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What Causes Low Energy Levels In The Morning?
Question: Hello Doctor
This time, it has been a real battle.
The Mad dark clouds were heavy.
I am on the following medicines
Morning
150 XL well butrim
Night
15 mg Cipralex
.5 or .75 Rivotril
25 mg Seroquel
The energy levels in the morning are extremely low.
No productivity.
Anxiety exists.
As plan B, I have decided to be employed again to have best of the Both the worlds (and the worst) and run the business from back.
I am taking seroquel which makes me drowsy against increasing the rivotril.
There are 2 reasons.
1. Non Availability or difficulty of getting it.
2. I dont want to become benzo dependence
Doctor. I need to know how can i get off the seroquel.
The psychiatrist in doha can prescribe only this medicines.
He does not even know about Vilazodone and it is not available in Doha.
I am travelling to Dubai and will check there.
Also my vitamin D is 29.
My thyroid and blood work is good and clean.
This time, it has been a real battle.
The Mad dark clouds were heavy.
I am on the following medicines
Morning
150 XL well butrim
Night
15 mg Cipralex
.5 or .75 Rivotril
25 mg Seroquel
The energy levels in the morning are extremely low.
No productivity.
Anxiety exists.
As plan B, I have decided to be employed again to have best of the Both the worlds (and the worst) and run the business from back.
I am taking seroquel which makes me drowsy against increasing the rivotril.
There are 2 reasons.
1. Non Availability or difficulty of getting it.
2. I dont want to become benzo dependence
Doctor. I need to know how can i get off the seroquel.
The psychiatrist in doha can prescribe only this medicines.
He does not even know about Vilazodone and it is not available in Doha.
I am travelling to Dubai and will check there.
Also my vitamin D is 29.
My thyroid and blood work is good and clean.
Brief Answer:
Seroquel is better than hiking Rivotril.
Detailed Answer:
Hi XXXX,
It is good that you have made changes in the career front in order to reduce your stress. I am hopeful that this will reduce the risk of further relapses.
Seroquel is also a better option than hiking Rivotril. I was wondering if it would be possible for you to take a very small dose of Rivotril in the morning to counter the daytime anxiety. The night dose of Rivotril can be accordingly reduced. If there's any problem in night sleep, then Seroquel may be increased rather than increasing Rivotril. Seroquel is not associated with dependence and you will not find it difficult to quit, unlike Rivotril.
Please also try taking Cipralex in the morning. Shift it to the night only if it makes you sleepy. If you have been on the current dose of Cipralex for around 4 weeks or so, and are still not well, then it is time to consider a hike to 20 mg per day.
Do not worry if vilazodone is not available. Consider it just as a future option, which is effective and known to be weight neutral, as well as not associated with sexual side effects.
You have managed to overcome these problems in the past and am sure will succeed this time as well.
Best wishes.
Dr Preeti Parakh
Seroquel is better than hiking Rivotril.
Detailed Answer:
Hi XXXX,
It is good that you have made changes in the career front in order to reduce your stress. I am hopeful that this will reduce the risk of further relapses.
Seroquel is also a better option than hiking Rivotril. I was wondering if it would be possible for you to take a very small dose of Rivotril in the morning to counter the daytime anxiety. The night dose of Rivotril can be accordingly reduced. If there's any problem in night sleep, then Seroquel may be increased rather than increasing Rivotril. Seroquel is not associated with dependence and you will not find it difficult to quit, unlike Rivotril.
Please also try taking Cipralex in the morning. Shift it to the night only if it makes you sleepy. If you have been on the current dose of Cipralex for around 4 weeks or so, and are still not well, then it is time to consider a hike to 20 mg per day.
Do not worry if vilazodone is not available. Consider it just as a future option, which is effective and known to be weight neutral, as well as not associated with sexual side effects.
You have managed to overcome these problems in the past and am sure will succeed this time as well.
Best wishes.
Dr Preeti Parakh
Above answer was peer-reviewed by :
Dr. Prasad
Brief Answer:
Seroquel can be stopped abruptly.
Detailed Answer:
Hi XXXXX,
It does make sense not to hike Cipralex now if there is persistent improvement. You can wait for a few more weeks.
Regarding Seroquel, you can stop it abruptly as the dose you are taking is quite small. There is no withdrawal, though obviously you may have lighter sleep as compared to with Seroquel. Alternatively, you can also try taking half of 25 mg for a couple of days before stopping.
Vilazodone is taken in the dose of 10 mg in the morning initially. After 7 to 10 days, it is increased to 20 mg per day in the morning. You will need to reduce and taper off Cipralex when vilazodone is started as both medicines are of the same group and should not be combined. Discuss with your doctor before making these changes.
Best wishes.
Seroquel can be stopped abruptly.
Detailed Answer:
Hi XXXXX,
It does make sense not to hike Cipralex now if there is persistent improvement. You can wait for a few more weeks.
Regarding Seroquel, you can stop it abruptly as the dose you are taking is quite small. There is no withdrawal, though obviously you may have lighter sleep as compared to with Seroquel. Alternatively, you can also try taking half of 25 mg for a couple of days before stopping.
Vilazodone is taken in the dose of 10 mg in the morning initially. After 7 to 10 days, it is increased to 20 mg per day in the morning. You will need to reduce and taper off Cipralex when vilazodone is started as both medicines are of the same group and should not be combined. Discuss with your doctor before making these changes.
Best wishes.
Above answer was peer-reviewed by :
Dr. Naveen Kumar
Doctor
My vitamin d reading came ad 29.
Is it ok ?
Or do I have to take supplement.
Thanks
My vitamin d reading came ad 29.
Is it ok ?
Or do I have to take supplement.
Thanks
Brief Answer:
Take Vit D supplements.
Detailed Answer:
Hi XXXXX,
Your vitamin D level is just below the cut-off which is 30 as per reference range given by most labs. Technically, it does indicate deficiency but obviously, only a mild one. You can take Vitamin D supplements for a few weeks to make sure that level stays in the normal range. The usual protocol is 60000 units once weekly for 6 to 8 weeks.
Best wishes.
Take Vit D supplements.
Detailed Answer:
Hi XXXXX,
Your vitamin D level is just below the cut-off which is 30 as per reference range given by most labs. Technically, it does indicate deficiency but obviously, only a mild one. You can take Vitamin D supplements for a few weeks to make sure that level stays in the normal range. The usual protocol is 60000 units once weekly for 6 to 8 weeks.
Best wishes.
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Above answer was peer-reviewed by :
Dr. Deepak
Answered by
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