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Can Antidepressants Cause Chronic Fatigue Syndrome?

Most people are aware that antidepressants are often used to treat chronic fatigue syndrome, but what many don’t know is that there are cases by which they actually can cause temporary cases of “fatigue” that could technically be diagnosed as chronic fatigue syndrome. The fatigue often sets in after a person has been medicated with an antidepressant or antipsychotic for an extended period of time, and may be thought of as a long-term effect of the treatment.

In other cases, people notice that when they pursue antidepressant withdrawal, one of the symptoms is fatigue. In many cases, the withdrawal is so prolonged, lasting for months (as opposed to “days” like most doctors suggest), that people believe they have developed “chronic fatigue syndrome.” Based on the relatively vague diagnostic criteria for chronic fatigue syndrome, a doctor may end up throwing another medication onto your existing cocktail – which may end up impeding the recovery of your natural, homeostatic energy levels over the long-term.

Did you have chronic fatigue syndrome before taking an antidepressant?

The most obvious question to ask yourself is whether you struggled with chronic fatigue syndrome prior to taking an antidepressant. If you have always been fatigued, then there’s really no need to question whether it was caused by your medication. However, if you developed the extreme fatigue after treatment with an antidepressant (or array of psychotropic medications), your physiology will likely recover (assuming you don’t exacerbate the problem by throwing more medications at it).

Identifying when you developed chronic fatigue

It is important to clearly identify when you first developed symptoms of chronic fatigue so that you understand whether it was caused by your medication or whether you’ve always had it. Usually the severest cases of chronic fatigue are caused by toxins and/or a latent virus.

  • Pre-antidepressant: Those that were extremely fatigued to the point that it was “chronic” prior to taking their antidepressant know that it wasn’t caused by their medication. Therefore if you had it before you took the drug, it’s unlikely that the drug was the root cause. It could have amplified the fatigue at a later date, but it wasn’t the specific cause.
  • During treatment: If you developed the extreme fatigue during your treatment, it may be a side effect of the medication. Many people develop fatigue in the early stages of treatment, but it doesn’t end up becoming chronic; it eventually subsides. However, some people experience fatigue throughout their entire course of treatment; this is usually caused by neurotransmitter alterations. That said, if a medication made you feel energetic for a year or two, then you became chronically fatigued, it’s likely that antidepressant-induced physiological changes were the cause.
  • Withdrawal: Nearly every withdrawal from an SSRI is characterized by fatigue. For some, the fatigue lasts longer than others. During withdrawal, the physiology needs an extended period of time, low stress, and nourishment to reset itself to homeostatic functioning. If not given proper care, the fatigue can often persist until the physiology recovers and stress is reduced.

How Antidepressants Can Cause Chronic Fatigue Syndrome…

Below are some ways by which antidepressants may contribute to the development of chronic fatigue.  Understand that since each person is unique, an interplay of these potential causes (to varying degrees) is very likely.

  • Adrenal mining: Some people believe that certain antidepressants (e.g. Paxil) are capable of essentially “mining” the adrenal glands while taking them. This is one theory as to why the Paxil poops out (or stops working) because the adrenal glands become fatigued and no longer make adequate cortisol to maintain alertness. This can lead people to feel tired while still taking the medication and the fatigue can persist for a long period until the adrenals have been given sufficient time to recover.
  • Chemical imbalance: It is known that antidepressants alter levels of various neurotransmitters like serotonin, dopamine, and norepinephrine. They also indirectly alter the functioning of many others and the exact changes made in the brain aren’t really well-known. The fact that many antidepressants can cause a chemical imbalance and actually deplete various neurochemicals over time could lead to fatigue.
  • Gut microbiome: There is significant evidence suggesting that antidepressants significantly alter the gut flora and are capable of causing microbial dysfunction within your gut. When your gut bacteria becomes disturbed and significantly altered, this can lead to numerous physiological responses, one of which is fatigue.
  • Hormone alterations: It is thought that levels of various hormones become altered with psychotropic treatment. Some believe that antidepressants lower testosterone levels, change leptin production, as well as cortisol. Although there isn’t much evidence suggesting how antidepressants affect hormone levels over the long-term, it is likely that they could cause an imbalance.
  • Motivational deficit: Taking antidepressants can make people feel emotionally numb and decrease their motivation. This is often referred to as emotional blunting or “apathy” and is a common experience. It can turn you into an amotivational zombie because you don’t have any emotion to support the motivation.
  • Sedation: A very common effect of antidepressants is that they make people feel sedated and/or drowsy as a side effect. If you find yourself sleeping a bunch while taking the drug, it could be that the alteration of certain neurotransmitters is making you excessively fatigued. This is very common among drugs that affect serotonin as well as histamine.

