# Social Anxiety/Depression Medication to fight Lethargy



## TyrosineKinase (Jan 20, 2010)

Hey, I just recently went to the psychiatrist again. My Wellbutrin dosage was increased to the max dosage, to see if it would help with the intense lethargy/low motivation/low energy/extreme tiredness associated with depression. I was previously on 300mg dosage for around 6 months. He wanted to try Effexor next if this didn't work.

I asked about being prescribed either Dexedrine, Adderall, Vyvanse, or Ritalin to help combat these symptoms but, as expected, my psych refused.

His rationale was as follows... since he was treating me for depression and not ADHD, he could not prescribe the above medications.

I explained to the psych everything, including the crumbling of my relationships with friends/girlfriend, inability to do activities due to always sleeping and lethargy, etc.

My question is for those who also experience the lack of energy aspect of depression/social anxiety disorder, what sort of medication could be possibly prescribed to combat this, besides the ADHD medications? I can't continue waiting another year and a half trying more anti-depressants when they obviously aren't helping in this regard.

I already tried caffeine, yohimbine, and nicotine.

Thanks


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## crayzyMed (Nov 2, 2006)

Provigil or trivastal may be good options.


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## mike8803 (Feb 21, 2010)

Find a new p doc


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## crayzyMed (Nov 2, 2006)

mike8803 said:


> Find a new p doc


Another option lol.


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## TyrosineKinase (Jan 20, 2010)

Does anyone know if these are difficult to obtain medications like the ADD meds are notorious for?

This is something that I have been discussing with my therapist for quite some time. I don't really like asking about medications because I have this kind of 'irrational' notion that the doctor would think I'm trying to get the medication for other uses besides treating depression and social anxiety, since I am a college student.

Thanks


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## crayzyMed (Nov 2, 2006)

TyrosineKinase said:


> Does anyone know if these are difficult to obtain medications like the ADD meds are notorious for?
> 
> This is something that I have been discussing with my therapist for quite some time. I don't really like asking about medications because I have this kind of 'irrational' notion that the doctor would think I'm trying to get the medication for other uses besides treating depression and social anxiety, since I am a college student.
> 
> Thanks


Why dont you get tested for ADHD? Seems like the easiest route to get stimulants. You seem to have alot of ADD symptons.


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## TyrosineKinase (Jan 20, 2010)

Hey CrayzyMed,

I asked my psychiatrist about this but he said he saw no evidience of me having adhd. He told me that if you didn't have it as a child then you don't have it as an adult. He said it doesn't just 'spring up' in adulthood from nowhere.

He said that the only way he would consider perscribing these medications was if my parents came in and explained my childhood or I showed him report cards from elementary, middle, and highschool. The problem with this is that I never received anything lower than an A and my teachers only said positive things about me on these report cards so there would be nothing there to suggest that I had ADHD.

Basically he said that he's treating me for depression and depression is causing these ADHD like symptoms.


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## TyrosineKinase (Jan 20, 2010)

In addition, what I don't understand is why is it not possible to prescribe these medications if they deal with the symptoms that are affecting my relationships and making my life worse? Anti-depressants are only exacerbating the effects. I don't see the downside of prescribing stimulants when my therapist, who is a drug addiction specialist, himself says that I display no addiction tendencies. ie. I refuse to drink alcohol or smoke or other recreational drugs and haven't abused the benzos I have been prescribed.

These stimulants seem to deal with the exact problems that I am having, while the anti-depressants deal with none of them.

He had a response to this when I posed this very question to him. I can't remember what he said exactly but he made some sort of comparison to taking Tylenol for symptoms while not addressing the illness itself. I responded that I am willing to still take the Wellbutrin combination with the stimulant as I know this is what some people do, but he still refused.

My life's falling apart around me and I find a medication that addresses the exact problems I'm experiencing while I wasted time on medications that addressed none of them, and being refused said medication, I became extremely frustrated and had to go to the emergency room the night of the psychiatrist visit for lung spasms from a panic attack and extremely high heart rate (I forget the term they had for me there, it had 3 letters in it and it started with a 's' or a 'c'.)

