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Author Topic: Depression and Fatigue  (Read 3627 times)

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Offline escapevelocity

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  • snow.
Depression and Fatigue
« on: February 05, 2007, 12:21:55 AM »
Hi everyone,

I'm on a combination that works great for keeping vl down and cd4 up.  I have two pretty significant side effects, and I'm having a hard time getting my doc to take them seriously.  The first is fatigue.  The second is depression.  Both are common side effects of sustiva, which I'm pretty sure is the culprit in my regimen.  I've been on this regimen for over 5 years.

The fatigue and depression are definitely having an impact on me.  Because I have to sleep so much to recover my energy, I feel like a drone most of the time, and feel like my life is not really my own anymore.  This of course contributes to the depressed feeling.

My doc is absolutely against treatment interruptions or drug holidays.  Has anyone else out there stopped using Sustiva (or another drug) because of the depression effect?  Have you found another drug that works better?

Thanks in advance for any advice, friends.  This is my first post.  I've been reading a lot of the posts on here and want to express my deep appreciation that you're out there!


Offline lydgate

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Re: Depression and Fatigue
« Reply #1 on: February 05, 2007, 12:49:17 AM »
Hi escapevelocity,

Depression is horrible; and fatigue, everyday, intolerable. You shoudn't have to live like that.

First question: are you on any anti-depressants?

Second question: has your doctor suggested alternatives to Sustiva?

Third question: have you had resistance testing done (geno and pheno) to know which drugs would work and which wouldn't?

Here's a link to a thread I remember offhand, about wanting to give up Sustiva. It had 40+ responses.

http://forums.poz.com/index.php?topic=1006.0

Plenty of Sustiva-related posts here. If you think that really is the culprit, you might want to think about switching it for something else, if possible.

Jay

Her finely-touched spirit had still its fine issues, though they were not widely visible. Her full nature, like that river of which Cyrus broke the strength, spent itself in channels which had no great name on the earth. But the effect of her being on those around her was incalculably diffusive: for the growing good of the world is partly dependent on unhistoric acts; and that things are not so ill with you and me as they might have been, is half owing to the number who lived faithfully a hidden life, and rest in unvisited tombs.

George Eliot, Middlemarch, final paragraph

Offline Miss Philicia

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Re: Depression and Fatigue
« Reply #2 on: February 05, 2007, 01:11:02 AM »
And tell your doctor that as long as your numbers are OK he should do his job and pay attention to "quality of life" issues.  This isn't 1989.
"Iíve slept with enough men to know that Iím not gay"

Offline escapevelocity

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Re: Depression and Fatigue
« Reply #3 on: February 05, 2007, 01:19:12 AM »

First question: are you on any anti-depressants?

Second question: has your doctor suggested alternatives to Sustiva?

Third question: have you had resistance testing done (geno and pheno) to know which drugs would work and which wouldn't?


Hi Jay,

Thanks for the links.  To answer your questions... (1) I was on "effexor" but I had a terrible reaction to it.  Something I've seen referred to as "Brain Shivers" elsewhere on the net and a tremendously bad emotional response.  I also tried the generic form of wellbutrin, and it made me extremely agitated... a similar feeling to nicotine withdrawal - no fun.  (2) Nope.  (3) Nope.  I get the feeling that the geno/pheno testing would cost more than I can afford with my current plan, but I can look into it.

Thank you for the link.  I'll read up on the sustiva post.

I really appreciate the response!

 - John

Offline escapevelocity

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  • snow.
Re: Depression and Fatigue
« Reply #4 on: February 05, 2007, 01:27:16 AM »
And tell your doctor that as long as your numbers are OK he should do his job and pay attention to "quality of life" issues.  This isn't 1989.

THANK YOU!  My doctor is a sweet, kind-hearted guy, and I think he's coming from the "if-it-ain't-broke-don't-fix-it" perspective.  I have to get him to realize that it is broke.  I've been complaining of fatigue and depression for several years.  He's helped me through a lot, and is usually pretty attentive, but I think he takes a very conservative "stay the course" approach to regimens.  I obviously need to be more forceful about this.  Thanks for the message!

