Persistent tiredness despite normal
vitamin D and
B12 and good anxiety control could be due to medication side effects, underlying sleep issues (such as sleep apnea or poor sleep quality), low physical activity,
thyroid dysfunction, or residual depression. Aripiprazole and atomoxetine are usually activating, but sertraline at higher doses can sometimes cause fatigue in sensitive individuals. A careful medication review, screening for thyroid profile, sleep quality assessment, and discussion about dose adjustments or timing of doses may help.
Next Steps
• Consult your treating psychiatrist or take a second opinion with any other psychiatrist to review your current regimen, especially medication doses and timings.
• Request basic lab workup including CBC,
thyroid function tests,
fasting blood sugar, and possibly iron studies.
• Discuss possible gradual medication adjustments if side effects are suspected.
• Consider a sleep hygiene review and evaluation for sleep disorders.
Health Tips
• Do not stop or change any medication on your own; sudden changes can worsen symptoms.
• Maintain a consistent sleep schedule, regular light physical activity, and balanced diet.
• Keep a symptom diary noting fatigue levels, sleep quality, and daily activities to share with your doctor for a clearer picture.