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Antidepressants for fatigue?

hope4thebest's picture
hope4thebest
Posts: 108
Joined: Aug 2012

I am about a year out since my bilateral mastectomy and am doing the reconstruction. This has been a long process and it is really starting to wear me down physically and mentally. I was doing very well through the diagnosis and all the major surgeries -5-, but am still in alot of pain. This keeps me up at nite, I am already taking xanax and meds for the pain. I am not in a good mood, I am getting by. People are telling me I should try antidepressants, but I don't want to take more unless I have to. Should I just ride this out? Fatigue has really been hard to deal with but I am still exercising and that seems to help the most. I just don't feel well. Also have low iron on my last CBC. Is this pain going to last forever?? I'm only 42 and am getting discouraged.

SIROD's picture
SIROD
Posts: 2204
Joined: Jun 2010

Hi,

They say that exercise is very helpful in combating fatigue. However, why not inquire from your primary care doctor for another kind of medication if xanax isn't helpful. Just enough to get you over the rough spot.

Being diagnose, going through surgeries, reconstructions and everything else is a lot to deal with and in such a short amount of time.

Pain, fatigue, depression does get better in time. If pain persist they can give you some medication for that also.

Hang in there, you will soon see the glimmer of light at the end of this dark tunnel and you will be back again into the wonderful sunlight. I know it is hard to believe at this point where you are in this journey.

Best wishes to you,

Doris

Rague
Posts: 3556
Joined: Aug 2009

Fatigue, pain and depression go 'hand-in-hand' - any one can cause (or at least aggrivate) either or both of the others. Anti-depressants are not 'majik' and do not work for all but for some they are fantastic. I know there are newer drugs often used today with FM and CFS in the 90's but anti-depressants were used then as TX for either. Did nothing to help me then but did help many.

What is being done to deal with your blood work issues? That can cause fatigue.

There is someone out there with the expertise to give you help. It could take seeing a different Dr than you are currently seeing (Ondo, PC, Physchiatrist, etc.)

Winyan - The Power Within

Susan

Pinky68's picture
Pinky68
Posts: 206
Joined: Jul 2012

I've been presribed anti-depressants and has worked well for me. I agree with Susan, it's not a cure-all but has helped..Exercising helps a lot.
Give it some time and know we are here for you!
It does get better.
Take care,
Joyce

Alexis F's picture
Alexis F
Posts: 3604
Joined: May 2009

I've never taken antidepressants, but, I know that exercising has helped me to regain my energy a lot. If your doctor feels you need an antidepressant, maybe just try it and see if it helps you. Hoping you feel better.

Hugs, Lex

disneyfan2008
Posts: 5915
Joined: Oct 2010

not being funny...could someone explain exactly what "fatigue" is?

not to take away from topic...in anyway...

Denise

laughs_a_lot's picture
laughs_a_lot
Posts: 1369
Joined: Mar 2011

Is being tired. Probably also means being tired even after waking up from sleep.

Rague
Posts: 3556
Joined: Aug 2009

For me 'Fatigue' = total exhaustion - only being able to what I have to to sustain life. 'Tired' is different - not wanting to do is lot is a different! It can be a matter of symantics/word meaning..

Oh yeah - 'fatigues' was the term used for years for clothing worn by militar6y personel.

Good question - words mean different in different scenarios - thus different to each of f us.

Winyan - The Piwer Within

Susan

lynn1950's picture
lynn1950
Posts: 2574
Joined: Jun 2008

Low iron could be the culprit. You are on the right track by exercising.

But fatigue is part of the whole cancer shebang; in fact, my oncologist said it is the most common complaint he hears - he hears it from me as well, and I am four years out this month. Xanax is a great medication to relieve anxiety, but I found that it makes me really groggy and sleepy. Maybe something other than the Xanax would give you some relief. I take antidepressants and they have really helped me with issues of depression and anxiety. For a long time I took Zoloft with Abilify, but have recently switched to Viibryd alone and it seems to be helping a lot.

What kind of reconstruction are you having? How soon are you to being finished? Five surgeries is a lot!

Don't be afraid of anti-depressants. They may just be what you need. xoxoxoxo Lynn

CypressCynthia's picture
CypressCynthia
Posts: 4017
Joined: Oct 2009

My first thought when I read your post was I wonder if the xanax (and pain meds) are contributing to the way you are feeling. Sedation is an expected side effect of any narcotic. And the top 4 adverse effects of xanax listed at Epocrates:

Xanax
"Common Reactions
drowsiness
fatigue
impaired coordination
irritability"

Of course, you have to take care of the pain so that you can move and heal. Pain meds are given to help patients ambulate so that they can recover faster. Take your meds and then take short walks and build a little each day. Do begin to wean yourself from them as appropriate. Don't exercise so much that your pain is worse though.

