypothyroid and Vitamin D deficient so added levothyroxine and a Vit D supplement to my combo.

[*Laurie*]

I think getting your thyroid checked is a great idea & you're fortunate to have a doctor who bothers with it. So many psych disorders are due to thyroid imbalance, but most doctors don't seem to want to deal with that.

As for SSRI's- in my experience, they are very sedating for most people. Not only sedating...they seem to drain away energy. It's an unfortunate side effect.

[Laurenbean]

Originally Posted by zoiecat

I don't know about the rest but I get terrible fatigue from SSRI's. When I was on Lexapro and or Zoloft years ago my doc gave me Wellbutrin to counteract the fatigue. I later learned the Wellbutrin was what gave me horrible vivid nightmares. Recently I was on Lexapro and Rexulti. The fatigue was so bad I quit the Rexulti a couple months ago and I have since quit the Lexapro as well. So far so good. I take one about every 5 days. I fear the SI will come back eventually and I will have to go back on but it is so nice to have a bit more energy. That is not to say I don't feel exhausted all the time just from the depression alone but it is still better. I hate the meds. I would be interested in something that would help as well. You said you have ADD, my friend gave me half an ADD pill for a few days when I started my meds and it really helped give me more energy. Are you on something for the ADD? I would think it would help as they are just basically uppers. I wish my doc would subscribe something like that. I just might go back on the Lexapro if she did. She does not yet know I quit the Lexapro. I don't' see her again until December. My T is aware though. Good luck to you.

thanks for responding! I was on Adderall and then vyvanse for a while through my general practitioner. Like you, I really wanted to be on it for the fatigue/depression rather than ADD because I find they help so much with energy. It is odd that they don't look into prescribing them more for depression though, there is that abuse problem with some. Any luck with your doc? Are you still off of the Lexapro? How are you feeling?

[Laurenbean]

Originally Posted by WildcatVet

I never had a problem with sedation when I was taking antidepressants...just the opposite...they made me hypomanic. But when I started my BP meds I was extremely depressed...fatigued constantly...so my pdoc added Provigil and then Nuvigil (because he was giving me samples...these two drugs are $$$$$ and often not covered by Medicare or private insurance).
I loved the stuff! Gave me all day energy...without the jitters and racing heart rate... Hopefully it will do the same for you.
P.S. I also found out I was hypothyroid and Vitamin D deficient so added levothyroxine and a Vit D supplement to my combo.

Unfortunately, I just had a full blood work panel done and nothing significant showed. I mean, that's great! But it does obviously explain my fatigue so its tough. Did you find a difference between the Provigil Vs. Nuvigil? He upped my Provigil to 200mg last week but Im still crashing by about 3PM (although it has helped some). I'm not sure if he will want me to give up on the Provigil entirely or up the dose again, this time to 200mg morning, 200 mg afternoon? What was your dosing? I'm curious because I'm wondering if I should ask about Nuvigil if it is much different Thanks for any insight

[still_crazy]

hi. amphetamines and ritalin -were- the standard treatments for many forms of depression, until the FDA and DEA cracked down. Now, a lot of people who would have been diagnosed w/ some form of depression are given a label of ADD/ADHD, and still given amphetamines. Its...stoopid, lol.

some doctors still use the old school stimulants in mood disorders, so its no unheard of, even today. sometimes, wellbutrin is used w/ other antidepressants, to combat lethargy, apathy, fatigue. doesn't always work, but it does seem to help some people, some times.

sorry about your situation. this is...the state of psychiatric 'treatment' in the 21st century, lol.