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Re: Effexor causing severe constipation ?! » Racer

Posted by ben on September 21, 2004, at 1:06:57

In reply to Re: Effexor causing severe constipation ?! » ben, posted by Racer on September 20, 2004, at 15:18:50

> Unfortunately, that does seem to be a side effect of the anti-depressants that target serotonin -- presumably because there are so many serotonin receptors in the digestive tract. Did your GI guy have any other options to offer? Or has your pdoc recommended anything?
>
> The only thing I can offer is either trying a punctuated dose of a serotonin blocker like cyproheptidine, or switching to another AD, or maybe adding something like atomoxetine which can cause diarrhea. I'm not sure any of those are great solutions, but if your doctors will get together to work on this with you, there may be another option.
>
> Like you, psyllium didn't help me when I was experiencing this. A low dose of a stimulant might help, though -- that's what finally helped me when a short trial of a med caused intense, painful, constipation. I'd been taking a tablespoon of psyllium three times per day with 24 oz of water each time, as well as the water I regularly drink, and 30 minutes per day jogging. That didn't help, after two weeks of utter blockage. Two days into 100mg of modafinil, though, emptied pretty much everything out. A more typical stimulant might help you. (I had some modafinil left over from an earlier prescription, and I was desperate. Self-prescribing isn't normally on my list of Good Ideas, but in this case it helped and I was so relieved.)
>
> You might also talk to your pdoc about an antidepressant with a more balanced action on the monoamines, although if Effexor is working for you, leaving well enough alone would normally be the first choice.
>
> Best luck.

I think also that the problem is serotonin related but as you know it is a very complex theme. All the subtypes of serotonin receptors and the drugs acting as agonists and/or antagonists on one/mostly on more receptors. And what are the consequences ?!
What about bethanechol or a stim like Ritalin ?
My pdoc doesnt think it comes from Effexor, he thinks its like an IBS or something somatogenic - thats what pdocs mostly are thinking when they are concerned about side effects from antidepressants - unfortunately antidepressants have a lot of them (incl. the new ones)!

many thanks for your posting, ben


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