I guess I sort of lost hope on the medication end because I know that I'm just going to end up trying other anti-depressants knowing that none of them are really going to do anything for me in regards to these symptoms, which is a huge deal because it's all for nothing if the social anxiety issues are addressed if I'm physically and mentally unable to deal with the activities involved in social settings.


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## CopadoMexicano (Aug 21, 2004)

TyrosineKinase said:


> My question is for those who also experience the lack of energy aspect of depression/social anxiety disorder, what sort of medication could be possibly prescribed to combat this, besides the ADHD medications?
> Thanks


 Taurine, L-Theanine, or energy drinks.


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## TyrosineKinase (Jan 20, 2010)

They don't work.

I already discussed these options with both the therapist and psychiatrist and tried them along with dietary changes.


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## meyaj (Sep 5, 2009)

Speaking as somebody who takes d-amphetamine daily, I'm not sure it's exactly what you're looking for. Sure, you feel alert while under the acute effects of the stimulant, but then afterwards you're even worse than baseline. Ideal for moments of fatigue and lethargy, but not so much the chronic, 24/7 type, in my opinion, which I also deal with. Being constantly under the influence of a stimulant isn't practical either. In my experience, a proper antidepressant is the best way to really inject some energy and alertness into your lifestyle as a whole.

Which antidepressants have you tried? The SSRIs, IMO, are worthless in this regard. By FAR the most effective at combating symptoms like these for me was a noradrenergic tricyclic called nortriptyline. It's moderately anticholinergic so you take it before bed (and you will sleep like a baby, but not feel hungover), and I've never felt so refreshed in the morning nor have I ever had nearly as much daytime energy as I did on nortriptyline. Much better than stims, as far as I'm concerned, if this is your goal. Best thing of all is that you get to reap the benefits ALL DAY, EVERYDAY, rather than short periods of stimulation followed by crashes, as well as fighting to keep tolerance down by taking entire days off. Dry mouth was my only real side effect, but stimulants are even worse for this anyways.

I've got several very severe issues, and it wasn't adequately dealing with all of them so I had to move on to an MAOI, but I'm very slowly working up my dose on it. Once I'm at the max, I hope to incorporate notriptyline back into the mix, as it was a fantastic drug experience for me, the best I've tried so far, and I STRONGLY recommend giving it a shot before you go doctor-shopping for stims. Can't guarantee it will work for you in particular but I seriously can't think of any benefits to going with stims for this if there's a chance nortriptyline could work. I hope you consider trying it, and if you do, don't give up on it until you're at about 150mg daily.


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## Arisa1536 (Dec 8, 2009)

Um well i think its rude your Psychiatrist flat out refused a stimulant like ritilan but they do that 

try a benzo, it picks you right up
well not clonazepam or Valium but the faster acting ones are great for that
the only thing is doctors get funny about it, however if u have never abused them or taken them before you should be able to get them
they stop the lethargy anyway

ones like
Lorazepam
Xanax
Olazepam
Temazepam 

ETC or even pop a zopiclone (it used as a sleep aide but gives me heaps of energy)

Tip: if u take a benzo with a strong cup of coffee you will feel the effects much sooner and have energy and be wide awake That is if its a short fast acting one

i am on clonazepam and they do the opposite of give me energy so do not go on them for this problem


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## meyaj (Sep 5, 2009)

^
wat


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## TyrosineKinase (Jan 20, 2010)

Thanks for the input Meyaj. I'll ask my psych about that medication during my next visit which should be in a little less than a month to give my current dosage time to notice the effects. I do feel skeptical about this, however, since Wellbutrin was supposed to help with this very thing and has done nothing in this regard.

I was first put on Zoloft. I used this for months up until the max dosage.
Then I went on Cymbalta, then Celexa, then Wellbutrin. After that I was prescribed a combination of Wellbutrin and Celexa. Now I am on the max dose of just Wellbutrin.

