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When fatigue does occur as a direct medication side effect, it is usually: Most noticeable in the first one to two weeks after starting or increasing a dose Mild to moderate in severity and temporary in most cases More pronounced at higher doses such as 10 mg or 15 mg Accompanied by other adjustment symptoms such as nausea or reduced appetite The good news is that for most patients, any medication-related fatigue settles as the body adapts to the new dose