Also, try using an NSAID instead of a narcotic/xanax for your pain whenever you can. That may really help with your fatigue and mood.

I don't know when your last surgery was? I usually had pain for 1-2 months after, depending on the extent of the surgery. Pain is usually worse at night, so you may only need pain meds then?

If you are now having some anemia, that is not surprising after all of your surgeries. Your body usually recycles iron, but it can't make new iron if the iron is lost with bleeding (periods, surgery, etc.). Ask your onc if it is ok to take a multivitamin with iron every day for awhile until you build it back up. Read the label because many multivitamins don't have iron (note though: it is not a good idea to take iron if you don't need it, so check with your onc or pcp).

Finally, depression after cancer can be very real, so if this is severe and persists, talk to your oncologist. He/she will know which antidepressants are compatible with your treatment.

Hope you feel better soon!

hope4thebest's picture
hope4thebest
Posts: 108
Joined: Aug 2012

Hi Ladies,

Thank you for the help on this. Fatigue for me is feeling tired even when you just wake up, never being fully rested, heavy limbs, being sore all over. Tired but cannot sleep. Even small things seem like huge tasks. I started bilateral reconstruction with expanders last July. Surgery in June 2011, 2 lumpectomies, then the bilateral mastectomy in July, followed my an emergency surgery in July to fix a hemtoma. Reconstruction continued with surgeries in Nov and May, nipple reconstruction, and next one due in Nov again.

I have no idea about the side effects of all the surgery, I just focus on getting it over with. If you have any info I should know, please send it my way.

My iron started to drop the first of the year, the fatigue kicked in about April. I have been exercising by walking an hour 4-5X week, that is probably too much and I thank you Cypress Cynthia for reminding me to have some compassion for myself and not overdo it. My iron levels have come back up because Doc gave me some iron tablets last month.

Pain for me comes later in the day and now disrupts my sleep. I also wake up sore. Mostly it is muscle pain. But, I also see a chiropractor and she helps keep my neck, back and hip joints in line.

I have started an antidepressant because this is really beginning to wear me down. My PCP is very qualified but I am a new patient to her. I am thinking I am suffering from depression that started prior to my diagnosis. Either way, I am dealing with it now and you ladies are helping me navigate through these waters.

I am not sure which NSAID you recommend? I am trying to get away from the meds but still have so much anxiety and discomfort. Happy that you and my PCP seem to understand.

Thank you so much,
Annie

Megan M's picture
Megan M
Posts: 3001
Joined: Dec 2009

Annie, after all you've gone thru, you have every right to be tired and depressed. I am very sorry that you are though and pray that with the iron pills now and the antidepressant that you will start to feel better. Just go easy on yourself as you've really been put thru the mill.

Gentle hugs,

Megan

laughs_a_lot's picture
laughs_a_lot
Posts: 1369
Joined: Mar 2011

Not all cases of depression are long term. Sometimes people are on anti depressants just to get over the hump of a large issue (6 weeks to 2 months). Cancer and 5 surgeries are a pretty big issue.

laughs_a_lot's picture
laughs_a_lot
Posts: 1369
Joined: Mar 2011

Not all cases of depression are long term. Sometimes people are on anti depressants just to get over the hump of a large issue (6 weeks to 2 months). Cancer and 5 surgeries are a pretty big issue.

Cypress Cynthia is right about the other meds causing fatigue. Also remember that if you have had your primary care physician for years then he would have the best insight from the medical community as to whether you are depressed short term, long term, or not at all. He has seen you through several phases of your life.

laughs_a_lot's picture
laughs_a_lot
Posts: 1369
Joined: Mar 2011

Double post

kacee999
Posts: 110
Joined: Oct 2012

I suffer from chronic fatigue since my 2nd chemo session in February (going on 9 months now) AND all over body pain. My Onc gave me pain pills which really didn't seem to do it. Finally went to a rheumatologist a week ago and he gave me two prescriptions I swear have saved my life!!!! He gave me NuVigil for fatigue. Boy does it work! AND he gave me LYRICA for the pain. Lyrica is generally used for Fibromyalgia. I noticed a difference after the FIRST DAY!!! OMG!!! As for anti-depressants, don't feel badly about asking for something. This cancer process is dibilitating to the best of us, and no one will look sideways if you request some help. This might be a good time for an SSRI (Selective Serotonin Reuptdate Inhibitor). It's not a "transquilizer" like Xanax. It gets into your system and works 24 hours a day. You will just notice that you are NOT unhappy. The stuff can work miracles.

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