My original reasoning behind taking the psycho stimulant route was similar to the reasoning why I was prescribed Benzos (on an as needed basis). My anxiety is very severe but also very episodic so I take the Xanax to get me through those times. However, my energy and lethargy issues are mostly ongoing. But when the times arose that I needed the mental/physical energy to do something (ie. go out and do an activity with my girlfriend), I would use the stimulant. Does that make any sense or am I being confusing, haha? In a nutshell it seems like the psycho-stimulants could do for the moments I needed to do an activity as the benzos could do for the moments I needed to avoid a panic attack and be social. 

Coming from someone who has used stims, is that typically how they work?

And Arisa, I already stated in my post that I have been on Benzos for over a year and a half. In addition, I have no idea how they are "picking you right up" considering they make me and everyone else I know extremely tired... you know... considering it's a sedative and hypnotic.


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## Ehsan (Mar 21, 2009)

i suggest L-DOPA. it will do all of those for you.
i used to oversleep before but now i ave some problem with little sleep time and increased energy!


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## jenladell (Mar 18, 2010)

Lipo-6 gave me a lot of energy, but maybe a little too much, and if you already have a decreased appetite then it wouldn't be a good idea. 
http://www.nutrex.com/nutrex/lipo6.asp

I saw you've tried other supplements, but maybe Ginseng would work for you. I just take it whenever I need to and it makes me feel much better and able to be productive. 
http://www.bodybuilding.com/store/now/gin.html

Either way, I hope you find something that works, and that your doc eventually comes around!


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## Arisa1536 (Dec 8, 2009)

i thought this thread was meant to encourage people not pick on someone who is trying to help you out
so both of you are being very rude TyrosineKinase and meyaj


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## meyaj (Sep 5, 2009)

Arisa1536 said:


> i thought this thread was meant to encourage people not pick on someone who is trying to help you out
> so both of you are being very rude TyrosineKinase and meyaj


Actually this thread is meant to give the OP some good suggestions, which I did, and in fact, TyrosineKinase started it so he'd probably know best. Your post was just the opposite of everything that is common knowledge in medicine, it was nonsensical. Perhaps I was a bit rude, but TyrosineKinase was just pointing out the obvious.

Then again, you also called doctors "rude" just because they're not your personal drug dispenser and won't just give you anything you ask for, so maybe your definition of rude is just anything that offends your sense of entitlement. With a lot of posts like this I'd just bite my lip, but you're 25 and have the attitude of a pre-teen girl...


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## Arisa1536 (Dec 8, 2009)

meyaj said:


> Actually this thread is meant to give the OP some good suggestions, which I did, and in fact, TyrosineKinase started it so he'd probably know best. Your post was just the opposite of everything that is common knowledge in medicine, it was nonsensical. Perhaps I was a bit rude, but TyrosineKinase was just pointing out the obvious.
> 
> Then again, you also called doctors "rude" just because they're not your personal drug dispenser and won't just give you anything you ask for, so maybe your definition of rude is just anything that offends your sense of entitlement. With a lot of posts like this I'd just bite my lip, but you're 25 and have the attitude of a pre-teen girl...


You are a nasty person, for someone with social anxiety i would expect a little sympathy, i mean first you tell me off for taking zopiclone through the day which is MY choice, then you gang up on me in this thread and secondly i was unaware it was an offense to call a doctor rude, i mean the thread did not suggest to me that the main poster here was happy with his doctor, i was on his side, further more you insulted me and called me a pre teen girl, well forgive me but you should know that people with anxiety issues and sorts suffer intense paranoia and other such things, i would have thought you of all people would be less judgmental


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## TyrosineKinase (Jan 20, 2010)

-Arisa-

Meyaj and I weren't being rude at all. Benzos by definition and by my experience don't give energy. That's all I was saying; I wasn't writing in an ill-tone towards your post. I'm sorry you took it that way.

-jenladell-

Thanks for the recommendation. However, before I was deemed clinically depressed I used to be into weight lifting and body building. So I am all to familiar with the fat burners on the market and have tried all the ingredients in them while suffering from depression to try to combat the lethargy and low energy aspect. However, nothing on the supplement end of things works, which is why I'm trying the prescription route now.