My experience with antidepressant-induced chronic fatigue

Back when I was taking Paxil back in the early 2000s to cope with my social anxiety and depression, it worked great for awhile. However, I hit a point on the medication where my energy level began to noticeably drop. During this drop period, I had extreme difficulty getting out of bed and became excessively tired.

I would sleep for 12 to 14 hours per day and my family would do their best to get my (seemingly) lazy ass out of bed. Although I wanted to have enough energy to get out of bed, I was excessively fatigued – to the point that most of my day was spent either sitting on a chair or the couch. Long story short I went through “antidepressant roulette” and no medication helped my energy – in fact Cymbalta made the fatigue even worse.

My energy remained low and it was highly frustrating – I could barely function. At the time I didn’t really know what to do and wasn’t getting any good advice. I truly believed that in addition to depression, I had simultaneously developed chronic fatigue syndrome – and my parents agreed. However, since I had many difficulties with all antidepressants and psychotropics (including worsening of depression), I stopped using them.

In the meantime, I had experienced at least 8 to 10 months dealing with (or at least attempting to deal with) chronic fatigue.  Even when I started to notice my energy levels returning approximately 1 year after I had discontinued all psychotropics, I still wasn’t at 100%.  When I finally started listening to my therapist and practicing guided meditation, self-hypnosis, etc. and relaxing each day to minimize anxiety, I noticed that my energy continued to improve.

I chalk this improvement up to the fact that stress was decreased.  When stress is high, it acts as a barrier for physiological healing.  By reducing stress, the adrenals become less taxed, neurotransmitter activity starts to stabilize, and hormone production changes.  In addition to stress reduction, I threw some light exercise into the mix; each day of going for a simple bike-ride

I also focused on eating relatively healthy and supplemented by diet with fish oil per recommendation of my therapist.  Whether it actually helped, I’m not sure, but I’m not going to dismiss the possibility.  It took nearly 1 year and 6 months for my energy level to fully return to what it was pre-medication.  This may seem like a long freaking time (and that’s because it is).  Even though it took a long time, I feel lucky to have escaped from the depths of chronic fatigue.

Looking back, I couldn’t believe that I had gone from a person thinking that I was eternally doomed with chronic fatigue to a person that had a full tank of energy. My experience goes to show that full recovery (in terms of energy level) is possible with enough time and the proper approach.

What may have caused my specific case of chronic fatigue syndrome?

If I wanted, I could’ve easily been diagnosed with chronic fatigue syndrome, but knew that most of the medications used to treat the condition, I had already tried (e.g. antidepressants). I didn’t see a point in having another diagnostic label tacked on what was already: major depression, severe anxiety, and premorbid schizophrenia (yikes). Below are some hindsight speculations as to what may have contributed to my antidepressant-induced chronic fatigue.

  • Adrenals: I believe that my adrenals were extremely taxed from being on an array of different medications. This lead to underproduction of certain hormones necessary for maintaining alertness and optimal cognitive function. If I had to place the bulk of the blame on one medication, it would’ve been Paxil.
  • Depression: My depression had actually increased for most of the time that I took medications. This increase in depression likely contributed to an increase in fatigue… this may have elevated slow, theta waves in certain parts of the brain in which they create dysfunction and tiredness.
  • Excessive sleep: Getting plenty of sleep is good to let the body heal, but when excessive sleep becomes a habit, it’s a problem. I got into a routine of oversleeping as well as being lazy around the house in order to cope with the fatigue. Although it’s difficult to force yourself to get up instead of sleep for 14 hours, it’s usually necessary for recovery.
  • Neurotransmission: The newly created neurotransmitter imbalances as a result of taking antidepressants for an extended period may have also lead to fatigue. Since most antidepressants that I took targeted serotonin, I’m guessing that they provoked problems within the serotonin system that caused fatigue.
  • Stress: I already had a significant amount of stress resulting from social anxiety as well as depression. Since I was in school, socializing, trying to fit-in, and getting homework done all increased my stress – which made me more fatigued. When your adrenals are already fried from the medications, and you’re stressed, it becomes nearly impossible for them to recover.
  • Withdrawal: Withdrawing from many antidepressants “cold turkey” may have served as a shock to my nervous system, leading to fatigue and a slower overall recovery. (Read: Quitting Paxil Cold Turkey). There are many elements of withdrawal that also increased my stress, which likely amplified, or at the very least, fostered my existing fatigue.

