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Chronic fatigue on taking LISINOPRIL, ZOLOFT, CLONAZEPAM.

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I'm a 27 yr old married Male Med Student. 235 lbs 6'3 with fatigue that effects my productivity. hx: adhd dx in early childhood, taken stimulants since then. I take 60mg xr a day in morning sometimes at 3pm, Lisinopril 40, Zoloft 150. In the last month Clonazepam 0.5mg (at night only), L-tyrosine 500mg, and Magnesium 400mg. Fx hx HTN. I have BP 125/80 usually. Tachycardia @ 120bpm sitting at desk. No exercise. Normal ekg, sleep study, blood labs, sleep (unrestful). I suffer fatigue, severe premature ejaculation (<30 sec). No PE 6 years ago, fatigue since high school. I make cannot remember if any symptoms started as a result of taking a drug. Though I started Zoloft after depression spell about 6 years ago, been taking since. Fatigue worstened around that time as well that persisted past depression. I remember bad side effects as child from adderall and I believe i was taking fairly large doses, atleast 40-50mg. I predict that I have ADD sluggish cognitive type, but dont know. Im still fatigued after 1 month rest from adderall. Im sluggish around 40mg. PE not affected by topical OTC desensitizers. Prim care doc suggests adding propanolol to bring down rate and maybe effect PE, but might exacerbate fatigue; suggests switching SSRI's for PE. Im curious about the effects on dopamine and thats why I started l-tyrosine. Recently starting 75mg Adderall 1 week ago has helped the fatigue a tremendous amount.

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Category: Internal Medicine Specialist

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Category: HIV- AIDS Specialist
 32 Doctors Online

Thanks for using for your query.
So the current issues you are facing are fatigue and severe premature ejaculation.
What I noticed from your history is you have been on Zoloft and Adderall since a long time, and that itself can lead to premature ejaculation and other sexual problems like loss of sexual interest and impotence in some rare cases.
I will recommend you do think about some other anti depressants as you're fairly young and the medicines has already caused severe PE. You can do kegel exercises to strengthen your perineal muscles. Apart from this, I agree with your physician and suggest Propranolol for the tachycardia. I will suggest you discuss the option of propranolol and venlafaxine as they act well together without any interactions and does not cause fatigue.
Feel free to discuss further,

Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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