Stimulants causing fatigue?

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    • #112817

      For the past six months I have been fairly stable on 25mg Adderall XR, 150mg Welbutrin, and 20mg Celexa to treat my ADHD, generalized anxiety disorder, major depressive disorder, and an autonomic nervous system dysfunction called POTS.

      About a week and a half ago my psychologist recommended that I increase my Welbutrin dosage to 300mg, and add a second afternoon 25mg Adderall XR dose, to deal with my fatigue issues and better deal with my depression.

      I have felt TERRIBLE since starting these new meds. I will sleep for 14 hours and still not feel rested, and need to take a 2-3 hour nap in the afternoon. My normal schedule is to wake up at 6:30, take my morning meds (the Adderall and Welbutrin), and go back to sleep for another 15-30 minutes so I feel more alert getting ready in the morning. However, on the new dosages, I will take these meds, and immediately pass back out until noon! I don’t know how but these stimulants are making me more fatigued than ever. I tried this morning to get up and have breakfast and then take my meds right before I had to leave for class. The moment they kicked in I felt like I was going to collapse, and immediately went back to bed. The afternoon dose of the Adderall has also done similar things recently, not acting as long, as potently, and crashing much harder much sooner.

      My current theory is that there is some kind of drug interaction going on that I don’t understand, or I have diagnosed narcolepsy (not a joke).

      Anyone have any idea what is going on, or have any advice on what to do?

    • #112822

      I’d go to a endocrinologist who isn’t afraid to prescribe the dosage of thyroid meds some people need. If the fatigue is not related to your pills and thyroid is responsible. I’ve never felt better or had my meds work this well, until I got on 90mg of NP Thyroid & I’m only 33 years old. Thyroid does not just affect old-er people. Look up everything your endocrine system does. If it’s out of whack, adrenal fatigue, weight gain, lethargy, memory problems, etc etc. It’s the manager of the body. Hope you feel better soon!

      • #113253

        Sleeping 17 hours a day and still tired? This is a big deal and you need to get seen ASAP.

        Skypark’s info about thyroid contains some accurate info, but it’s a bit overstated.

        Thyroid is ONE possible factor in fatigue. It is common and often underdiagnosed and undertreated, or goes undiagnosed for too long. To say that “if you’re tired like that, it MUST be thyroid” is not accurate at all.

        Thyroid problems do not come on suddenly and make you suddenly – within a week – start sleeping most of the day and still tired. They creep up on you gradually over months or years. And hypothyroidism does not cause unintentional weight loss.

        Any sudden change in your health or worsening of symptoms that happens immediately after a change in meds is most likely related to the meds. Call your doctors office and get an appointment ASAP. Tell the receptionist you believe you’re having a bad reaction to the meds and that you’re sleeping 17 hours a day.

        They should get you seen right away. That is not normal or okay.

    • #112827

      I had blood work done fairly recently and the thyroid levels were within normal bounds. I will check the numbers tomorrow morning and do some research to see if that is a potential problem, but I don’t think so. I also am losing weight unintentionally not gaining it, so I feel like there must be something else at work here.

    • #112990

      My TSH was in the “normal” range. But, what’s frustrating is the normal range is relative. It will vary by lab & who’s to say that your “normal” is my “normal.” Based on my symptoms, the 1st dr finally prescribed me a measly 15mg and I’ve been feeling like I needed thyroid for the last 6yrs.

      This 2nd doctor want you feeling “GREAT.” He knows that normal range doesn’t mean much if you’re still suffering and not feeling good. He is not stingy or too conservative with his thyroid rx’s. My mom found him after struggling to get the dr. to prescribe the current amt she was taking before. I encouraged her to find someone better & she found this guy for us both.

      GOOD LUCK!!!

    • #113002

      I’ve been on both Wellbutrin and Adderall before. If you’ve ever taken Wellbutrin on its own, did it make you sleepy? Drowsiness is a common side effect. It made me sleepy when I took it, too. Maybe this is too simple a theory, as you must have considered it, but the Adderall addition might not be enough to offset the Wellbutrin addition (even if they are technically the same proportion as before, people react differently to different dosages of medicines).

      Definitely also ask your doctor about the drug interaction.

      • This reply was modified 2 years, 6 months ago by nvalefreedom.
    • #113093

      Keep in mind that we are all unique and we will all respond to medication in different ways. That is part of what makes a psychiatrist’s job so difficult. If you are having issues with your medication, work with your doctor to make small incremental changes. A few things to consider:
      1. try a different stimulant; Ritalin, Focalin, Strattera
      2. try MYDAYIS, this is a newly released form of Adderall XR that extends the release further into the day
      3. try to remove Celexa or replace it with another SSRI or an SNRI, seroquel, abilify or another medication. There are lots of choices you can discuss with your doctor. Your issues may well be with the Wellbutrin or Celexa and extreme fatigue is a side effect of these types of medication.
      4. I take Adderall XR (2x20mg). I take them one before breakfast and one after (about 45 min later). This allows for a smoother and prolonged effect through the day. I also keep a bottle of Adderall (immediate release) that i can adjust my dose late in the day by adding 1/4, 1/2 or a whole tablet depending on need (I never need the whole tablet late in the day).
      5. Cognitive Behavioral Therapy (CBT) – well worth the investment for ADHD, anxiety and depression.
      Unfortunately, changing medication take time and you need 2-4 weeks on each change to see if you get the desired effect. Hopefully, you have a doctor that is patient and will work with you through your side effects and some can be rough to get through. You are the world’s foremost expert in your own mind and body. You should have a doctor that works with you and treats you that way.
      Good Luck!

      • #113116

        Holycrap! A new adhd medication, my fingers can’t look this up fast enough.

