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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by blnch on March 14, 2004, at 13:44:18
I've been reading here off and on for 3 yrs. I do not notice all that many who complain of serious GI problems with ADs. Am rather astounded by this, since they all are processed thru the gut, if for no other reason. Also depressives (like me - I have Major Depressive Illness, recurrent) are known to have a whole body illness, the gut being one of our "sore" spots.
I have GI distress (LOTS) with all ADs - all classes. I must take Prevacid just to attempt them. This distress used to pass, now it seems to start up - not at first dosing like in past - but about one week in. I have no organic damage.
Does no one else here suffer to this extent? When I am constantly physically ill with this, it also "triggers back" the depression the ADs are designed to alleviate. It's a horrible catch 22.
Just started Paxil CR - also seeing very few posts on this. So far (day 5) the GI problems are less, but an ever present possibility down the line.
Posted by snapper on March 14, 2004, at 16:47:40
In reply to GI Problem with ALL ADs, posted by blnch on March 14, 2004, at 13:44:18
Hey, I know what you mean , the very thing that the meds are supposed to be helping is hard to distinuish what is the side effects and what is the anxiety and or mood disorder..FWIW I have read that 90% of serotonin receptors are found in the gut-hence to strong adverse GI upset etc...
I know it is so frustrating !!!
GOOD LUCK TO YA
SNAPPER
Posted by Sad Panda on March 15, 2004, at 0:55:11
In reply to GI Problem with ALL ADs, posted by blnch on March 14, 2004, at 13:44:18
> I've been reading here off and on for 3 yrs. I do not notice all that many who complain of serious GI problems with ADs. Am rather astounded by this, since they all are processed thru the gut, if for no other reason. Also depressives (like me - I have Major Depressive Illness, recurrent) are known to have a whole body illness, the gut being one of our "sore" spots.
>
> I have GI distress (LOTS) with all ADs - all classes. I must take Prevacid just to attempt them. This distress used to pass, now it seems to start up - not at first dosing like in past - but about one week in. I have no organic damage.
>
> Does no one else here suffer to this extent? When I am constantly physically ill with this, it also "triggers back" the depression the ADs are designed to alleviate. It's a horrible catch 22.
>
> Just started Paxil CR - also seeing very few posts on this. So far (day 5) the GI problems are less, but an ever present possibility down the line.
>
>Hi,
What ailments are you getting? I get Nausea & Diarrhea. Remeron fixes these side effects for me & gives me a good nights sleep. Paxil causes some muscarinic blockade like the old TCA's & can slow the bowel & give dry mouth. Have you tried TCA's or just SSRI's?
Cheers,
Panda.
Posted by blnch on March 15, 2004, at 9:25:14
In reply to Re: GI Problem with ALL ADs » blnch, posted by Sad Panda on March 15, 2004, at 0:55:11
All SSRIs, All SNRIs, Remeron, Many TCAs, MAOI Parnate - all now cause problems. Nausea, GERD. Constipation biggest problem: Remeron, Effexor, and Neurontin absolute worse for this. Constipation ends up seeming to increase the GERD. Nothing including Zoloft or Prozac has actually given me diarrhea.
First couple days, I thought Paxil CR (not regular) was miracle, as no constipation. VERY normal. Now, it looks like it will likely be same as regular Paxil in this regard.
I hear most GI complaints being like yours.
Maybe I am in minority, or just not many talk about the "opposite" response.I am now forced as result of above to have ECTS end of April - they were to be end of March, but there was a "clerical" error. Unbelieveable! This was ONLY reason I had to start the Paxil CR.
I have HAD IT with this GI nonsense!I plan to go ADs-free for life & do maintenance ECT. I have always prior (2 full courses) had 100% remission, with absolutely no headaches; no memory loss. Done Bilaterally. Key is finding a good practiontioner, IMO.
Thank you both for your replies.
