Cylert for fatigue?

RE: medication resistant depression, on 11/11/99 that I wrote.

What drugs would you recommend to overcome fatigue and difficulty concentrating to be combined with Effexor?  I took Cylert and Prozac in the past with good results, are there any newer, better alternatives to Cylert these days? My anxiety attacks are under control, thanks to the Effexor and I think I could try a low dose of a stimulant again to "clear my head" and give me an occasional boost.  I am currently in therapy, just had a good physical, and otherwise in good health and good cardiovascular shape, so most of the obvious fatigue causes have been evaluated.  
P.S.  A sleep clinic evaluation and ADD testing are pending insurance approval.  I don't think I could have anemia as you suggested, wouldn't it have showed up on my recent "physical" blood tests?
Thank you again, Brian

[HFHS-M.D-HG]

Dear Brian,

               I am glad that your anxiety attacks  are under control with Effexor. I am not sure, from the information that was provided, whether you were tested for thyroid abnormalities/ electrolyte abnormalities etc. which can contribute to weakness. Since you had a normal physical with blood tests being done, I would assume that you may not be having anemia., Stimulant medications like Ritalin, Cylertand Dexedrine are used in the treatment of   ADHD (Attention-Deficit Hyperactivity disorder) , Narcolepsy  and  Depressive  disorders (particularly treatment resistant depression and depression in older people). The side effects  from these  medications are decreased appetite, weight loss, dizziness, slowed growth, insomnia. These medications were shown to be habit forming.

             I would prefer to wait  for sleep clinic evaluation and ADD testing before considering any stimulant usage. I would recommend  that  you discuss with your psychiatrist/ physician in detail about   the alternatives that are available. I wish you good luck.

Key words: ADHD