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Iam A Physician My Daughter Has Been Recently Diagnosed With
Question: iam a physician
my daughter has been recently diagnosed with PCOS with multiple cysts on one ovary and the other ovary shows a follicle
she has severe hypothyroidism since 10 yrs requiring 250 mcg of thyroxine daily
her initial symptoms 10 yrs ago were severe depression and anxiety with hypothyroidism
and severe weight gain
recently progressed to PCOS
She had been treated with antidepressants for may years and recently her moods are slightly stable with ecitalopram and aripiprazole
the main problem is LACK OF ENERGY ALWAYS
she wants to study and achieve her goals but lack of energy hinders her progress and some time she doesn't even have energy to do with daily chores
is there any solution?
her periods have recently become irregular with inter menstrual spotting but are corrected by hormone pills
she does not have cushings and her cortisol is normal
could there be some adrenal insufficiency also?
here are my questions
WHAT IS THE CAUSE OF LOW ENERGY?
1. she is using ecitalopram 20mg/DAY
2. ARIPIPRAZOLE 4MG/DAY- IS THIS DOSE ENOUGH?
3. VYVANSE 30MG SOS- IT CRASHES IN 2 HRS -IS THERE ANOTHER DRUG WITH SUSTAINED ACTION?
4. ADVISE ON EXERCISE DID NOT HELP, SHE CANNOT PUSH HERSELF
4. THYROXINE 225 MCG
5. ADRENAL INSUFFICIENCY?
my daughter has been recently diagnosed with PCOS with multiple cysts on one ovary and the other ovary shows a follicle
she has severe hypothyroidism since 10 yrs requiring 250 mcg of thyroxine daily
her initial symptoms 10 yrs ago were severe depression and anxiety with hypothyroidism
and severe weight gain
recently progressed to PCOS
She had been treated with antidepressants for may years and recently her moods are slightly stable with ecitalopram and aripiprazole
the main problem is LACK OF ENERGY ALWAYS
she wants to study and achieve her goals but lack of energy hinders her progress and some time she doesn't even have energy to do with daily chores
is there any solution?
her periods have recently become irregular with inter menstrual spotting but are corrected by hormone pills
she does not have cushings and her cortisol is normal
could there be some adrenal insufficiency also?
here are my questions
WHAT IS THE CAUSE OF LOW ENERGY?
1. she is using ecitalopram 20mg/DAY
2. ARIPIPRAZOLE 4MG/DAY- IS THIS DOSE ENOUGH?
3. VYVANSE 30MG SOS- IT CRASHES IN 2 HRS -IS THERE ANOTHER DRUG WITH SUSTAINED ACTION?
4. ADVISE ON EXERCISE DID NOT HELP, SHE CANNOT PUSH HERSELF
4. THYROXINE 225 MCG
5. ADRENAL INSUFFICIENCY?
Brief Answer:
Consultation
Detailed Answer:
Hello, and thanks for your question.
I would ask the following questions:
1. Has she had a sleep study? With MSLT? This may be narcolepsy or another sleep disorder.
2. Does she take the escitalopram at night, rather than the morning? It can rarely be sedating.
3. Aripiprazole can sometimes be sedating.
4. Has she been on higher doses of Vyvanse? It is the longest-acting stimulant but can be used at doses up to 70mg.
5. Has she had a Vitamin D level drawn? Low Vitamin D can cause this.
Dr. Sheppe
Consultation
Detailed Answer:
Hello, and thanks for your question.
I would ask the following questions:
1. Has she had a sleep study? With MSLT? This may be narcolepsy or another sleep disorder.
2. Does she take the escitalopram at night, rather than the morning? It can rarely be sedating.
3. Aripiprazole can sometimes be sedating.
4. Has she been on higher doses of Vyvanse? It is the longest-acting stimulant but can be used at doses up to 70mg.
5. Has she had a Vitamin D level drawn? Low Vitamin D can cause this.
Dr. Sheppe
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Prasad
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