~blnch
Posted by HappyGirl on March 15, 2004, at 12:09:14
In reply to GI Problem with ALL ADs, posted by blnch on March 14, 2004, at 13:44:18
Hi:
I too have 'occasional' GI problem, ... mine is mostly 'stomach upset,' so called 'acid reflex' problem.
Before taking Wellbrutrin SR, I did NOT have this problem, then my superior suspicion is to be 'Wellbutrin SR.' This med. works GREAT on my depression along with ADD that brought on by my Bp II. Then, I can NEVER afford to eliminate this med., even though I know there are other med. similar to WB, but WB is #1 med. in those areas.
In my case, I took Prevacid that helped me a great deal before Bp II, ... but after Bp II with med. combo., this med. offers me nothing but 'dizziness' along with 'slight nauseous feelings.'
So, currently I've been taking 'Maalox'/Max. whenever acid reflex started 'flare-up.' Luckily, after having got used to WB sr, it's started more miler discomfort.
In my guess, your problem might be getting better as your system gradually accomodates your med. regimen.
As for a note, ... in order to avoid 'acid reflex' problem, I eat 'well-cooked' meals as much as possible. Also, try to avoid salty and spicy foods, especially around the bedtime.
H.G.
Posted by blnch on March 15, 2004, at 13:31:21
In reply to Re: GI Problem with ALL ADs/Wellbutrin, posted by HappyGirl on March 15, 2004, at 12:09:14
Thanx - forgot to mention WB IR and WB SR. The IR (regular) version was actually a bit less upsetting nausea wise for me (I know this is opposite of what is put out there), but the constipation was as bad if not worse than Effexor. It is the only AD besides Parnate where I could not get past the extreme agitation. Parnate scared me to death. My BP dropped to 50/80 by day 5. Weird: exhausted but agitated "inside."
Let me make clear that I have always been a real trooper, until last 2 yrs, but suffering too much for the 4 yrs prior. That means 20+ years of being ULTRA compliant, perhaps TOO compliant - living thru then adjusting to all side effects. I have been told many times by pdocs I am the most compliant patient they have ever encountered.
Now things have changed. I do not think it is my age. I think my GI tract is simply worn out by what ADs do to it. That's the only thing left it can be, it would seem. I am just amazed I don't see others here saying same. Maybe most posting these days are much younger? I am 52.
Posted by Margit on March 15, 2004, at 19:39:18
In reply to GI Problem with ALL ADs, posted by blnch on March 14, 2004, at 13:44:18
I have always had GI problems as a companion to my depression and panic disorder. Usually, for me though, once I go into remission the symptoms do somewhat subside.
But I have been taking acid blockers (Nexium, Prevacid, etc.) in high doses and it never helped while in a relapse. I have had GERD (acid reflux) to the point that at one time I had esophagitis, grade III (which is pretty bad).
Paxil is about the only AD, I tolerate to a certain degree (am on Paxil CR right now). I also had some luck with the TCAs. Prozac, Zoloft, and Effexor were untolerable because of GI side effects. Remeron was ok for my stomach, but didn't help for my depression. Wellbutrin was way to agitating (no effect on stomach though). Nardil was GI neutral, but had other difficulties with it.
There is a great link on GI problems in regard to PD and depression. Some of the info there had helped me out quite a bit.
Check the "Frequently asked questions" section for GERD and Carafete.
Posted by Sad Panda on March 16, 2004, at 8:24:10
In reply to GI Problem with ALL ADs, posted by blnch on March 15, 2004, at 9:25:14
> All SSRIs, All SNRIs, Remeron, Many TCAs, MAOI Parnate - all now cause problems. Nausea, GERD. Constipation biggest problem: Remeron, Effexor, and Neurontin absolute worse for this. Constipation ends up seeming to increase the GERD. Nothing including Zoloft or Prozac has actually given me diarrhea.
>
> First couple days, I thought Paxil CR (not regular) was miracle, as no constipation. VERY normal. Now, it looks like it will likely be same as regular Paxil in this regard.
>
> I hear most GI complaints being like yours.
> Maybe I am in minority, or just not many talk about the "opposite" response.
