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Depression

Question
Posted by: Kathleen | 2019/08/05

Q.

Which meds are causing extreme fatigue.

Good Day Doctor, Asking for a patient that has Aspergers, and suffers from depression and anxiety. She has started to feel emotionally better, stronger, however, the fatigue is extreme, and so extreme that it is impacting on her life, her work, her being able to be a normal person. Could you please advise me, which of these meds, or a combination of these meds is the culprit. That way we could maybe take a different time etc. Currently she takes the meds before bed time, battles extremely to wake up and is really suffering from fatigue. The medication is: Omez, Euthyrox, Epitec, Luvox, Inderal and Abilify. Please give your opinion it would be much appreciated.

Expert's Reply

A.

Depression expert
- 2019/08/05

Hello Kathleen,
Puzzling.  No drugs whatever are recognized by appropriate experts, or authorities like the American drug agency the FDA, as effective in treating Asperger's. It is best treated, often by a psychologist with experience in dealing with this and related conditions, using CBT ( Cognitive-Behaviour Therapy and similar psychological methods. 
It is indeed recognized that people with Asperger's may develop a Depression and/or anxiety disorder, which can be treated with an Antidepressant ( also effective for the Anxiety Disorder ) ; though CBT is also effective in treating these problems.
Of the drugs you mention, Luvox ( Fluvoxamine) is an antidepressant and will also treat anxiety, and can cause drowsiness.
Inderal ( Propranolol ) is used for blood pressure and similar problems, but can control some PHYSICAL symptoms of anxiety, though not the psychological symptoms of it.
Euthyrox is a trade name for Levothyroxine, a treatment for an under-active thyroid gland / hypothyroidism.  Does your friend have thyroid problems ? It would not ordinarily be used to treat depression or anxiety.
Omez is a trade name for Omeprazole, used to treat gastric disorders like ulcers, and gastric reflux.  It's not a treatment for Asperger's or depression.
Abilify is Aripiprazole, used to treat schizophenia and some Bipolar Disorder ; it has been used to treat irritability in Autism. It might cause drowsiness.
Epitec is Lamotrigine, an anticonvulsant, used in epilepsy and sometimes in Bipolar Disorder, though it seems recently to be used, by some doctors, for all sorts of situations, for reasons that baffle me.  It can cause drowsiness.
Obviously, especially as the sedation she feels is causing her significant problems,  she needs to discuss this with her treating doctor, who might have some special reasons for using this particular combination of drugs, and, knowing the details of her diagnosis, previous responses to drugs etc., would be in the best situation to advise on what drugs she might substitute, how to gradually reduce some, and so on.

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