Why a Chronic Fatigue Syndrome Diagnosis Stemming from Antidepressants can be Problematic

Assuming the antidepressant(s) you were taking was the root cause of your chronic fatigue, there are some problems with getting formally diagnosed. In most cases a formal diagnosis is viewed as requiring “lifelong” treatment; medical professionals will always view you as suffering from a “chronic” condition on top of your depression.

The professionals often fail to realize that the antidepressant medications were the root cause of the newly developed fatigue, but instead they assume it’s just another new development. Though the fatigue is real, we know it stemmed from the antidepressant. It’s almost comparable to getting misdiagnosed with Bipolar 2 disorder after going through an array of psychotropics – it’s a temporary phase resulting from using medications.

  • Eugeroics: You may be given a drug like NuVigil to help you maintain alertness. While it may work to offset the fatigue, it may be a hindrance to recovery of your physiology. If you have adrenal problems resulting from antidepressants, this drug not only may be patching the problem, it may magnify it over the long-term.
  • Helplessness: Another diagnosis sure makes people feel good… not. Anytime you get diagnosed with another condition, you feel even more hopeless and become confused about your own mental health. This leads to helplessness and feelings of being “trapped,” unable to improve because you’re always battling something new.
  • Long-term prognosis: Assuming you are treated with medication like a eugeroic or psychostimulant, they will work, but may not be favorable over the long-term. They can mask the fatigue by activating the CNS, but you may need the exact opposite in order to heal and for your body to restore its energy levels.
  • Psychostimulants: Taking these drugs over the long-term can lead to a host of problems such as dependence, addiction, abuse, and exacerbation of fatigue. Not only can these medications be taxing on your adrenals, they can activate the fight-or-flight response of the sympathetic nervous system, alter hormones, and deplete dopamine.

How I Decreased Fatigue and Restored My Energy Levels after Antidepressants

At the time, I didn’t have a specific plan of action in place to recover from the antidepressant-induced fatigue that I experienced. In fact, I didn’t even fathom the possibility that I would ever overcome it; I assumed that I was fated to become a lifelong “sloth.” My energy was so low that I was convinced I had a brain tumor; an MRI eventually ruled this out. In hindsight, there are some specific things I could’ve done that helped me overcome my fatigue.

  • Acceptance: It was important to accept my current situation as well as how I was feeling. I needed to accept that I was tired, and needed to honor that feeling rather than ruminate over it. Constant brooding over the fatigue and contemplation as to why I felt fatigued only stressed me out more, which I now know can increase the fatigue.
  • Avoiding stimulants: Assuming my adrenals were already taxed and/or overexerted, I made a conscious effort to avoid stimulants. By stimulants I mean caffeine, energy drinks, etc. – I wasn’t taking psychostimulant medications, but if I was, it would’ve been beneficial to avoid those as well. Ironically these can be great for treating actual cases of chronic fatigue, but may exacerbate the fatigue in the long-term if it was caused by antidepressant usage.
  • Diet: Cleaning up the diet and eating foods that jive well with your physiology is key. I’m not going to make specific recommendations because I’m not a dietician, but I will say that getting plenty of vegetables, some fruits, and high-quality protein is beneficial.
  • Exercise: There’s no need to run a marathon, in fact excessive running probably won’t be much help in recovery. Simple exercise like walking and/or light jogging for short periods of time can help the body heal. High intensity stuff may impede recovery.
  • Letting time pass: While your body is attempting to heal itself, it is important to understand that time needs to pass before you will fully recover. Many people want to rush the process and stress themselves out because they aren’t patient enough to put up with their fatigue. Accepting the fatigue and understanding that time needs to pass to recover is crucial.
  • Relaxation techniques: Engaging in relaxation techniques that shut down the sympathetic nervous system promotes healing. The quicker you can reduce activation of your fight-or-flight response, the quicker you will recover. In fact, most people notice that when they are able to tone down the fight-or-flight, their energy level substantially increases.
  • Sleep: Getting plenty of sleep is still good when you are fatigued because the body may need the sleep to heal itself. That said, make sure you aren’t sleeping excessive amounts – set limits. You may want to play around with the amount you get and also track the quality.  Adjusting sleep is one of many ways you can use biohacking to improve mental health.
  • Supplementation: Really the only supplementation that I took was fish oil. Whether this actually helped my brain recover or not is debatable. However, even if it didn’t really do anything, it may have had a placebo effect on me at the time, leading to a slight reduction in anxiety and improvement in mood.
  • Therapy: To mentally cope with the fatigue, I sought out help from a trained psychotherapist. Although she may not have realized the extent to which I was struggling, she often gave me really good advice about how to cope with my anxiety and depression while being off of medication.