      • #113117

        When did this come out?
        HOLYCOW, it’s $280-ish dollars on goodrx—better have good ins for this one.
        They do have a savings offer until 12-19-19…maybe this’ll get some people till they add it to their good insurance’s formulary.

        Very cool, long acting single-entity amphetmine. I haven’t researched fully, but my guess is, this doesn’t have the d-amphetamine in it.

        Wow, according to their study, they claim it works up to 16hrs.

    • #113728

      I have heard that if adderall makes you tired, you probably need a lower dose, but I don’t know if that is true. I will say I started on 5 mg adderall xr once daily and eventually got up to 20 mg. I felt really sleepy on the 20 mg and had major restless leg syndrome, so I went back down to the 15 mg and feel much better. I still get worn out in the afternoons, but I think it is from medication wearing off. Good luck!

    • #132798

      Some of the answers here are entirely untrue. This has nothing to do with your thyroid. It could be serotonin syndrome which is an emergency. However, you should not be taking wellbutrin and celexa together. Hope you’ve gotten this straightened out

    • #133240

      When I was on 25 after about a year I had the same experience. My sweet spot was 15 mg anything more I got too much side effects. Fatigue anxiety weight loss.

    • #186540

      Hey guys , I was taking adderall 20mg for awhile and it was great . I even got a second job and was really excelling. I moved to a different area and changed pharmacy. I was getting TEVA at Walgreens and started getting AUROBINDER at CVS (different generic brand) . It made me feel the complete opposite. It was terrible . Problem was I get 3 months at a time due to COVID. Therefore , I was basically stuck with these, so I did my research and realized my body had a reaction to the CVS brand. Once 3 months passed I called and got my script sent to a Walgreens . Issue was solved . Adderall is not suppose to make you fatigue and tired . Doctor can’t help when it comes to brand .

    • #188419

      Just found this thread again while searching through my email. A few months after posting this I got a sleep study done and got diagnosed with Narcolepsy, and reading this post again with the benefit of hindsight that was pretty clearly the case.

      I am doing substantially better now that I have proper medication for my narcolepsy, and if anyone else is having similar symptoms, it might be worth while to see a sleep specialist.

    • #188422

      Thanks for letting us all know your outcome…usually you never know how things turned out!
      Your posting reminds me of the many I have seen on this discussion forum, in which people were ADHD and have often thought that they were narcoleptic also…possibly because of excessive theta waves in the brain, (this is JUST ONE possibility some people have brought up).
      Don’t know about the excessive theta wave theory, but I think I have narcolepsy as well. Surely the symptom of “often falls asleep at traffic lights” should count for something?? BTW, I get plenty of uninterrupted sleep, and more since Covid quarantine…probably ten hours a night. Yucch. I don’t want to sleep my life away.

    • #188424
      Dr. Eric

      There are too many simpler explanations than a lot of the ones proposed…. like the POTS (Exhaustion / fatigue is listed as a symptom) a stimulant could potentially increase the tachycardia, the severity of the depression, and the side effects of the non-stimulant meds.

      I would want a comprehensive overview of everything that you are dealing with for an explanation with an updated physical and blood work-up.

      After that, I would push for a second opinion.

      This is definitely not the work dor Dr. Google.

    • #188499

      There are two types of thyroid diagnosis- Hyperthyroidism & Hypothyroidism. One makes you lose weight unexpectedly, and the other makes you gain weight unexpectedly.

    • #188512

      Truer words were never spoken, Dr. Eric.

      Dr. Kim

    • #190588

      I use to take 40 mg and stopped for a year. Just got back on 20 mg. It’s not working either. It use to work like all day I was so motivated never Depression and now it’s just not helping at all. I do have thyroid issues and a pituitary adenoma but that’s regulated. I don’t even take the Xanax I use to take 3 mg a day. So it’s bizarre to me. Anyone ?

    • #192620

      I have this exact issue – along with also having dysautonomia.
      An interesting phenomenon happens with dysautonomia where since many with POTS have poor blood return from their lower body from not enough vasoconstriction we are used to running on adrenaline – literally to keep enough blood to our vital organs. This causes the tachycardia etc.
      When introducing a stimulant, some will experience enough vasoconstriction to relieve this enough that it finally allows the body to relax. For anyone reading this, and especially the physicians, it’s like running a marathon on adrenaline for years then being able to relax. The body isn’t used to it. It also relieves muscle pain because appropriate vasoconstriction works better than a body pushing adrenaline.
      For me, my body pain will go completely away and I’ll get sleepy. I’ll also notice my heart rate will get pretty low – yes, on stimulants! This also works if I drink a lot of caffeine. Explaining this to people is hard because many don’t understand dysautonomia.

    • #192860
      Plumb Line

      In addition to the good advice posted above, may I ask whether you’ve ever had a sleep study done?

      Take a look at the epworth sleepiness scale. If you are unrefreshed by sleep or experiencing hypersomnolescence during waking hours, perhaps discussing it with a sleep medicine specialist is advisable.

    • #195236

      Hi! You cannot mix adderall and Wellbutrin. I don’t care what your Dr. says. No, I am not a Dr.,
      I am glad I read this. It is a red zone. My Dr. didn’t know and I googled it and saw another Dr. and she told me the same. Please, get a second opinion and research it. I take Wellbutrin but hours before I will take half a tablet of time released Adderall and I get tired and feel weird but adder all never worked for me. Please get a second opinion. God Bless!

    • #195394

      I take Mydayis. Im on 25 mg. It works pretty well. Stable, smooth release throughout whole day and into night, with little notice of come down or weening off.

      I was on vyvanse for years before starting Mydayis two years ago. So far, its been working well for the most part.

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