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## Arisa1536 (Dec 8, 2009)

thats alright TyrosineKinase you did not insult me for the whole SAS forum to see, i just misread your post and for that i apologize


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## meyaj (Sep 5, 2009)

Arisa1536 said:


> You are a nasty person, for someone with social anxiety i would expect a little sympathy, i mean first you tell me off for taking zopiclone through the day which is MY choice, then you gang up on me in this thread and secondly i was unaware it was an offense to call a doctor rude, i mean the thread did not suggest to me that the main poster here was happy with his doctor, i was on his side, further more you insulted me and called me a pre teen girl, well forgive me but you should know that people with anxiety issues and sorts suffer intense paranoia and other such things, i would have thought you of all people would be less judgmental


I never told you off for taking zopiclone through the day. I said that I had tried it once and had total amnesia because of it, so that I found it to be a poor choice. There was nothing unreasonable about what I said.

I have very severe social anxiety, depression, generalized anxiety, etc, to the point where I am surviving on government disability right now, so of course I understand how hard it is.

But using our condition to rationalize spoiled child-like behaviors and attitudes is the kind of thing that is a known BARRIER to treatment. It's known as a secondary gain, and we might not even realize it, but it allows us to become comfortable with our situation because it allows us to get away with things we otherwise wouldn't. It's not healthy, and I'm just hoping you can see that, even for your own sake. I'm sorry if it seems like I'm attacking you but that's really not my intention.


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## Arisa1536 (Dec 8, 2009)

meyaj said:


> I never told you off for taking zopiclone through the day. I said that I had tried it once and had total amnesia because of it, so that I found it to be a poor choice. There was nothing unreasonable about what I said.
> *
> I have very severe social anxiety, depression, generalized anxiety, etc, to the point where I am surviving on government disability right now, so of course I understand how hard it is.*
> 
> But using our condition to rationalize spoiled child-like behaviors and attitudes is the kind of thing that is a known BARRIER to treatment. It's known as a secondary gain, and we might not even realize it, but it allows us to become comfortable with our situation because it allows us to get away with things we otherwise wouldn't. It's not healthy, and I'm just hoping you can see that, even for your own sake. I'm sorry if it seems like I'm attacking you but that's really not my intention.


i would like to add that i do not work either, my anxiety and depression is severe also, i just added that i have paranoia and OCD i guess my problem is not extreme social anxiety, i battled with it through my teenage years but its not a huge problem for me now, i came to this forum to discuss mental illness and different medications and how they interact in the body


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## catlady858 (May 10, 2012)

*be careful!*



Arisa1536 said:


> Um well i think its rude your Psychiatrist flat out refused a stimulant like ritilan but they do that
> 
> try a benzo, it picks you right up
> well not clonazepam or Valium but the faster acting ones are great for that
> ...


Please be careful taking things like xanax if you are severly depressed because it can give you the confidence you need to kill yourself. I know that sounds harsh and weird but my mom took xanax and once my SAD was so severe i was considering not doing something i had to do and she gave me a 1/2 of a 1/4 mg and It helped but as i was driving i realized that i felt really confident in my need to kill myself (which is not the desired effect) and the only reason i did not run myself into a tree was bcz i was in my moms car and it was the only good one we had.. once i had that thought i fought it and as u can see did not do it but i never took a xanax or similar drug again so just be careful and make note of those kinds of feelings.

Also I was looking to find some medication to help with my lethargy and severe depression and someone suggested ADD meds so i was researching when i found this site. I just can't seem to get up and do the things i need to do, I am anemic which is not helping but I am barely living here just sort of existing and keeping myself and my pets alive and feeling really bad about not getting things done that need doing and also about just feeding and watering the pets and not giving them the attention i used to be able to. Seriously tho standing up saps all my energy its hard to even make it to the other rooms in my house im exhausted once i do that and i dont think its all the anemia. *sigh* I really hope you find what you're looking for!


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