Bottom line: Energy Levels will Return in Time…

Assuming you have stopped taking your antidepressant and aren’t under the influence of any substances, your physiology should fully recover to its pre-medication state of functioning. If you are still on a medication, there’s no guarantee that your physiology will be able to heal itself and that you’ll be able to overcome the fatigue. Furthermore, if you are highly stressed and aren’t able to find a way to minimize your stress, the fatigue will likely persist until you find a way to manage it.

In my experience dealing with fatigue, it can seem impossible to overcome. As long as you are giving the body what it needs to recover (e.g. nourishment) and are avoiding things that trigger stress and tax the adrenals, you should eventually regain your energy. It can be highly frustrating to feel fatigued, unproductive, and mentally foggy all the time, but based on my experience, any form of antidepressant-induced fatigue can be overcome with time and proper effort.

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18 thoughts on “Can Antidepressants Cause Chronic Fatigue Syndrome?”

  1. I discovered and read all of this a while ago, whilst trying to find answers to my cfs diagnosis. So this inspired me to persevere with yet another attempt at withdrawal from sertraline. I was prescribed it for what was really a reaction to stress and tiredness 20 odd years ago! How readily they offer it to desperate but vulnerable people, but then you are on your own.

    Each protracted attempt failed, as I still suffered withdrawal symptoms: then either a “flatness” in the early years; but in more recent years, akathisia, which is so distressing. I had believed the marketing hype: that my brain “needed” it in order to be “normal”; but my most recent reluctant return to sertraline was purely out of distress, and a desperate need to get relief from it.

    Then I was diagnosed with cancer, had surgery, and eventually ended up with this cfs diagnosis in late 2015. But rather than surgery being the cause, I realised that I had been experiencing this in ever increasing intensity over the years (slow on-set cfs) but all of my different symptoms had never been connected nor acknowledged by gp’s!

    So, here I am offering hope to anyone who is desperately seeking a possible cause/resolution…I have felt a great improvement as I have withdrawn, despite some unpleasant temporary symptoms! I feel alive again, which I did not think I would ever feel again: I could only see a future of crippling disability, and battling for recognition from many segments of society.

    What I am left with is coping with anger as I have been so let down, misunderstood, and pretty much alone with all this. I don’t relate to my support group for m.e/c.f.s/fibromyalgia any more…some are taking ssri’s of course, and just are not open to this information.

    I am not exaggerating when I say that sertraline has ruined my life: how I have felt, functioned, related with others (including my children), potential for achievement. I am hoping to channel all this frustration into positive changes…to try to turn it all around!

  2. I would like to get in contact with whoever wrote this, I am actually a scientist and am interested in these findings. Perhaps not a scientist for too long given my poor health currently. Anyway, I feel like this is exactly what has been occurring to me over the past 2 years. I’ve been on SSRIs for 10 years since I was 18. Now 28, chronically fatigued, depressed, lack motivation to do anything, and have chronic headaches and muscle pain.

    I have been like this everyday for 2 years now. Been to several doctors and have had several scans and tests done and nothing. Currently still on SSRIs for my anxiety and neurosis, it has been the only constant medication I’ve been taking. I always thought that my chronic fatigue was caused by my headaches and muscle pain, but maybe it is the other way around. I’ve changed my diet and attempt to exercise regularly but still am plagued by this rubbish.

    • You’re not alone, buddy. Same exact story, except I’m 35 and have probably been dealing with this issue a few more years. So many medical tests… and nothing. So many medications… and nothing. Different diets… nothing. Different supplements… nothing. Countless hours spent reading and wondering what was wrong with me.

      I could go on, but you get the point. I’ve concluded what I was afraid to admit to myself all along; there’s nothing wrong with me and there never has been. My doctor prescribed an antidepressant for my mild anxiety about 15 years ago and my life has never been the same. Instead of digging myself out, I continued to listen to and trust doctors, take more meds and now find myself so deep that recovery is nearly impossible.

