Managing Fatigue and Weakness in Schizophrenia: Treatment Options Explored

Q: Managing Fatigue and Weakness in Schizophrenia: Treatment Options Explored

Hello Ah Hua： I'm not sure which medications you have taken. <br>The situation you described could indeed be a side effect of the medication, but it may also be a negative symptom of schizophrenia. <br>This would depend on the medications you have taken in the past and whether yo

Schizophrenia, feeling tired during the day, experiencing physical weakness, and having a significant sense of fatigue?

Hello, Doctor: I have been diagnosed with schizophrenia for three years and have been undergoing medication treatment for the same duration.
I have switched between four different oral medications, and currently, I take one pill of Perphenazine daily.
Over these three years, I have experienced poor daytime energy, fatigue, and a general sense of weakness.
Sometimes, I sleep more than 10 hours at night, but I still feel the same way during the day—tired, fatigued, and weak.
Due to my schizophrenia, I am unable to work.
My doctor has informed me that this is related to my condition and not the side effects of the medication.
Despite trying four different oral medications, this issue remains unresolved and significantly impacts my life.

How can I address this problem (poor daytime energy, fatigue, and weakness)? Should I continue with the medication and wait for improvement? I have heard that injectable medications have fewer side effects; would it be worth considering switching to injections? Are there different formulations for injections, such as those administered every two weeks, monthly, or every three months? Thank you, Doctor.

Ahua, 30~39 year old female. Ask Date: 2021/05/10

Dr. Lin Mianzhang reply Psychiatry

Hello Ah Hua: I'm not sure which medications you have taken.
The situation you described could indeed be a side effect of the medication, but it may also be a negative symptom of schizophrenia.
This would depend on the medications you have taken in the past and whether you experience these symptoms even when not on medication.
As for long-acting injectables, their side effects are similar to those of oral medications, and the injection intervals vary depending on the drug's composition and formulation.
For example, with the medication Perphenazine that you are taking, there are long-acting injectables with the same active ingredient that are administered once a month (such as Seroquel) and others that are given every three months (like Invega Sustenna).
However, the long-acting injectable for Risperidone must be administered every two weeks.
I recommend discussing with your physician whether to adjust your medication.
If you want to determine if your fatigue and physical discomfort are caused by the medication, it may be more accurate to undergo inpatient observation.
Wishing you peace and health!

Reply Date: 2021/05/10

More Info

Managing fatigue and weakness in individuals diagnosed with schizophrenia can be a complex issue, often influenced by a combination of the disorder itself, the medications used for treatment, and other lifestyle factors. Your experience of persistent fatigue, weakness, and a lack of energy, despite adequate sleep, is not uncommon among those with schizophrenia, and it can significantly impact daily functioning and quality of life.

Understanding the Causes of Fatigue
1. Schizophrenia Symptoms: Schizophrenia can manifest with negative symptoms, such as lack of motivation, social withdrawal, and cognitive impairments, which can contribute to feelings of fatigue and weakness. These symptoms can make it challenging to engage in daily activities, leading to a cycle of inactivity and increased fatigue.

2. Medication Side Effects: While your doctor suggests that your fatigue is primarily due to schizophrenia, it's essential to consider that antipsychotic medications can also contribute to feelings of tiredness and lethargy. Common side effects of many antipsychotics, including those in the atypical class (like Perphenazine), can include sedation and fatigue. If you've been on multiple medications without relief, it may be worth discussing this with your healthcare provider.

3. Sleep Quality: Even if you are sleeping for long hours, the quality of sleep matters. Conditions like sleep apnea or restless leg syndrome can disrupt sleep cycles, leading to non-restorative sleep. This can leave you feeling tired despite adequate sleep duration.

4. Lifestyle Factors: Diet, exercise, and social engagement play crucial roles in overall energy levels. A sedentary lifestyle can exacerbate feelings of fatigue, while a balanced diet can help improve energy levels.

Treatment Options
1. Medication Review: It may be beneficial to have a thorough review of your current medication regimen. If fatigue is a significant issue, your doctor might consider adjusting the dosage or switching to a different antipsychotic that has a more favorable side effect profile regarding energy levels. Some patients respond better to certain medications, and finding the right fit can take time.

