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What helps depression fatigue?


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Ever since my first manic episode followed by months long depression, I've had varying levels of fatigue. It doesn't seem to go away. Frequently, I have fatigue spells where I'm forced to lie down and it is by far my most debilitating symptom, psychosis being #1. 

Besides diet, exercise, and supplements, what helps you all with depression fatigue? I've switched meds multiple times and they of course can be a contributing factor. I've been told that Wellbutrin can be stimulating and I'm wondering if certain meds can boost my energy. I'm on Lamictal and Abilify, recently switched from Invega. Thanks!

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Well, you're on Abilify, which tends to be stimulating for most people, but for some it can be sedating. Lamictal can be stimulating for some, but like Abilify, can be sedating for some too.

I'm not sure of your diagnosis, so it's hard for me to recommend a good medicine, but like @looking for answers said, Wellbutrin and stimulants are good. Also the eugeroics Nuvigil and Provigil would be good options if you can get your insurance to pay for them. Sometimes the SNRIs can be stimulating, the non-stimulant ADHD medication atomoxetine (which is an NRI) can be stimulating too, as well as higher doses of the secondary amine TCAs desipramine, nortriptyline, and protriptyline (which are all mostly NRIs) all have a tendency to be stimulating.

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@alen

 

Nuvigil really helps me out. I take 200 mg a day. Provigil didn’t work that well for me even when I was taking twice a day. I see a sleep dr for very mild sleep apnea and also very probable other sleep disorders. My test results were skewed because of the meds I take so the daytime sleep study’s test was inconclusive. In order to have a non skewed test results you’d need to go off all meds for I think she said 2 weeks. Hahahahaha, nope. Not happening. Luckily she didn’t insist I do this.

Anyway, I fell asleep but didn’t hit REM during the “naps” during the daytime study. Which we knew would happen but if I had that daytime study done it would make insurance have to cover the nuvigil or provigil. This is all according to my sleep dr. But *knock on wood* no problems getting the nuvigil covered by insurance yet. 

So to anyone out there who can’t get nuvigil or provigil prescribed talk to your sleep dr about trying a daytime sleep study just to see if it would help you get those meds covered by insurance. A nighttime sleep study isn’t a bad idea either. You might have mild sleep apnea too and not even know it! I know I was shocked! Not saying it’s for everyone, but if you meet certain criteria you might want to inquire about these studies and see a sleep dr specialist. 

Good luck! I know just how much it sucks to be so damn tired all the time!

Edited by Wonderful.Cheese
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Well, Abilify is the number one med that helps me, but since you are already on it then I suppose you have to look for something else. A lot of people like Wellbutrin, but it's strong norepinephrine action is something that I cannot tolerate. Finally, thee are stimulants such as methylfenidate and amphetamine. They can be very good for fatiue, but good luck getting a doctor to prescribe them.

How long have you been on Abilify and what dose are you taking? Abilify is a bit like an antidepressant in that it takes time to work. So you have to give it a few weeks before you can say it is working or not. And the dose is important. Abilify didn't start working for me until I hit 10 mg.

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@mikl_pls My diagnosis is Bipolar 1 with psychotic features. Also, I tried Nuvigil and it did not go well at all. Never trying that again. 

@Wonderful.Cheese I actually did a sleep study last year and no sleeping disorder was diagnosed. 

@jt07 I’m on the injection form at 400 mg, so 15 mg a day spread over a month. I’m going to switch to pill form this month. My first injection was October 18th. 

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Talking about my eating habits with my therapist made me realize that my fatigue is greatly exacerbated by my lack of appetite and my under eating...I am now working on trying to eat more. Sigh. My depression makes me so disinterested in food. 

Edited by alen
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On 11/5/2018 at 6:43 PM, alen said:

Talking about my eating habits with my therapist made me realize that my fatigue is greatly exacerbated by my lack of appetite and my under eating...I am now working on trying to eat more. Sigh. My depression makes me so disinterested in food. 

I tried Ensure-type drinks when I had trouble eating.  The vanilla-flavored ones went down easily.  Just be careful not to overuse them.  I got hypervitaminosis, which can cause problems.

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  • 3 weeks later...

What dose of Abilify? I'm on anywhere from 5 mg to 20mg depending on the situation (I can move up or down as needed) and if I take anything over 7.5 it usualy makes me tired. Right now I am on 15 because I am very hypo so we are trying to "keep it that way" and not go any higher "up" with the mania. I got a little silly a few days, so I took 20mg and it made me almost zombie like. So that may be your dose, not sure. It is for me. But to beat depression fatigue I have found that those Energy drinks wake me up. They keep saying they aren't healthy, and too much caffeine is bad for you but when you're depressed and you just need to get out of bed... it does help... 

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