      I wish I could go back. Naïve doctors prescribing AD’s to naïve patients. That pretty much sums it up. I used to have so much life, such motivation and so many dreams. Now I find myself dragging through life. What a waste. And yet people are profiting from this recklessness.

      I’m not a fan of lawsuits and such, but seeing a class-action lawsuit in this regard is something that I would fully support. Big pharma and supporting docs should be ashamed of themselves.

  3. I’ve been on Effexor for 16 years. I cannot get off of it and I feel like it’s killing me. Depressed and anxious everyday. Dead tired everyday around noon. I have to sit in traffic every day in the morning and it’s the worst. The Dr. keeps prescribing klonopin for anxiety which seems to work but I fear I’m getting hooked on it.

    I have a high stress job and a bad marriage. The only reason I try is for my 2 teenage boys. This feels like an endless spiral of doom. I have no support… counselors don’t really help. Sleep away the weekends… I’m 48 I feel like my life is over. Any suggestions? Thanks.

  4. The Internet can do a lot of harm by people self diagnosing, which I have to admit I’ve done a few times. I have been searching and searching and am grateful I kept looking. I started having really bad side effects while on SSRI to a point that my side effects where worse then the depression and anxiety that I had before the medication. I ended up switching to SSRI medication after I found the antidepressant I was on wasn’t really doing the job anymore.

    I instantly felt better but it didn’t stay that way for long so they upped my dose to to 100 and that’s when I started feeling really out of it. I would be in the middle of a conversation and not remember what I was just talking about, extreme fatigue especially after about 2-3pm. I don’t lay down and there were many days I would go home before picking up my girls to lay down. Then came the anxiety and panic attacks. I was a mess.

    I went about it wrong and stopped taking them a couple days before seeing my doctor and he said there was no point weening off them if it’s been a few days. Just as it was when I went on them the first few days off I felt amazing. I do definitely feel better but the fatigue really scared me. I’ve been off for a couple weeks and was in tears today because I was worried something was wrong.

    I’m grateful for this article because I know now what is going on and that I may not feel better right away but it will happen. Thanks for all the suggestions, everyone is manageable and can see them helping. I’m not sure what the future holds in regards to needing anti depressants. I’d love to not have to take them. I’ve dealt with depression my whole life so I have to be ok with the possibility of going on something.

    Just hard because it’s such trial and error. For woman I find that after having kids and getting a little older hormones are outta whack already, add depression or anxiety to the mix makes things difficult. I’m not against antidepressants I just wish this information was a bit more readily available. Especially the fact you’re dealing with depression and anxiety issues.

  5. I am 5 months off Effexor which I was on for 12 years. I weaned myself off over a period of 4 months. I was on 225 mg at the end. If I had only known how it would rob me of my life after being off of it, I would have NEVER naively started. My problems were minute back then.

    Depression, anxiety, chronic fatigue, weight gain are a few symptoms since being off this drug. I don’t want to see another Dr. only to be put on more medication. And so I wait; wait to feel normal again. I wish I knew how long this would take. I am missing out on so much happiness.

    • Hey Janet, I notice it’s a while since you wrote your comment, but as I recognize myself to some degree in your story, I was wondering how you are doing now? Is your energy back yet? When did the fatigue start, during withdrawal, immediately after you quit, or some time after?

      I quit effexor a little less than a year ago, after struggling with heavy withdrawal symptoms I managed to get off them after about two months with steady reduction. Didn’t notice anything while on them, only if I ever forgot a pill. Then, about 4 months after coming off them I got a job, with a bit of added stress to my life during the initial training… I crashed my third week.

      And I have not been even remotely better since that day. Nothing can explain my fatigue, and I’m not depressed (I would have recognized that much). Stumbling over this text and the comments again makes me furious I was ever talked into trying it, if that could be the reason why I now sit here with a shadow of what my life used to be.

    • K, I’m with you. I was depressed for years before I started SSRIs. Being tired is better than being suicidal. For years I took trazodone to help me sleep, then a couple years ago it stopped working. I have tried all the alternatives (worked for a while, then didn’t) and had a sleep study. For the last year I’ve had provigil to help me be more alert, now the provigil effect is wearing off. Merrie, feel free to contact me if you need more people to talk to.

