Conversation: The conversation between human and AI assistant.
[|Human|] I have graves disease and I still wake up feeling tired and sick. I was diagnosed in 2007. I do see a doctor regularly. Is there a reason for this or to be expected with graves disease? Is there something I can take to feel better? I currently take an alka seltzer and lay down for an additional 20 minutes. Throughout the day I am tired and fatigued. I tend to feel somewhat better with abit more energy after 5PM most days. Prior to bedtime I take 1 .25mg Alprazolam tab and then another half tab of .25mg. Maybe this is why I feel tired and unwell in the mornings? Too much Alprazolam? I take Methimizole, Bystolic , Synthtroid, Topomax and Cytomel as well. It seems as the day goes on I feel better. Maybe there is something I can take or do to feel better? Any information will be helpful to this very complex disease.
[|AI|]  Hello, welcome to Chat Doctor. From the history it appears that you are having anxiety and depressive symptoms. These symptoms are very common in thyroid related illness like graves disease. So, monitor thyroid function test (T3, T4 and TSH) frequently, as medicine changes may require according to test results. Alprazolam is antianxiety and hypnotic medicine. It should not be used unsupervised and for long term, which can lead to dependence on it. It is better to get evaluated by psychiatrist, so that long term treatment can be initiated in form of Chat Doctor.  Wish you all the best.