One way adventurers suffer the lethargy affliction is via the Serpent-class ability in their Hypnosis skill. Another way is via the Weaponmastery ability mastered by Runewardens, Infernals, and Paladins. HEWing either arm will give recurrent lethargy until such a time as all wrist fractures are cured.
Eating a ginseng root or a ferrum flake will cure the lethargy affliction.