  6. This is extremely interesting. I’ve been suffering with CFS for about 18 months now. 2 years ago I took citalopram for 3 days – and immediately stopped as my cognitive ability massively declined, my memory was appalling – I just couldn’t think and I was hugely concerned at the going from an intelligent person to someone who couldn’t even organize a shopping trip – yes it was that bad.

    Even though I only took the pill for three days and stopped this severe brain fog continued for many months following. It began to slowly clear after 4/5 months but I noticed that I’d begun eating huge amounts of foods and craved carbs all the time – if I didn’t eat I felt awful. I went to see a nutrionist (last time I will ever do that) and was told I must have candida. I then spent months on various candida diets, all the time feeling worse and worse.

    I began having headaches, memory and concentration declined and I felt exhausted all the time. Eventually a doctor diagnosed me with CFS. Since then I’ve tried vitamin drips, hydrocortisone, LDN, HGH, all the supplements in the world – for the last 18 months I’ve tried everything – and at some points felt a little better, and at others back to square one. I recently stumbled across a supplement that has made me feel pretty much back to myself, which I’m absolutely ecstatic about – a couple of weeks ago I started taking high dose L-tyrosine.

    The first time I took it I felt fantastic – sharp, motivated, elated. L-tyrosine is a precursor to dopamine. Low levels of dopamine cause you to have fatigue, memory problems – and – massive craving for food particularly carbs (as food raises dopamine). 2 years of pain – if only I had a doc who knew their ar*e from their elbow. I’ve seen no less than 20 medical professionals, most doctors and professors and none of them even began to suggest something in this area.

    In many respects it’s actually a little scary how little these people know. It’s clear to me now that the SSRI created this opiate depletion/imbalance, which caused my fatigue, memory and concentration difficulties. I had all the symptoms of CFS (and therefore as CFS is diagnosed by symptoms I had technically had CFS) but my problem was low dopamine levels, easily rectified by 2000mg L-tyrosine in the morning and 1000mg at night a couple of hours before bed.

    I read a really interesting piece by Dr Myhill (on her website) about different people having different opiate dominance and hence personality type – so it lists personality traits and then identifies you as a certain dominance – I’m undoubtedly dopamine dominant – and hence why I believe my symptoms were so severe from lack of dopamine. It seems people react differently to SSRIs and I wonder if it has something to do with these different opiate dominances.

    For me – SSRIs made two years of my life extremely difficult, in many ways robbing me of two years as I have socialised very little and my career has stagnated. Hopefully I can now continue my life as it was previously! I’m not entirely certain where I go from here – will I need to take L-tyrosine ongoing – has citalopram permanently effected my natural production of dopamine. More research needed – but at least I now know why I’ve been unwell.

  7. Hi, also wondering if anyone who has posted here with similar stories would be willing to talk to me. I’d like to write a story on this. I’m a professional writer and would ensure anyone who contributed would get to have the final say on what I write about their experience. I think our voices need to be heard.

    I can’t believe my chronic fatigue is so far outside the norm that it’s not the experience of many others. If I could publish a piece in a periodical, that might help even more people. I’m very serious about this (though not such a serious person myself). Thanks! And I’m happy to share my credentials too.

    • Hi Merrie! This website posting is great relief to share and have the courage to “hang-on” when facing Chronic fatigue induced by SSRI/SNRI’s! I agree 100% with the author based on my own experience of Paxil I got against anxiety at college. Sure I’d be happy to contribute and share for your article as CFS has affected me during Paxil usage (18 years) and after discontinuation (1 year)!

      With regards to “mirtazapine” that you tried, it knocked me out for 48 hours and my doctor said I was “too sensitive” and not compliant and to get the benefits I would have to bare with the bad side-effects for 2 weeks. Yet, it freaked me out to be so fatigued / immobile that I did not touch that medication again. I changed doc. and the new one said his patients often complain about not being awake at all on “mirtazapine” till evening (they are usually on disability).

      So mirtazapine is only good to knock you out” when life is absolutely unbearable. As to CFS and the aftermath of long-term Paxil use I am battling every day with the damage the drug has probably done to my adrenals / Brain and unable to work! Fortunately, I have a loving and patient wife and no major stress at present.

      CFS as well as cognitive & sexual decline (at 50) despite healthy food and regular exercise (that I force myself to do) make it hard to believe in recovering, yet this article gives hope that with time and natural methods it is possible to overcome CFS. Thanks!

