CHRONIC FATIGUE/PAXIL

[Suzi]

Our doctor just perscribed Paxil for my 22 year old daughter who he dignosed as having chronic fatigue syndrome.  She has been ill off and on ever since she had mono 2 1/2 years ago.  She has always been extremly active and highly motivated.  She is an opera singer who is studying voice performance.  She had to drop out of school for awhile and has been told to cut back.  For awhile she was sleeping all but a few hours of the day.  She also gets sore throats and swollen glands at least every other week.  With those symptomes and after blood tests ruling out other things he has decided it is chronic fatigue.  Is Paxil normally given for chronic fatigue?  I have read about some bad suicidal side affects and other things and am very concerned.  She takes 20 mg a day.  Please advise if the dosage should maybe be lower or not at all.  I have not noticed that it has been given for this illness.  Thanks

[HFHS.MD-AJ]

Suzi,

It seems you are concerned about your daughter's diagnosis of chronic fatigue syndrome, as well as her treatment with Paxil.

Chronic fatigue syndrome is a disorder with an unknown cause, characterized by severe disabling fatigue. Enlarged lymph nodes (glands), sore throat, etc are other possible manifestations. The disorder is estimated to affect about one out of every thousand people, mostly young adults, more often women than men. There are no specific tests available for this diagnosis, which is usually made only after other medical and psychiatric causes of chronic fatigue (such as hypothyroidism, multiple sclerosis, infectious mononucleosis, AIDS, and depression, to name a few) have been excluded. Treatment is mainly supportive (pain-killers, psychotherapy, etc), but antidepressant medications such as Paxil may be helpful, especially if there is secondary dysphoria (depressed mood). Paxil does not make people suicidal, and is in fact effective for treatment of depressive symptoms including suicidal ideation. Paxil is usually started at a dose of 20 mg a day. I urge you to discuss your concerns further with your daughter's treating physician.

[tlsteven]

I have had paxil in the past and it seemed to help but the side effect i had was tiredness . 20 mg. is the normal starting dose the worst was coming off the paxil, have you thought about zoloft this does not cause fatigue and is in the same family. Just remember you usually hear about the bad effects befor the good and everyones body adjusts differently i to had mono and fatigue and prefer zoloft. Hope this helps some

[Cathy]

I am taking Prozac and amytryptaline for fibromyalgia and know of others who take Celexa and amytryptaline for chronic fatigue. It is becoming a more acceptable combination for these illnesses.  There is some evidence that there is a serotonin problem associated with these illnesses and these prescriptions have helped.  I have been taking Prozac and Elavil for several months now and my pain has nearly disappeared.  I also have more energy and feel almost normal.  I have a friend who has chronic fatigue and takes Celexa and Elavil for it. He feels much better also.  I have experienced no side affects from these medications.  My friend, however, felt jittery on the Prozac and that is why he was changed to Celexa.  Cathy S.