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What Causes Lethargy, Laziness, Muscle Pain Throughout The Body And Coldness In Feet?

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Posted on Thu, 28 Apr 2016
Question: since i was a child I had inferiority complex (which has really got better now) and I was mostly depressed. about 10 years back I saw a psychiatrist and I was on medication, stopped the medication, depression triggered again and this was repeated I think 3 or 4 times. About a year and half back I was on Cipralex 20mg for over 15months, I stopped it after I thought I'm doing fine. In the beginning after I stopped I was doing great with lots of enthusiasm, vitality, motivation, energy but after about two months of stopping, I started getting very irritated, unreasonable anger, feeling sad etc... My doc prescribed various medicines like serta, bupron, venlor etc one after the other which I couldn't tolerate the side effects... the usual side effects were frequent urination with painful bladder, feeling very week, tired, tremors in hands, muscle pain, lathergy etc. Bupron i dont remember why but my doc withdrew it.
Currently I've restarted with cipralex 5mg for first 4 days and 10mg since last 10days. My mood seems to be getting better, I'm feeling relaxed but my problem is

1) I feel very lazy with lethargy not feeling like doing anything.
Is there any medicine to take along cipralex 10mg to feel energetic, active, vitality, motivated

2) I feel my whole body muscles are having mild pain like soreness, especially thighs, legs, shoulders, arms... And my feet are always cold. my anus muscle is painful for no reason like hemoroids or fissure or fistula, my nerves are week.

3) I'm worried does cipralex cause any long term side effects, for my father was taking cipralex20mg for about 2years for depression and later he developed Thrombopenia and then MDS and then AML.

4)About a year ago I have my brain MRI scan done, which says mild atrophy for the age.

I'm hypothyroid and well in control with frequent blood tests for TSH & FT4 done and well maintained with eltroxin 75mcg

My doc upon my request has prescribed neurobion injection 1amp every 3months.

I also take Hycibex tablet once a day since 1year.
I take calcirol 1gm once a month since around 6months as my vitamin D is a little low.

Since all these anti depressant drugs have caused lack of sexual interest my endocrinologist had prescribed testosterone gel which I'm applying half satchel every day since over a year and my testosterone level is on the lower side of normal level.
when I was 15 years old, about 24years back I had swallowed about 10-15 tablets of gardinal which was prescribed to my elder sister for epilepsy. I got unconscious and was hospitalised for a few days.

I'm 39years old, weighing 68kgs, 5'8" with normal blood test results for renal, hepatic, thyroid, hematology lipid profile tests, I'm not diabetic.
I want to feel energetic, motivated, enthusiastic like feel for first few days after withdrawing antidepressants.


Kindly advise.

Thanks & regards
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (1 hour later)
Brief Answer:
modafinil can be added

Detailed Answer:
Hello,
Thanks for using healthcaremagic.
I have gone through the details provided in query and understand your concerns.


I will prefer to answer your four questions keeping in mind the complete medical as well as family history.

1. Since you are feeling less energetic and lazy I think modafinil 100 mg can be added to your current treatment which can be increased to 200 mg after one week if there is inadequate response.

2. The symptoms are indicative of somatization which commonly occurs with long term depression. I do not think you need to do anything special except keeping yourself active to the maximum possible extent. Also it is advisable to supplement your diet with vitamin B complex which is available over the counter on most medical stores.

3. Cipralex is relatively safe and do not cause any life threatening side effects as mentioned for your father. It was possibly a coincidence rather than any casual association. You will probably agree with me that after use of Cipralex on multiple occasions you are doing well and it is helping you for a great extent.

4. Age associated mild atrophy on MRI is normal and occurs in all of us to some extent. It is considered normal and I do not feel it needs further explanation.

I hope this helps you.
If you have more questions feel free to write back to me.
If not please close the query and rate the answer if possible.
Thanks and regards.
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Dr. Ashok Kumar Choudhary

Psychiatrist

Practicing since :2000

Answered : 3350 Questions

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What Causes Lethargy, Laziness, Muscle Pain Throughout The Body And Coldness In Feet?

Brief Answer: modafinil can be added Detailed Answer: Hello, Thanks for using healthcaremagic. I have gone through the details provided in query and understand your concerns. I will prefer to answer your four questions keeping in mind the complete medical as well as family history. 1. Since you are feeling less energetic and lazy I think modafinil 100 mg can be added to your current treatment which can be increased to 200 mg after one week if there is inadequate response. 2. The symptoms are indicative of somatization which commonly occurs with long term depression. I do not think you need to do anything special except keeping yourself active to the maximum possible extent. Also it is advisable to supplement your diet with vitamin B complex which is available over the counter on most medical stores. 3. Cipralex is relatively safe and do not cause any life threatening side effects as mentioned for your father. It was possibly a coincidence rather than any casual association. You will probably agree with me that after use of Cipralex on multiple occasions you are doing well and it is helping you for a great extent. 4. Age associated mild atrophy on MRI is normal and occurs in all of us to some extent. It is considered normal and I do not feel it needs further explanation. I hope this helps you. If you have more questions feel free to write back to me. If not please close the query and rate the answer if possible. Thanks and regards.