    • Hi Merrie, If you are still looking for people to talk to who have experienced extreme fatigue (and weight gain!) from being on Paxil for 17 years, I’d be happy to share my story. Thanks! I am currently on my 11th day of “weaning off” the Paxil under my doctor’s supervision.

  8. Thank you for writing this! It’s my story to a T. I’m glad to hear others tell these stories because it helps the rest of us who are trying to figure out what could be wrong. I have spent the past eight months titrating off of cymbalta, gabapentin, and alprazolam. I tapered off cymbalta first and had the gamut of withdrawal effects for a couple months. Then I tackled gabapentin, going from 2000 mg daily to now zero. I can’t even describe the anguish I’ve experienced.

    I almost took my life, and I’m a mom with three wonderful kids and a loving husband. I have had so much grief from meds that were meant to help me recover from the grief and anxiety accompanying the death of my son and postpartum depressions in all four pregnancies that I want to shout on the rooftops to any person considering going on antidepressants to really stop and consider what they might trade for it.

    But of course, life is far from easy, and I never thought to ask these questions first. As it is, I suffered from chronic fatigue for ten years (!!). The fatigue went away two months after the cymbalta was out of my system, and the depression and anxiety are continuous problems. Major problems. But I’m learning meditation, exercise, and all the other nonmedical approaches to dealing with the anxiety and depression.

    As proof that the cymbalta is the cause of my chronic fatigue (because I didn’t know for sure), I had an identical response to a similar med the doctor prescribed to help me with tapering off the gabapentin: doxepin (SNRI). Within hours of taking just a fraction of the first dose, the fatigue just overwhelmed me so I immediately stopped taking it. Then, two months later, my doctor, desperate to help me with the severe rebound anxiety and depression I was having (from my own biology and tapering off alprazolam) prescribed mirtazapine (a “tetracyclic” antidepressant).

    I’ve taken it three days in a row and the results have been: bad fatigue after the first dose (but very little anxiety–yea!!), severe fatigue after the second dose (hardly any anxiety), and today, no anxiety but absolutely debilitating fatigue (just like I’d had for so many years). I’m now certain that my fatigue wasn’t my own weakness but truly a drug effect, and I wish doctors would know more.

    It’s so far from a perfect world we live in, but this piece of information could truly save so many people anguish from wondering why they’re so fatigued. I still have an uphill battle on my hands, but at least I know that chronic fatigue is caused by antidepressants (in my case). May my information bless someone else, like yours has.

  9. Well almost same happened when I discontinued, but fortunate enough to know that it is deficiency of iron and B12, so tried a combination of it in Feroglobin, and luckily resolved the problem. Still I’m using it since 4 months, as whenever I don’t take it even for a day, symptoms reappear. At least I’m satisfied to work normally as before taking antidepressants.

  10. Thank you for sharing your experience with antidepressant related fatigue. I took Effexor for 9 years. About 3 years after I started taking Effexor, my energy levels began to drop. My Dr. ran tests and then diagnosed me with Chronic Fatigue Syndrome. He sent me to a specialist who also ran tests and then prescribed steroids. Neither my Dr. nor the specialist ever suggested that the fatigue could have been caused by the antidepressant.

    When I stopped taking Effexor last August I realized that this medication was actually the reason why I had no energy and was sleeping 14 hours a day. It has now been 10 months since I discontinued Effexor. Some days I feel more energetic, but I still experience many days when I feel extremely fatigued. It is a relief to think that this continued fatigue may still related to taking an antidepressant. I hope that my body will eventually repair itself and that I will once again regain the energy level that I had prior to taking Effexor.

    • Wow this post literally saved my life! Here’s what I’ve been dealing with. I had been on an anti-depressant off and on for 24 years. I was on Effexor for the last 10. I decided I wanted to be less medicated and see if I could control my anxiety disorder with a more natural approach. In August of 2014 I began my year long taper. In June of this year I managed to break free of it unfortunately I became very anxious and went on and off Lexapro over a month’s time which I know can’t be good for anything. I am off everything now the last few weeks.

      While I was coming off the Effexor I began experiencing extreme fatigue (I had always had so much energy before). Now it seems like every day around noon I begin a dissent into a horrendous fatigue which lasts until about 7pm. I kept looking for any information from any source that would explain what on earth was happening to me. Some sites hinted at fatigue being a withdrawal symptom, but stated that it should resolve itself after a few months. I was overjoyed to find your story here. I now have hope that this will pass. Thank you so very much!


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