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What Causes Lethargy, Depression, Joints Pain And Difficulty Walking?
Question: I hada quadruple CaBG july 2014 complicated post op by resp failure related to cingenital cardiac defect of ASD AND PFO. I had intracardiac shunting post op.
Also I suffered a mid cerebral artery stroke with Left weakness and left neglect residual hemianopia. My wuestion is im still so lethsrgic depressed even though im on wellbutrin. I havebosteo arthritis and loys of joint pain with difficulty walkinf and exercising . I have gained abot 30 piunds postnop somebi contributebyo bea blockers inwrnt to a dirtbdocyornhe gave me phentermine and topamax do yountjnk this is safe forvme to use.?
Previously 2007 I had inferior wall STEMI WITH four coroary arterial stentsvolaced
Also I suffered a mid cerebral artery stroke with Left weakness and left neglect residual hemianopia. My wuestion is im still so lethsrgic depressed even though im on wellbutrin. I havebosteo arthritis and loys of joint pain with difficulty walkinf and exercising . I have gained abot 30 piunds postnop somebi contributebyo bea blockers inwrnt to a dirtbdocyornhe gave me phentermine and topamax do yountjnk this is safe forvme to use.?
Previously 2007 I had inferior wall STEMI WITH four coroary arterial stentsvolaced
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I carefully passed through your question and would explain that it is important excluding possible cardiac causes related to your symptoms.
For this purpose, it is necessary consulting with your cardiologist and performing a cardiac ultrasound to examine:
- for possible pulmonary artery hypertension
- the shunt degree
- Ejection fraction
- the cardiac structure, especially the right atrium and ventricle.
If cardiac ultrasound results normal, you should consider other possible causes of chronic fatigue and feeling lethargic. They could also be related to depression after stroke.
Wellbutrin could lead to mood changes and abnormal thoughts. From the other hand the fact that your situation is not changing, it means that further changes to your therapy need to be done.
I would recommend consulting with your doctor and discussing the possibility of switching to another antidepressant therapy ( you should know that all antidepressant can increase weight).
Regarding Topiramate, it is an anticonvulsivant, which can help reduce your weight. But it can cause sedation and aggravate your situation.
From the other hand Phentermine decreases sedation. It can help with weight loss and lethargy. But it can cause adverse effects such as palpitations or tachycardia. It can also interact with Topiramate.
I would recommend starting only with Phentermine , but after consulting with your cardiologist and concluding that your heart is OK.
I would also recommend consulting with a dietitian. There are also non-pharmacological ways to lose weight, and a careful diet could also be really helpful.
Hope to have been helpful!
Kind regards,
Dr. Iliri
I would recommend as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I carefully passed through your question and would explain that it is important excluding possible cardiac causes related to your symptoms.
For this purpose, it is necessary consulting with your cardiologist and performing a cardiac ultrasound to examine:
- for possible pulmonary artery hypertension
- the shunt degree
- Ejection fraction
- the cardiac structure, especially the right atrium and ventricle.
If cardiac ultrasound results normal, you should consider other possible causes of chronic fatigue and feeling lethargic. They could also be related to depression after stroke.
Wellbutrin could lead to mood changes and abnormal thoughts. From the other hand the fact that your situation is not changing, it means that further changes to your therapy need to be done.
I would recommend consulting with your doctor and discussing the possibility of switching to another antidepressant therapy ( you should know that all antidepressant can increase weight).
Regarding Topiramate, it is an anticonvulsivant, which can help reduce your weight. But it can cause sedation and aggravate your situation.
From the other hand Phentermine decreases sedation. It can help with weight loss and lethargy. But it can cause adverse effects such as palpitations or tachycardia. It can also interact with Topiramate.
I would recommend starting only with Phentermine , but after consulting with your cardiologist and concluding that your heart is OK.
I would also recommend consulting with a dietitian. There are also non-pharmacological ways to lose weight, and a careful diet could also be really helpful.
Hope to have been helpful!
Kind regards,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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