>
> I am now forced as result of above to have ECTS end of April - they were to be end of March, but there was a "clerical" error. Unbelieveable! This was ONLY reason I had to start the Paxil CR.
> I have HAD IT with this GI nonsense!
>
> I plan to go ADs-free for life & do maintenance ECT. I have always prior (2 full courses) had 100% remission, with absolutely no headaches; no memory loss. Done Bilaterally. Key is finding a good practiontioner, IMO.
>
> Thank you both for your replies.
> ~blnch
>
>Paxil is the SSRI most likely to cause constiptation unfortunately. Did Prozac do anything for you? Maybe the once a week Prozac might be worth a shot? You would be a prime candidate for the Patch if it ever gets released. The TCA's Doxepin & Imipramine are available as a topical cream for allergies, I wonder how many tubes full you would have to rub into your skin to get an AD effect. :)
Good luck with the ECT.
Cheers,
Panda.
Posted by blnch on March 16, 2004, at 10:37:15
In reply to Re: GI Problem with ALL ADs, posted by Margit on March 15, 2004, at 19:39:18
> I have always had GI problems as a companion to my depression and panic disorder. Usually, for me though, once I go into remission the symptoms do somewhat subside.
>
> But I have been taking acid blockers (Nexium, Prevacid, etc.) in high doses and it never helped while in a relapse. I have had GERD (acid reflux) to the point that at one time I had esophagitis, grade III (which is pretty bad).
>
> Paxil is about the only AD, I tolerate to a certain degree (am on Paxil CR right now). I also had some luck with the TCAs. Prozac, Zoloft, and Effexor were untolerable because of GI side effects. Remeron was ok for my stomach, but didn't help for my depression. Wellbutrin was way to agitating (no effect on stomach though). Nardil was GI neutral, but had other difficulties with it.
>
> There is a great link on GI problems in regard to PD and depression. Some of the info there had helped me out quite a bit.
>
> http://www.algy.com/pdi/
>
> Check the "Frequently asked questions" section for GERD and Carafete.
Thanx. We are all so different, as we already know. I realize Wellbutrin is easy on tummy for most. It was absolute worst for nausea for me + the acitvation.Remeron used to be my wonder drug, but no
longer. I have tried every natural and unnatural cure for constipation out there. Either no relief, relief then right back to previous state, or makes me feel so sick, I discontinue.Sinequan(doxepin) worked for me for many years - total remission - years ago. Now it is just too sedating and the constipation is even worse than it always was.
BTW, I do not have Panic Disorder. I have some Social Anxiety, but I am one who believes that depression & anxiety just go hand in hand, and that the DSM should be revised to reflect a Mood Disorders Spectrum, also including Bipolar Illness.
I will check out the link.
~blnch
Posted by blnch on March 16, 2004, at 11:12:50
In reply to Re: GI Problem with ALL ADs » blnch, posted by Sad Panda on March 16, 2004, at 8:24:10
> Paxil is the SSRI most likely to cause constiptation unfortunately. Did Prozac do anything for you? Maybe the once a week Prozac might be worth a shot? You would be a prime candidate for the Patch if it ever gets released. The TCA's Doxepin & Imipramine are available as a topical cream for allergies, I wonder how many tubes full you would have to rub into your skin to get an AD effect. :)
>
> Good luck with the ECT.
>
> Cheers,
> Panda.
>
>I would be fearlful of ever attempting the Prozac Weekly, as last time on regular Prozac, I started getting middle of night stomach cramps, similar to, but not as excrutiating as the ones I got with Lexapro.
BTW, tho many think Lexapro is a great drug, I am in correspondence with a pdoc from another state than mine - he has told me he is hearing reports US-wide that Lexapro indeed is causing stomach cramping and other GI problems, but not usually right when it is started. I know of a case here where it clearly caused pancreatitis. That one case could have been a "fluke"(as their Reps insisted)... then again.... buyer beware.