Offline poodlelover

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Re: Depression and Fatigue
« Reply #5 on: February 05, 2007, 01:33:41 AM »
I have taken Sustiva since day 1 almost 8 years now.  I had trouble with depression before starting treatment  but my doctor still wanted me on the sustiva.  I really didn't notice it making it worse but have also tried the effexor and this caused rapid heart rate.  From there i probably tried 3 different meds until Cymbalta came out.  It has really helped me alot.  Also is you have chronic pain like from neuropathy this drug helps with that as well.  Ask your doc about cymbalta and maybe it will help with your depression.  Once you get your depression in check it may also alleviate some of the fatigue.  Do you have weird and vivid dreams?  Sustiva is also known for this.   
Connie

Offline lydgate

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Re: Depression and Fatigue
« Reply #6 on: February 05, 2007, 01:34:28 AM »
Yup. Conservative is all very well -- until you start feeling like hell, despite good CD4 and VL numbers.

I may sound like a broken record to some about this topic, but anyway: at your next labs, ask to get your testosterone levels checked. HIV can fuck em up. And the fatigue, perhaps, may be due to that.  
Her finely-touched spirit had still its fine issues, though they were not widely visible. Her full nature, like that river of which Cyrus broke the strength, spent itself in channels which had no great name on the earth. But the effect of her being on those around her was incalculably diffusive: for the growing good of the world is partly dependent on unhistoric acts; and that things are not so ill with you and me as they might have been, is half owing to the number who lived faithfully a hidden life, and rest in unvisited tombs.

George Eliot, Middlemarch, final paragraph

Offline Miss Philicia

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  • celebrity poster, faker & poser
Re: Depression and Fatigue
« Reply #7 on: February 05, 2007, 01:48:42 AM »
Agreed.  Make him run your testosterone numbers.  He really should have done this when you brought up the issue already.  Perhaps it's just a matter of being forceful enough with an issue.
"Iíve slept with enough men to know that Iím not gay"

Offline escapevelocity

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  • Posts: 10
  • snow.
Re: Depression and Fatigue
« Reply #8 on: February 05, 2007, 02:01:12 AM »
Thanks for the replies everyone.  I did have my testosterone levels checked out at my last labs, and they are above average for my age group (surprisingly, since my sex drive is so low it's practically in reverse).  The cymbalta sounds promising, though my last foray into antidepressants made me feel so wacky, I have trepidation about more antidepressants. 

Strangely, I don't have the vivid dreams anymore that I recall.  I am able to sleep through the night okay.  I just need to sleep well into the morning, too, to feel rested, and even when I do get plenty of sleep, I'm not motivated to do much of anything.  Generally feel fuzzy, unfocused, unmotivated and slow.  I feel sad a fair amount and angry at odd intervals, but more just blah... a flat affect, low emotion dullness.  It completely sucks.

Offline poodlelover

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Re: Depression and Fatigue
« Reply #9 on: February 05, 2007, 02:15:24 AM »
Have you had a thyroid panel ran?  if not get one.  If your thyroid is out of whack it also can make you feel out of whack. 
« Last Edit: February 05, 2007, 02:26:30 AM by poodlelover »
Connie

Offline poodlelover

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Re: Depression and Fatigue
« Reply #10 on: February 05, 2007, 02:18:56 AM »
ok, is there an edit button anywhere i dont see one?  Also, i'd like to had your symptoms sound alot like what i was feeling,  I had a complete hormonal workout and everything  was out of whack.  My doc started me on bio-identicals and these are not just for women.  It's amasing at how much more energy i have, not as moody, and i don't have that brain fog any longer.
Connie

Offline Miss Philicia

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Re: Depression and Fatigue
« Reply #11 on: February 05, 2007, 02:24:20 AM »
ok, is there an edit button anywhere i dont see one? 

should be a button that says "modify" above your post next to "quote"
"Iíve slept with enough men to know that Iím not gay"