2. Long-Acting Injectable Antipsychotics: Switching to a long-acting injectable (LAI) antipsychotic may be an option worth exploring. These medications can provide stable blood levels and may reduce the burden of daily pill-taking. Common LAIs include Risperidone, Paliperidone, and Aripiprazole. They come in various formulations, with some administered every two weeks, monthly, or even every three months. The choice of LAI can depend on individual response and side effect profiles.

3. Psychosocial Interventions: Engaging in cognitive behavioral therapy (CBT) or other forms of psychotherapy can help address negative symptoms and improve coping strategies. Support groups can also provide social interaction and reduce feelings of isolation, which can contribute to fatigue.

4. Lifestyle Modifications: Incorporating regular physical activity, even in small amounts, can enhance energy levels and improve mood. A balanced diet rich in nutrients can also support overall health. Additionally, establishing a regular sleep routine can help improve sleep quality.

5. Monitoring and Follow-Up: Regular follow-up appointments with your psychiatrist are crucial. Keeping a diary of your symptoms, medication side effects, and daily activities can provide valuable insights for your healthcare provider to tailor your treatment plan effectively.

Conclusion
In summary, managing fatigue and weakness in schizophrenia requires a multifaceted approach. It is essential to work closely with your healthcare provider to evaluate your current treatment plan, consider alternative medications, and incorporate lifestyle changes that can enhance your overall well-being. Open communication about your symptoms and concerns will help your doctor make informed decisions about your care. Remember, finding the right balance may take time, but with persistence and support, improvements can be made.

Similar Q&A

Managing Sleep Issues and Fatigue in Schizophrenia Patients

Since childhood, I have often slept for long hours and frequently caught colds and fell ill. I always felt like I didn't sleep well, experiencing fatigue and poor mental clarity. It wasn't until my twenties that I discovered I had schizophrenia. I have undergone several...

Dr. Liu Junxian reply Psychiatry
Dear Sir/Madam, Regarding your inquiry about "hypersomnia," here are the explanations and responses: 1. You have been diagnosed with schizophrenia for approximately 6-7 years and are currently undergoing pharmacological treatment. 2. "Hypersomnia" is a commo...

Managing Negative Symptoms of Schizophrenia: Fatigue and Weakness Solutions

Thank you for your previous response, Doctor. I am Ah-Hua, and my last question was about schizophrenia. During the day, I feel very low in energy, mentally unwell, tired, and experience a lot of fatigue and physical weakness. I currently believe that these symptoms are caused by...

Dr. Lin Mianzhang reply Psychiatry
Hello Ah Hua: If the symptoms you mentioned persist even after stopping the medication, they are unlikely to be caused by drug side effects. However, in addition to the negative symptoms of schizophrenia, depression can also present similar symptoms. Therefore, it is important to...

Managing Fatigue and Low Energy While on Antipsychotic Medications

Hello, doctor. I have been living with schizophrenia for seven years and have tried various medications, but I still lack energy, which has caused me to frequently leave new jobs. I am currently relying on L-theanine, but occasionally I experience *rapid eye movement in the morni...

Dr. Qiu Junda reply Psychiatry
Hello: Some medications used for schizophrenia can indeed have a sedative effect, leading to feelings of fatigue and lack of energy. Please discuss with your primary physician whether this is a symptom issue or related to the medication. If it is due to the sedative effects of th...

Struggling with Mental Health: Seeking Solutions for Chronic Fatigue and Anxiety

Hello, I have been feeling unwell for over three years and living in great pain. I have consulted traditional Chinese medicine, psychiatry, and internal medicine, but there has been no improvement. I don't understand why these treatments haven't worked. Could you please...

Dr. Lin Yanhong reply Psychiatry
Hello: Your question: Thalassemia and psychogenic depression. There is treatment for depression, but there has been no progress. The most distressing part is feeling weak every day, being lethargic all day long, and feeling very dizzy upon waking up, with some pain. It takes a lo...