I am a female on antidepressants with a constant feeling of sleepiness, fatigue, lack of concentration, depression, and OCD. What should I do?

Q. How to overcome constant fatigue and sleepiness throughout the day in a female on antidepressants?

Answered by
Dr. Hafiz Muhammad Hassan Shoukat
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 14, 2023

Hello doctor,

I have constant fatigue (i.e. nodding off 10-20 times a day). I constantly feel like sleeping all the time even when I wake up in the morning till lunch, then after lunch, I crash badly some days. I am exhausted every minute of the day. I always live in pain from a car accident that happened in the past, but this is the first time in my life I have felt this groggy and tired. Some days I have much more energy then after a few days I am a mess. I get distracted easily, am foggy-headed, cannot concentrate, stare into space, and get a bit OCD about things like cleaning or making sure my environment is clear so I can work and focus, but I struggle even with that. When I need to sleep I need to stop my work immediately. Yesterday I had to sleep very quickly, I felt like I was drunk and I kept mumbling which was very strange. My diet is mainly good clean protein, good fats, greens as I am lactose, fructose, and gluten intolerant, and lots of water. I work from home as a graphic designer. Last year, I was competing in a fitness competition. I am quite healthy otherwise.

I have mentioned below my details:

  1. Sex: Female.
  2. Age: 44
  3. Weight: About 62 kg.
  4. Height: 162 cm.
  5. Current medication: Zoloft 100 mg.

I do not drink, smoke, or use any drugs. I am taking vitamins (high-grade iron, multivitamins) mostly in pre-workout so that I can stay awake and function. Recently I took certain tests and everything is okay. My thyroid, white cell count, and insulin levels are normal but my iron was 8 (should be over 15 from what I was told) which is a little low but the doctor said I am on my reserves and that I would be fine. I have never been able to make my iron levels high. My blood pressure was spot on, and even my sexual health tests were fine. I am a single mom of two kids with 90 % care. They are 12 and seven years old. My son has been diagnosed as autistic. I do have extreme stresses (mostly financial at this time), depression, anxiety, PTSD, OCD, and Agra/agoraphobia (following sexual assaults). I am concerned I might be bipolar even though the psychiatrist said I am not. I know depression can cause some of these symptoms, but I wanted to ask what I should do next. Any second opinions? What can I do? To whom should I speak? What can I do to help myself? How can I stop falling asleep as soon as I sit down?



Welcome to icliniq.com.

Thank you for your query.

I would suggest you talk to your primary care general doctor. You need to get some tests done including CBC (complete blood count), basic metabolic profile, and thyroid function tests. We can discuss this further based on these test results. Also, I strongly feel that you might have obstructive sleep apnea (OSA). You will need a sleep study called polysomnography and if positive, by managing that your symptoms will get better. Continue taking Zoloft during the night. Also, start taking Ferrous sulfate 325 mg thrice a day after meals. If your iron is that low, anemia may be a cause of fatigue and it will show up on CBC testing.

I hope this has helped you.

Thank you.

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