Offline ScooterTrash

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  • Posts: 69
Re: Depression and Fatigue
« Reply #12 on: February 15, 2007, 05:27:00 PM »
Quote
Strangely, I don't have the vivid dreams anymore that I recall.  I am able to sleep through the night okay.  I just need to sleep well into the morning, too, to feel rested, and even when I do get plenty of sleep, I'm not motivated to do much of anything.  Generally feel fuzzy, unfocused, unmotivated and slow.  I feel sad a fair amount and angry at odd intervals, but more just blah... a flat affect, low emotion dullness.  It completely sucks.
I don't really have any helpful advice... Just wanted to assure you that you aren't alone. I can't remember the last time I had a dream...
I'm taking Reyataz, Viread, and Zerit, but I don't think the meds are responsible for my depression. I think that living with this disease is responsible for the depression. The disease and the meds causes fatigue which combined with the fatigue from the depression cause a cycle that seems to snowball. I'm taking Lexapro and Trazadone for the depression. But because of local funding for mentall health, no one is monitoring the effectiveness of the anti-depressants... they are simply being prescribed by my infectious disease specialist because they were prescribed by a Psychiatrist who could only see me for six months. Every time I see my Doc, I mention the fatigue... He's never suggested any treatment or offered suggestions as to how to deal with the fatigue. Just kinda shrugs and says "yeah, it's a common symptom." I feel like if I could get over the fatigue, I could function normally... but I can't find a way to break out of the cycle.... It's really frustrating because the depression is causing a lack of physical activity, and the lack of physical activity is adding to the depression. And the system keeps me jumping through hoops that I no longer have the energy to jump through. My Infectious Disease Specialist has 15 minutes to spend with each patient. He has recently told me that he can only see me for HIV related issues and that I will need to find a primary care doctor for all other issues. (as if I'm supposed to know what's HIV related, and what's not.)
Please forgive my ramble... I just think that people in the medical profession need to take depression and fatigue more seriously, and they need to make it easier - not more difficult, to get help for these disabling symptoms.
Quote
Has anyone else out there stopped using Sustiva (or another drug) because of the depression effect?
Yes.. The depression caused me to just give up.... As a result, I am resistant to many of the meds.
« Last Edit: February 15, 2007, 05:53:41 PM by ScooterTrash »

Offline Christine

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  • Posts: 1,069
Re: Depression and Fatigue
« Reply #13 on: February 16, 2007, 07:07:03 PM »
Have your hematocrit levels checked also. Anemia can cause fatigue.

I have suffered from depression for years, and your description to me sounds like depression- fatigue, sleep issues, low sex drive.

The hard part is that Sustiva can mimic depression. Call your doctor and be more forceful about your concerns. I do understand his perspective of wanting you to keep you stable on Sustiva, but if your quality of life is suffering to the point that you are having trouble functioning in every day life, something needs to change.
Christine
Poz since '93. Currently on Procrit, Azithromax, Pentamidine, Valcyte, Levothyroxine, Zoloft, Epzicom, Prezista, Viread, Norvir, and GS-9137 study drug. As needed: Trazodone, Atavan, Diflucan, Zofran, Hydrocodone, Octreotide

5/30/07 t-cells 9; vl 275,000

Offline ManISOMan

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  • Posts: 168
Re: Depression and Fatigue
« Reply #14 on: February 23, 2007, 04:07:39 AM »
Hello,
I've never taken Sustiva, and I feel like fatigue is a major problem for me.  I take Reyataz, Emtriva, and Ziagen.  I just had my doctor check my testosterone levels and they are within normal range, and I'm not anemic. 

My doctor is also a very sweet doctor as far as personality goes, but he doesn't seem concerned if I am fatigued.  Perhaps that is because I don't work. 

I am depressed about some things in my life, but I know what they are, this was somewhat covered under my "Feeling Stuck" topic.  I'd also really love to have someone to share life with and I know I have more energy when there is someone in my life.  I do feel more motivated.  I'm pretty sure a pill isn't going to change that.  And as far as those people that say money can't buy happiness............well, I'm sure that winning the lottery would make a lot of things better in my life.   The biggest would be having my own space and the money to go out to places to be able to actually meet people or to travel to meet the people that you do meet on-line. 

I keep meeting guys that take steroids or have the testosterone patches and have read how one guy in the small HIV Positive publication, "counsels people to try a cycle of anabolic steroids each year."  He does state, "that people think it's illegal, but it certainly is not for people with chronic disease."  He also states that he uses a product called Juven twice a day.  When I asked my doctor about this, he said that steroids were a "vanity, South Florida" thing.  And as for the Juven, he didn't believe in "eastern therapies."  Now, this guy in the magazine is "way hot," and I'm guessing not too depressed as I'm sure doesn't have trouble getting a date.  Of course, I know his organs may not last as long as mine, but at least he'll go out having more fun.  The doctor did go into the harms of steroid use.  I guess, it's just a coin toss to see who will live longer.................who knows.  Often, I think I'd rather look like the guy in the magazine and take my chances, but I'd have to get another doctor. 