So agree - I am great candidate for a patch AD. Just wish it would be one other than selegine MAOI. Can't believe the "politics" and greed that is keeping this option from us!
What ever happened to "do no harm?"
Last two days - day 6&7 - the Paxil CR is already brightening my mood. I had heard it kicked in much faster than regular. In this, hopefully I have finally lucked out.
I am attempting it also because a young teen I know with exact same dx and GI/constipation problems is NOT experiencing them with the CR version. She had the same bad GI experience I had with Lexapro.
Maybe I will adjust to the CR down the line on this one problem aspect...so far - it's gone from not constipating to constipating. YIKES, I am so sick of this!
Thanx for the ECT thumbs up.
~blnch
Posted by Margit on March 16, 2004, at 18:53:35
In reply to GI Problem with ALL ADs, posted by blnch on March 14, 2004, at 13:44:18
blnch,
You might want to try some natural remedies such as fish oil or magnesium for the constipation. I am taking 8 capsules of fish oil (2.6mg EPA/DHA) and 600mg Magnesium glycinate in addition to the Paxil CR and it has helped tremendously in relieving constipation. I actually started taking it for mood enhancement in combination with other supplements, but this was a welcome side effect. I also feel that it has a postitive effect on my mood.
I know it is difficult to find your way through the medication maze; not all of them work and others have intolerable side effects. However, I am always so grateful, once a med does work and gets me out of a setback.
I hope the Paxil CR continues to work for you and that you can find a solution for the constipation.
Good luck
Posted by Jaynee on March 18, 2004, at 11:12:55
In reply to GI Problem with ALL ADs, posted by blnch on March 15, 2004, at 9:25:14
I suffered from the same problems on the AD's I tried. I only take Celexa before my period now, and I also take Cod liver oil and ALA. Something is working, because I feel very good.
For the stomach problems, I tried the PPI's, nexium, losec, pantaloc, etc, I also tried motilium. What I found worked best when on Celexa full-time, was the new one Zelnorm. It might be worth a try.
Good luck.
Posted by blnch on March 18, 2004, at 12:14:39
In reply to Re: GI Problem with ALL ADs, posted by Jaynee on March 18, 2004, at 11:12:55
Now we are getting somewhere! Sounds like you & I have the most similar symptoms. I am a candidate for Zelnorm (IBS-C) and I was given some samples & tried it, but I got very bad flu-like symptoms. You know they say it doesn't work for all women, also.
Seems like far more have IBS-D. My mother did.
Did you have any trouble starting up Zelnorm? If so, how so?
Thanx to all others for their recent replies.
~blnch
Posted by Jaynee on March 18, 2004, at 22:37:54
In reply to GI Problem with ALL ADs » Jaynee, posted by blnch on March 18, 2004, at 12:14:39
When I first started taking Zelnorm, I was taking it after I ate, and within about an hour I was having no problem with constipation anymore, basically I was on the toilet on and off for about 2 hours. When I actually took time to read the instructions on how to take Zelnorm, and started to take it just prior to eating, I didn't run to the crapper as much. Within about 3 days of taking it continously, I really found an improvement with all aspects of my stomach problems. The so called GERD and excessive burping, really slowed down and I was going No. 2 at least 2 to 3 times a day.
I didn't have any side-effects from Zelnorm. I quit taking it after about a month, but my stomach is bugging me again, so I am starting it again. How soon I forgot what it is like to be in pain, so I thought I didn't need it anymore, wrong. I will start Zelnorm again, and then go talk to my doc and see how long I have to be on this stuff. The good news is it helps.
You said you got flu symptoms from Zelnorm, what symptoms exactly? Like I said before I didn't get any side-effects, except the craps which calmed down in about 3 days. Maybe try to weather the flu symptoms and see if those symptoms go away after awhile, because if Zelnorm does work for you, believe me, it feels like a small miracle.
Posted by blnch on March 19, 2004, at 13:06:11
In reply to Zelnorm experience, posted by Jaynee on March 18, 2004, at 22:37:54
Yes, I experienced all you did for about same amount of time at start up on Zelnorm, but I was also VERY nauseous.
