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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by bram on March 2, 2004, at 0:42:45
I have a problem with lack of motivation and difficulty getting up in the morning. This happen after two weeks of taking any SSRI including Effexor. This is called a late onset side effect.
To counter attack this I tried stimulants, modafanil, mirapex but nothing seemed to work. Also non SSRI do not work for my depression. So I have one choice: relief from depr. or this extreme laziness in the morning that ruined my life.
I would like to know if anybody had the same problem and what they did about it.
Thanks
Posted by PeggyY on March 2, 2004, at 11:13:02
In reply to Lack of motivation due to SSRI's, posted by bram on March 2, 2004, at 0:42:45
Torque
I have experienced the lack of motivation in the morning for most of the winter. I am on prozac. My doctor recently put me on Keppra and Welbutrin. I haven't yet seen the effects of Keppra, but the Welbutrin is a definitely more of a stimulant. It makes me feel more energetic (curbs my appetite too, just a side benefit). Yesterday was sunny and I actually got out and walked a few miles. I haven't done that in months. My suggestion is Wellbutrin.
Peggy
Posted by PeggyY on March 2, 2004, at 11:14:29
In reply to Lack of motivation due to SSRI's, posted by bram on March 2, 2004, at 0:42:45
OOPs, meant to post to Bram, sorry
Posted by bram on March 2, 2004, at 12:27:59
In reply to Re: Lack of motivation due to SSRI's, posted by PeggyY on March 2, 2004, at 11:13:02
Peggy,
Thank you for your suggestion. I already tried Wellbutrin w/ no result. Only the SSRI seem to work for me. That would be the ideal medicine if it didn't make me feel so lazy to do anything in the morning.
By the way what's Keppra for.
Bram
Posted by SLS on March 2, 2004, at 12:32:14
In reply to Lack of motivation due to SSRI's, posted by bram on March 2, 2004, at 0:42:45
> I have a problem with lack of motivation and difficulty getting up in the morning. This happen after two weeks of taking any SSRI including Effexor. This is called a late onset side effect.
> To counter attack this I tried stimulants, modafanil, mirapex but nothing seemed to work. Also non SSRI do not work for my depression. So I have one choice: relief from depr. or this extreme laziness in the morning that ruined my life.
> I would like to know if anybody had the same problem and what they did about it.
> Thanks
I'm currently taking Zoloft 200mg. I've been on it for a few months now. I have not seen any reduction of motivation in the same way I experienced on Lexapro. Unfortunately, it's not doing much for depression.
- Scott
Posted by bram on March 2, 2004, at 12:49:06
In reply to Re: Lack of motivation due to SSRI's, posted by SLS on March 2, 2004, at 12:32:14
Scott,
Zoloft was the only SSRI that didn't work for me. I took up to 100 mg. I don't want to dicourage you. People respond differently to this kind of meds.
Posted by PeggyY on March 2, 2004, at 12:57:37
In reply to Re: Lack of motivation due to SSRI's » PeggyY, posted by bram on March 2, 2004, at 12:27:59
Bram
I am diagnosed as Bi-polar. Keppra is supposed to be a mood stabalizer. My dr said it would also help with anxiety.
I wasn't suggesting Wellbutrin alone. I tried that and it didn't work for me. However, I take the Wellbutrin in combination with my SSRI. I don't respond without those either. Wellbutrin is supposed to counteract some of the side-effects of SSRI's specifically the sexual side effects.
It works for me, at least that is my experience.I know everyone is different. I am also amazed at the different reactions people have reported here on the same medications. Everyones situation is different.
Posted by Bill LL on March 2, 2004, at 14:24:39
In reply to Lack of motivation due to SSRI's, posted by bram on March 2, 2004, at 0:42:45
Which antidepressant do you take? Clinical trials have shown that Modafinil (Provigil) works with most SSRI's except that it generally does not work very well with Celexa. Since it does not work with Celexa, it might not work with Lexapro since Lexparo is related to Celexa.
If you are on Celexa or Lexapro, you might consider a different SSRI along with Modafinil.
Another suggestion is to take Wellbutrin. As someone else said, although it might not work well for you alone, it might help if taken along with another antidepressant.
Posted by KathrynLex on March 2, 2004, at 16:05:54
In reply to Re: Lack of motivation due to SSRI's, posted by Bill LL on March 2, 2004, at 14:24:39
Hi Bill,
I take 15 mgs of Lexapro and have been thinking about adding Wellbutrin. Can I ask why you started taking Wellbutrin and what kind of side effects you experienced?
I'm interested in trying it becuase while I love Lexapro, its made me very lethargic.
K.
> Another suggestion is to take Wellbutrin. As someone else said, although it might not work well for you alone, it might help if taken along with another antidepressant.
Posted by bram on March 2, 2004, at 23:31:26
In reply to Re: Lack of motivation due to SSRI's, posted by Bill LL on March 2, 2004, at 14:24:39
Yes Bill. I took Modafanil w/ Effexor but didn't solve the problem. Effexor worked well and improved my social anxiety too. I decided to stop Effexor hoping that depression won't come back then I had withrawal effects the next day (75mg).
