Fatigue From Lithium or What?

[C.Layne]

I was diagnosed with Bipolar disorder and OCD. I've been taking Effexor XR 150mg (Only for about 2 weeks maybe), and my pdoc recently added 150mg Wellbutrin. I also take up 30mg of Propranolol a day and my lithium was recently increased to 1200mg. Also, 50mg of Trazodone at night. I've been sleeping 10-12 hours and it's very difficult to get out of bed, and my eyes tend to be slightly sore and I have a good amount of fatigue throughout the day. I am just curious to what you guys think is causing that and if it is the lithium will it go away? I requested Provigil but my pdoc thinks that it's not good for a Bipolar person, or it'll cause me to have a heart attack. I also decided I'll start taking my Effexor at night to see if that makes a difference.

[melissaw72]

Can your pdoc cut back on the trazadone or propranolol?  Also, I am on Provigil (for narcolepsy) and it really helps ... and I am SZA and have not had a heart attack from it.

[MiaB]

I've been on lithium for some years and can't recall fatigue being one of the major side effects.  Instead, I battle with cognitive issues, like word-finding ability.  That's not to say that it's not the source of your current problem, just that it's not been part of my experience.  My suggestion would be to speak to your pdoc, and also ask that s/he consider whether or not it's actually the Trazadone that's doing this to you.  It's also a possibility that you might need to have your lithium levels checked, since you've just recently had an increase.

 

I'm moving this to the side effects board, so that more people will hopefully respond.

[C.Layne]

miab, on 08 Apr 2014 - 08:48 AM, said:miab, on 08 Apr 2014 - 08:48 AM, said:

I've been on lithium for some years and can't recall fatigue being one of the major side effects.  Instead, I battle with cognitive issues, like word-finding ability.  That's not to say that it's not the source of your current problem, just that it's not been part of my experience.  My suggestion would be to speak to your pdoc, and also ask that s/he consider whether or not it's actually the Trazadone that's doing this to you.  It's also a possibility that you might need to have your lithium levels checked, since you've just recently had an increase.

 

I'm moving this to the side effects board, so that more people will hopefully respond.

 

 

sylvan, on 08 Apr 2014 - 09:42 AM, said:sylvan, on 08 Apr 2014 - 09:42 AM, said:

 

C.Layne, on 07 Apr 2014 - 6:08 PM, said:C.Layne, on 07 Apr 2014 - 6:08 PM, said:

I was diagnosed with Bipolar disorder and OCD. I've been taking Effexor XR 150mg (Only for about 2 weeks maybe), and my pdoc recently added 150mg Wellbutrin. I also take up 30mg of Propranolol a day and my lithium was recently increased to 1200mg. Also, 50mg of Trazodone at night. I've been sleeping 10-12 hours and it's very difficult to get out of bed, and my eyes tend to be slightly sore and I have a good amount of fatigue throughout the day. I am just curious to what you guys think is causing that and if it is the lithium will it go away? I requested Provigil but my pdoc thinks that it's not good for a Bipolar person, or it'll cause me to have a heart attack. I also decided I'll start taking my Effexor at night to see if that makes a difference.

If I were to bet, I'd bet on it being Trazodone and maybe propranolol. Trazodone is regularly used as a sleep med. Propranolol, being a beta blocker, will cause your heart rate to be slower and that might lead to some fatigue.

Also, could it be possible that the Li is helping to control the mania and maybe you're worn out from being manic and your body is needing the sleep? Just an idea.

I've tried Nuvigil. IMO, it's highly overrated. I got a 90 day supply and I bet I've got 80 of them left. It didn't do much for me and wasn't even worth taking.

It appears that you're on three ADs: Trazadone, Wellbutrin, and Effexor. Is this true? It is highly unusual for someone that is BP to be on this many ADs. I'd be scared to death of it flipping me into mania. Wellbutrin alone makes me speedy for the first few weeks. I couldn't take Effexor at all. I tried Trazadone for sleep--wasn't worth taking for me because of the rebound.

Also, as miab suggested, you should get a new blood test to get your Li level after the change in dose.

 

 

Yes, that is true. I take three AD. Lately I've been cutting the Trazodone down to 25mg. I haven't been feeling very manic or anything perhaps because of the lithium? Last time I took Effexor was without a mood stabilizer and it sent me into a bad manic state, but I wasn't aware of bipolar disorder or anything at the time. I haven't been taking the propranolol lately so It must be the trazodone. I also switched Effexor to a pm dose but haven't noticed much of a difference I am wondering if I should switch that back to AM and how is that done correctly? Every night I feel like I go through hell and back because of these strange dreams that honestly leave me with bizarre emotions towards people that were in the dream, I wake up feeling a little more different every day. I had went into a super bad depression after I quit all my meds in Dec. and coming back out of it slowly has been a tough one.

 

I talked to my doc and they suggested it was either the trazodone or perhaps the propranolol but I was having it before the propranolol. I need the trazodone to fall asleep and if I was to be done with the Trazodone what would you guys recommend? My doc told me there wasn't really anything better to get me to REM sleep, but he's just basic fam doctor or a PA actually. He once tried putting me on 175mg of Effexor twice daily, and pharmacy was annoyed because they don't even make that, and had to make a bunch of phone calls and got it started at 37.5. Another time he put me on 250mg twice a day of Lamictal to start and that put me in the hospital twice from feeling like shit and I had a rash that covered my entire body eventually. The hospital said it was suppose to be at 25mg twice a day not 250mg but I would've had the hypersensitivity nonetheless. Sorry for getting off topic but just giving some background to my PA. So is there a better sleeping pill that gets me to REM?

 

I am disappointed Nuvigil was not that great. But I heard there's a pretty good difference between Nuvigil and Provigil some say Pro works a lot better, but it still sounds like that's a big no no from my doctors.

 

@Mia I had my Lithium levels checked at 1200mg and my doctors are going to leave me at that because it will get toxic any further is what they told me, I believe it was slightly below where they wanted me.

 

My family doctor and psychiatrist and another psychiatrist met up for lunch and they discussed me, they recently have been discussing putting me on a stimulant because my pdoc thinks I may have slight ADD that's why he put me on Welbutrin for now until Bipolar symptoms are subdued. What do you guys think of that?

Edited April 14, 2014 by C.Layne