lethargic, listless, and tired from effexor

Hi,

I am a white male, 45, married, with one daughter, I have no abnormal external stresses in my life.  I have dysthymia and anxiety.  

Zoloft didn't help, then I tried effexor. At first I felt like I had found a wonder drug for the dysthymia (but nothing for the anxiety - more on that later).  The general malaise, anger, etc. were very much under control.  I attribute this to the drug and an excellent therapist.  I believe with dysthymia, you never CURE it, you manage it, live with it and accept it.  

Anyway, my concerns are now some of the side effect(s) I am facing.  Most significantly, I frequently feel very lethargic and listless.  I have a hard time getting the motiviation/ interest to commit to something, especially on an on-going basis. I usually feel lethargic but sometimes that changes and  I suddenly feel this rush of energy and enthusiasm and go great guns.  Then, after some time (the length of which varies) I can't get the ambition to reply to an email! Simply put nothing "lights my fire".  I can't say this never existed before the effexor, however, definately increased by meds.

Other less significant side-effects include: frequent lightheadedness, sexual, constipation, increased sweet-tooth.

As for the anxiety, had prior to meds.  I can't tell if it has worsened, but certainly not better.  By anxiety I mean being tense and worried for no reason even when in a pleasant environment (e.g. walking my dog, playing with my child).  The symptoms are a general tension in my body, especially in my neck.

Will Wellburtin added to Effexor help?  Thanks

[Roger Gould, M.D.]

I think you should sort out the side effects from the effect of the medication from an underlying issue.  The lethargy is not usually assosiated with Effexor, and may be the underlying condition, and require either a higher dose of effexor or the addition of wellbutrin.

Regarding the anxiety and worry, you should try to pin-point the imagery that occurs when it happens, and explore that.  That is a much more certain route to control then the medications, which although used for anxiety, can also increase the physiologic systems that are the representation of anxiety.

[Kasie]

I am a 29 yr old female with two boys.  I started on effexor in July/01.  I also experience severe lethargy but am not too concerned at this time because I think it's just the winter.  If this continues into the Spring, then I'll check with my doctor.  Aside from being tired, the effexor has helped me a tremendous amount.  What pleases me the most is my patience with my children.  I am tired but am getting along with my boys much better.  Even though I have to force myself to get off the couch and do something with them - at least now I have the desire to be involved with them even if I lack the energy.  They too are much happier since I started on the effexor.