Last 3 days the constipation has improved re: the Paxil CR. It will be two weeks on Monday.
Maybe I will steel myself for another try on Zelorm. I believe you that it must seem like a miracle!
Thanx Much!
~blnch
Posted by newgirl on April 1, 2004, at 9:45:04
In reply to GI Problem with ALL ADs » Jaynee, posted by blnch on March 19, 2004, at 13:06:11
I started Zelnorm yesterday. I've been having terrible IBS symptoms for some time now, so I saw my doc. After just 3 doses, the constipation seems to be gone, as does the gas. It seems like I'm in the bathroom more than I'm not. I feel a little nauseous too. I still feel bloated. Does the bloating go away? That's been a real problem for me lately. I work out and eat well, but I can't seem to get rid of the bloated feeling.
Any thoughts?
Posted by Jaynee on April 3, 2004, at 1:15:55
In reply to Re: Zelnorm, posted by newgirl on April 1, 2004, at 9:45:04
The bloating should go away, but give it some more time.
Posted by jparsell82 on April 3, 2004, at 17:26:40
In reply to Re: Zelnorm, posted by Jaynee on April 3, 2004, at 1:15:55
I'm surprised Remeron wasn't helpful. It has 5ht3 antagonistic properties which help relieve nausea. The better med which I'm waiting for to come out is called renzapride. I also have a lot of GI problems... acid reflux,constipation,bloating,nausea. Anyways, 5ht3 antagonists such as Zofran(ondansetron) are used to relieve nausea and other symptoms. 5ht4 agonists like Zelnorm(tegaserod) are used to help relieve constipation,etc. The new med Renzapride that's in clinical trials right now has a dual action as a 5ht3 antagonist & 5ht4 agonist. So, I'm hoping it will be the cure for all my GI problems. I hope it comes out soon. Here's a link about with a little bit about renzapride:
Posted by blnch on April 3, 2004, at 18:20:49
In reply to Re: Zelnorm, posted by jparsell82 on April 3, 2004, at 17:26:40
I am assuming you may be answering me, as I said the Remeron wasn't helpful re: GI for me. I have IBS(C variety) and Remeron was always ultra constipating.
About 7 years ago, Remeron did not bother my tummy in other ways, but not so any longer. GERD is bad on it.
Update: The Paxil CR constipation stopped at just short of 3 weeks on; I have not gained any of the 3-4 pounds I lost since starting Paxil CR; sedation passed at about the same time. Now, I will not be needing Zelnorm. Hurray!
I am bookmarking the link you provided, nonetheless. Thank You.
Posted by florence on April 6, 2004, at 21:32:23
In reply to GI Problem with ALL ADs, posted by blnch on March 14, 2004, at 13:44:18
I had stomach problems so bad that I eventually had an endoscopy, upper GI' sigmoidoscopy, barium enema,etc...That was years ago:like 14yrs! Tagamet was a prescript then..Anyway, I "discovered" many years later that the Prozac and other ADs were the cause. I was always constipated and bloated during my menstrual period and it was SO much worse when on the meds. Prozac only came in 20 mgs back then.I was taking it for menstrual migraines and not depression. I never had stomach problems before I took the drugs either!.....This week I tried Ritalin a stimulant to help with this chronic fatigue and it gave me a terrible gut ache.. Provigil gives me diahrea at doses over 100 mgs.. or sometimes at 50 mgs...I can never predict! At least it "hits" within a few hours of taking it so I can plan accordingly.
Posted by corafree on October 4, 2006, at 15:09:47
In reply to Re: Zelnorm, posted by Jaynee on April 3, 2004, at 1:15:55
Hi Jaynee.
Just began Zelnorm. Took it about a half hour before just now having a bite to eat.
I've had such horrible constipation ... 4-5 days then having to do a 'dulc*lax implosion' which usually lasted another 2 days.
I was happy 2C your post. Gives me hope.
bestwishes, cf
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