4th Johore Mental Health Convention 23 - 24 August 2002 Hyatt Regency Hotel Johor Bahru Energy and Fatigue In Depression  ROBERTD. BUENA VEINWURA, M.D., FPPA Associate Professor, Department of Psychiatty University of the East Ramon Magsaysay Memorial Medical Center Manila, Philippines  Clinical Research Physician in Neuroscience Eli Lilly Philippines, Inc.  Depression is arguably the most prevalent major psychiatric disorder In the world. Yet despite this, it is still a largely overlooked and undertreated condition. The symptoms that make up this syndrome can be divided Into three major clusters: affective, cognitive, and somatic In which the somatic symptoms can predominate in certain instances.  Patients with primarily somatic type of depression can present with a variety of symptoms which include fatigue, loss of energy, and a lack of motivation. In clinical practice, the reduction of energy among depressed patients is a frequent complaint.  From this perspective, therefore, it is important for the clinician to consider an antidepressant treatment that will not worsen these complaints, as what, can be expected from sedating AIDs. Fluoxetlne has been shown to have the capacity to increase energy levels among depressed patients who complain of fatigue and to ensure that they are able to resume the ability to perform work and activities at the soonest possible time.  The mechanisms by which fluoxetine is able to restore the energy within has only been recently elucidated primarily by Dr. Stephen Stahl. In his theory, Dr. Stahl attributes this ability to fluoxetine because of its inhibition of gamma aminobutyrlc acid (GABA) function through 5HT2C receptors on the neurons. Thus, the inhibition by GABA of dopaminerglc and noradrenergic functions are disinhibited by fiuoxetine.