ME or depression? If ME, do fluoxetine anti-depressants help?

[PhoenixDown]

Doctors use depression as a wastebasket diagnosis when they don't know what's wrong. I think it's irresponsible.

 

[Alvin2]

Doctors use depression as a wastebasket diagnosis when they don't know what's wrong. I think it's irresponsible.

very well put

 

[me/cfs 27931]

2. Fluoextine is not a great antidepressant for anyone having difficulty sleeping. The tricyclics (e.g. amitryptiline) are much better. If taken before bedtime, they have a sleep sustaining effect.

One tricyclic to use caution with is Vivactil (protriptyline), as it can have a strong stimulating/restlessness effect and increase anxiety. Not sure Vivactil is much prescribed these days though.

 

[Alex1]

Okay thanks all. I'm going to hold off on the anti-depressants for now and get to know the effect exercise has on my body. I assume if my legs are OK for the two days after the exercise it's unlikely that I have ME? Could anyone who has had post-exercise malaise describe what it's like? Internet descriptions are vague. Is it extreme pain, or your legs refusing to do what you want them to?....

 

[Valentijn]

Could anyone who has had post-exercise malaise describe what it's like?

It's a range of symptoms which start about 24 hours after the exertion. It can vary somewhat, but painful/swollen lymph nodes, fully body pain, dysautonomia, ataxia, cognitive problems, etc are pretty standard. Similar to a nasty flu, but usually without the fever.

 

[Alex1]

Hmm, could one symptom of post-exertional malaise be waking up in the night and finding it hard to fall back asleep? Maybe I'm stretching it a bit, but I don't usually wake up in the middle of the night but this time, the day that I had done exercise, I did. Or is it not related to the post-exertional malaise itself?

Sorry for all these questions, I'm kind of desperate to not have ME

 

[adreno]

Other than that, there is no particular reason for why fluoxetine would help with CFS/ME.

There could be another mechanism through which SSRIs could theoretically help ME/CFS – Akt/mTOR activation. However, it seems that in practice they don't help much, if any.

 

[adreno]

Hmm, could one symptom of post-exertional malaise be waking up in the night and finding it hard to fall back asleep? Maybe I'm stretching it a bit, but I don't usually wake up in the middle of the night but this time, the day that I had done exercise, I did.

Sounds more like sympathetic overdrive.

 

[Woolie]

Hmm, could one symptom of post-exertional malaise be waking up in the night and finding it hard to fall back asleep?

Yes!

When I first had mild PEM, I would find I was okay in the evening followng the exertion (normal tired), but in the middle of the night, I'd wake up suddenly with this feeling of my body running overtime. Time delay seemed to be around 8-12 hours. I didn't work out for years that's what it was.

PEM is not really so much in the legs, not as I experience it, its more like being ill. A feeling of hotness/burning fluey-ness, sore neck and glands and this feeling like my body's working overtime.

 

[Alex1]

Yes!

When I first had mild PEM, I would find I was okay in the evening followng the exertion (normal tired), but in the middle of the night, I'd wake up suddenly with this feeling of my body running overtime. Time delay seemed to be around 8-12 hours. I didn't work out for years that's what it was.

PEM is not really so much in the legs, not as I experience it, its more like being ill. A feeling of hotness/burning fluey-ness, sore neck and glands and this feeling like my body's working overtime.

Hmm interesting that you say it's not so much in the legs for you. This day following from my exercise, my legs have been tired and achy when I stand up. Still able to move, but achy. That could just be because I haven't done proper exercise for months though, combined with my lack of sleep. Argh, PEM is so hard to prove/disprove!

 

[Alex1]

Yes!

When I first had mild PEM

So your PEM is worse now than it used to be?

 

[JES]

Hmm interesting that you say it's not so much in the legs for you. This day following from my exercise, my legs have been tired and achy when I stand up. Still able to move, but achy. That could just be because I haven't done proper exercise for months though, combined with my lack of sleep. Argh, PEM is so hard to prove/disprove!

Nah that doesn't sound like CFS/ME type PEM to me. Not everyone with CFS/ME or everyone or this forum has it though. Fluge and Mella have for example noted that men and women have distinct mechanisms in how they attempt to compensate for the energy defect. Women have more depleted amino acid levels, so I wouldn't be surprised if the heavy PEM symptoms are more typically seen in women. As men have more muscle mass to begin with, they seem to be less vulnerable in this aspect. I'm for example getting mainly mental PEM, that is, my brain needs to recover (sometimes for days) from heavy socializing or meetings.

 

[Alvin2]

I'm kind of desperate to not have ME

We all are so don't worry about it

Your symptoms sound like some kind of infection but it could be lots of things, i don't know what your doctor is like but could you request a referral to a specialist, for more tests (and not a psychiatrist or a psychological "specialist")

 

[Woolie]

So your PEM is worse now than it used to be?

Yes. . Its much more obvious now.

Yes, it could be your legs are achey because you've genuinely overworked the muscles. Or it could be PEM. Its hard to say. Some clues its PEM and not just normal tiredness/acheyness from overexertion:

* you consistently sleep more poorly the night following overexertion (normal overexertion usually improves sleep the following night)

* you still feel bad when you wake up the next day, even when you slept well (with normal overexertion, a solid night's sleep cures almost all it, except a bit of muscle stiffness)

* the discomfort is not just in the muscles you worked the most. For example, I have pain in my neck and shoulders after walking too much (which isn't much actually). And a lot of general, fluey malasie.

* your pain/malaise does not diminish over time like after normal overexertion. It might even get worse. Some people describe a delayed PEM effect that kicks in 24-48 hours after exertion. Some people describe longer delays (but the longer the delay, the trickier it is to be really sure about the activity that triggered it).