Now I'm taking Lexapro and Clonazepam 0.25 mg (5 years) that I'm trying to quit but fear the bad withrawal effects that I experienced before for 3 weeks or so.
Posted by Donia on March 3, 2004, at 0:53:34
In reply to Re: Lack of motivation due to SSRI's » Bill LL, posted by bram on March 2, 2004, at 23:31:26
Hi, I just posted down lower on the board about fatigue and lexapro. I have no energy and am always napping. I was wondering if anyone knows anything about the new non prescription for fatigue called Altovis. I would like to try it and wonder if it is ok to take with lexapro. If anyone knows anything please let me know.
Donia
Posted by Bill LL on March 3, 2004, at 9:20:29
In reply to Re: Lack of motivation due to SSRI's » Bill LL, posted by KathrynLex on March 2, 2004, at 16:05:54
I started Wellbutrin about 6 weeks a go while on 30 mg Lexapro. I now take 25 mg Lexapro with 150 mg Wellbutrin XL.
The reason I started Wellbutrin was to help with ADD symptoms. I felt hper from the Wellbutrin the first week, but I now have no bad side efects from it.
The Wellbutrin has definitely helped with focus, and also helps with the tiredness.
It also has given me some degree of relief from the sexual side effects of Lexapro for 2 reasons. By itself, the Wellbutrin helped. And then after a couple of weeks on it, it allowed me to decrease the dose of Lexapro.
My depression is pretty much non-existent, at least for now.
Posted by Bill LL on March 3, 2004, at 9:31:53
In reply to Re: Lack of motivation due to SSRI's, posted by Donia on March 3, 2004, at 0:53:34
I copied this from the Altovis website:
Altovis Proprietary Blend:
Green tea leaf extract (provides 100 mg caffeine) cordyceps extract (mycelium), Eleutherococcus senticosus/Panax ginseng standardized extracts (root), vinpocetine (from vocanga tree seeds), and octacosanolIf I'm not mistaken, Panax ginseng is the same as Siberian Ginseng. The good thing about Siberian Ginseng is that it generally does give energy after a month or so of use. Dr. Weil (a reputable physician who writes about herbs) recomends Panax Ginseng, but he cautions that it can cause jitteriness which may not go away with prolonged usage. He says that American Ginseng does not cause jitteriness, but it doesn't give as much energy.
I'm not very familiar with the other ingredients.
Posted by catcrazycarmen on March 3, 2004, at 11:44:19
In reply to Lack of motivation due to SSRI's, posted by bram on March 2, 2004, at 0:42:45
Effexor had the same affect on me. I just wanted to sleep all the time and mornings were awful. Like you, SSRI's seem to be the only ones that work for me. Zoloft has always worked the best for me although it does totally destroy my libido. I'm thinking of switching to Lexapro to see if the sexual side effects are any less. But I'm starting to wonder if all SSRI's are going to have this affect on me. I tried Wellbutrin and it didn't have the sexual side effects but it made me an extremely irritable raging bitch!
Posted by Donia on March 3, 2004, at 17:43:07
In reply to Re: Lack of motivation due to SSRI's, posted by Bill LL on March 3, 2004, at 9:31:53
"Dr. Weil (a reputable physician who writes about herbs) recomends Panax Ginseng, but he cautions that it can cause jitteriness which may not go away with prolonged usage."
So, does this mean if you take it for a while and you are jittery, that even if stop taking it you will still be jittery? Like an effect that wont go away even if you stop taking it?
Donia
Posted by Bill LL on March 4, 2004, at 9:22:41
In reply to Re: Lack of motivation due to SSRI's, posted by Donia on March 3, 2004, at 17:43:07
No. He specifically said that it goes away when you stop taking it.
> "Dr. Weil (a reputable physician who writes about herbs) recomends Panax Ginseng, but he cautions that it can cause jitteriness which may not go away with prolonged usage."
>
> So, does this mean if you take it for a while and you are jittery, that even if stop taking it you will still be jittery? Like an effect that wont go away even if you stop taking it?
> Donia
Posted by interject79 on March 5, 2004, at 22:02:07
In reply to Re: Lack of motivation due to SSRI's, posted by Donia on March 3, 2004, at 0:53:34
It probably is okay to take with Lexapro, but the benefits might not be all that great. Fatigue can be a persistent side effect of SSRIs at certain strengths. Lexapro (and Celexa) is known to be sedating as is Paxil. Prozac is often more activating, as is Effexor. Zoloft can be slightly activating. But I've found that 'activating' when referring to an SSRI is a misnomer, unless you become hypomanic or manic.
SSRIs seem to have an antagonistic impact on dopamine (perhaps dopamine receptors) and even acetylcholine--even if it's an indirect one--so it is difficult to rid oneself of the fatigue. Your doctor might have suggestions for augmenting or lowering your dosage. However, IMO SSRIs shouldn't be utilized indefinitely. I believe they work best in acute circumstances, then very gradually and safely tapered.
Best,
interject
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