Another thing is that I noticed I had a lump right under my left nipple, this was just after being involved in a relationship and I thought it might have been sore from that until I felt the lump.  I told my doctor I had a lump and he said he couldn't feel one.  Well,  I let it go, until the day I simply said I want to have this checked.   Well, I had a mammagram and then they did a sonogram and I definitely did have a lump, it was actually given a 5 on the birad scale.  Well, I had a mastectomy, yes that is what they call it, and fortunately it was benign.  I was told it was gynecomastia and was caused by meds.  I could have lived with the pain, but I wanted to know whether or not it was cancerous.  And, now I have no pain for which I'm thankful.   Although I've begun to get lumps on the inner part of my elbow and arms, and I'm told they are just lipomas.  I have had x-rays of the elbow and was told there wasn't anything there. 

And the last time, I hesitated to tell the doctor I had a rash on the inner part of my buttocks, he said I had folliculitis.  This was a scheduled visit on Jan 25th.  I woke up last Wednesday, February 14th and had a rash on the upper left part of my back.  I went to the doctor's office and said I needed to be a walk-in.  The very nice guy behind the counter said we don't take walk-ins.  I said well, I need to see someone and showed him my rash.  He said he could have the nurse take a look and go from there.  I said, whatever you can do.  Meanwhile my doctor walks out to get some papers and we exchange hello's, and he exits the reception area.  Well, the nurse comes out and tells me the doctor is making rounds at the hospital.  I said, "no, he isn't, I just saw him."  To which she responded, "well, he is headed there."  I was slightly annoyed at this point.  Well, the other doctor did see me for all of two minutes and gave me  a prescription for the treatment. Now, the plus side is, I was seen by a doctor and the office is just minutes from my house and the pharmacy is right there as well.  But, I can relate to how you feel about having a nice doctor, but nice doesn't always cut it.  But, I've had other doctors and felt the same way, or liked a doctor to find that he was no longer working or moved on. 

So, now I've rambled, but it's just that I can well relate to fatigue, having a nice doctor, and feeling frustrated......................there is however, the convenience of the doctor's office and the pharmacy..............and people at the pharmacy are great, and vey personable. 

Just some of my past and more recent experiences.  Thanks again for reading.  Just another day in the life of Aids/HIV.
Scott

Of course there are those that will look at the time of this posting and say of course you're tired, you're up too late.  I've always been a night owl and when I worked I've been a night auditor in a hotel and also a bartender.  It seems that even when I get up early and have a full day, I just can't go to sleep early.  At times, I can.  And I guess when you feel like you don't necessarily have a reason to get up early, why bother?  I know, breakfast is a good reason!

Offline ManISOMan

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Re: Depression and Fatigue
« Reply #15 on: February 23, 2007, 04:19:11 AM »
I meant to mention and forgot, that the rash was shingles.  Apparently that's what had started on the 25th when the doctor said it was folliculitis and prescribed Bactrim.  Anyway, I'm almost through with taking the acyclovir now that the other doctor prescribed.

Offline ManISOMan

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Re: Depression and Fatigue
« Reply #16 on: February 23, 2007, 03:18:25 PM »
Okay, for the person that mentioned "illiteracy in the forum," I stand corrected.  In my earlier post, I should have typed mammogram.  I did question myself, and thought it may be wrong.  I thought well, they are mammary glands, but the word is dervied from mammography.  And, I did use spell check, something I don't usually do, as I keep a dictionary beside the computer, and the reason I didn't use it was I thought I'd give the spell check a try.  Well, I guess spell check doesn't have mammogram in it's vocabulary.  I do apologize for my mistake.  They usually are typo's, but that wasn't. 
Scott

Offline ManISOMan

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Re: Depression and Fatigue
« Reply #17 on: February 23, 2007, 03:26:12 PM »
Okay, I stand corrected again.  I must just be going crazy.  I typed in mammagram and it was highlighted by spell check.  Sorry, spellcheck.  And, I would've sworn that I didn't see the word "mammagram" highlighted this morning. 

 


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