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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by Septembersun on September 23, 2005, at 10:58:33
I have tried a bunch of different antidepressants, all SSRI's, and have always had bad side effects in my stomach to the point where I had to stop taking the medication. I really need to take something, and I was hoping someone out there, who has also expereienced stomach pain from these meds, could recommend an antidepressant that might not be as harsh? Thanks.
Posted by Racer on September 23, 2005, at 12:28:32
In reply to Antidepressants and stomach trouble, posted by Septembersun on September 23, 2005, at 10:58:33
About 95% of the serotonin in your body is working in your gastrointestinal tract, so any of the anti-depressants -- except Wellbutrin, which has its own issues -- are likely to cause some stomach upset. The good news is that it usually goes away. How long were you on the various SSRIs before discontinuing them?
If the SSRIs that you've tried have helped otherwise, it might make more sense to add something in to help you stomach until your gut adapts to the reuptake inhibition from the meds. And if you haven't given them enough time to see if they'd work or not, it still might be worthwhile to give that a try so that you can see if they will work.
Otherwise, you're a bit stuck. There are non-anti-depressant anti-depressants to try, like Lamictal, or Wellbutrin, or a couple of the TCAs. All of those will come with their own drawbacks, though, so I'd say it's probably worth giving the SSRIs enough of a chance to see if they will work for you.
Hope that helps.
Posted by linkadge on September 23, 2005, at 18:27:41
In reply to Re: Antidepressants and stomach trouble, posted by Racer on September 23, 2005, at 12:28:32
Remeron blocks the 5-ht3 receptors and rarely has nausia as a side effect. It can sometimes prevent nausia and stomach problems associated with SSRI's.
You may want to lower the SSRI dose, and add some remeron.
Linkadge
Posted by blueberry on September 24, 2005, at 5:02:11
In reply to Antidepressants and stomach trouble, posted by Septembersun on September 23, 2005, at 10:58:33
I agree with the remeron suggestion. I'm very skinny and have been losing weight, bad. I asked my doc for remeron, not for its antidepressant reasons, but for insomnia and for appetite. It works good for those.
Even though the starting dose is 15mg, I cut the pill in half and take just 7.5mg. Now I have a good appetite and I'm finally eating again. There is a group of serotonin receptors related to the stomach, not to mood, and remeron blocks those receptors so they can't be influenced by the extra serotonin floating around from the other antidepressant.
Plus, remeron can boost the effectiveness of the other antidepressant by causing more serotonin release at low doses, and norepinephrine release as well at higher doses.
Posted by ravenstorm on September 24, 2005, at 9:52:30
In reply to Re: Antidepressants and stomach trouble, posted by blueberry on September 24, 2005, at 5:02:11
I was put on remeron and at first it helped my stomach but then after about six months on it it gave me horrible heartburn and stomach problems. I couldn't stop taking it immediately (had to wean off which took much longer than expected) so my stomach continued to be damaged. I have been off of it for nearly five months and my stomach is still destroyed. I desperately need to be on a medication and now can not take anything! If you have severe stomach problems and are mentally ill you are totally and utterly screwed.
Just as a comparrison, I also got bad heartburn on prozac, but after I stopped it my stomach returned to normal. UNLIKE remeron. My stomach has improved somewhat (meaning I can eat now but still feel like crap) but has never gone back to normal.
My heart goes out to you.
Posted by Phillipa on September 24, 2005, at 12:50:35
In reply to Re: I wouldn't take remeron!, posted by ravenstorm on September 24, 2005, at 9:52:30
I'm definitely wierd. Remeron didn't even make me tired. And I took it with other sleep meds. Fondly, Phillipa
Posted by Declan on September 24, 2005, at 15:00:02
In reply to Re: I wouldn't take remeron!, posted by Phillipa on September 24, 2005, at 12:50:35
Phillipa, hello, how much Remeron were you taking? Less sedation at higher doses?
I got sick of my insomnia, had stopped taking Parnate, and took 7.5mg mirtazapine last night. Best sleep in years, but now I'm up I feel weird (of course), there's that stomach sensation that ravenstorm referred to, and the head thing (would turn into a headache at a higher dose?). I might try 3.75mg tonight.
I think these drugs are really toxic, but what to do?Declan
Posted by Phillipa on September 24, 2005, at 18:38:06
In reply to Re: I wouldn't take remeron!, posted by Phillipa on September 24, 2005, at 12:50:35
Declan I took l5mg of remeron. Since I now seem to require so much of a med does this make me a fast or slow metabolizer. I would venture a guess it's fast metabolizer. Fondly, Phillipa
Posted by Declan on September 24, 2005, at 19:42:22
In reply to Re: I wouldn't take remeron! » Phillipa, posted by Phillipa on September 24, 2005, at 18:38:06
Phillipa, I wish I was a fast metabolizer so that I can metabolize this stuff out of my system. The dr who gave it to me was talking about imbalances, and I was too tired and unhappy to argue with him.
I would have preferred Ambien, all things considered.
Have you been evacuated?
Declan
Posted by Phillipa on September 24, 2005, at 23:05:27
In reply to Re: I wouldn't take remeron! » Phillipa, posted by Declan on September 24, 2005, at 19:42:22
Declan, There is nothing going on in NC at this time but last week with Ophelia we went inland to Charlotte . Fondly, Phillipa
Posted by ed_uk on September 25, 2005, at 9:46:17
In reply to Re: I wouldn't take remeron!, posted by Declan on September 24, 2005, at 15:00:02
Hi Dec,
>Best sleep in years
:-)
>I feel weird
In what way? When I first started Remeron I felt a bit like my head was full of cotton wool. It passed after a few days though.
>stomach sensation
Heartburn?
>I might try 3.75mg tonight
I tried it once and it seemed to work.
Kind regards
~Ed
Posted by Declan on September 25, 2005, at 17:00:26
In reply to Re: I wouldn't take remeron! » Declan, posted by ed_uk on September 25, 2005, at 9:46:17
I didn't repeat Remeron. I'd hate to feel so bad I thought it was worth taking. And I do not need to be more angry and irritable. I suppose it will be chinese herbs and *no more* than 2 alcoholic drinks a night. I'm reduced to measuring out 60mls whisky (for the night) with a measuring cup. I drink it quickly, and I feel it come and go.
Declan
Posted by ed_uk on September 26, 2005, at 16:30:19
In reply to Re: I wouldn't take remeron!, posted by Declan on September 25, 2005, at 17:00:26
Hi Dec,
Mirtazapine really made you feel that bad?
~Ed
Posted by Declan on September 26, 2005, at 17:43:34
In reply to Re: I wouldn't take remeron! » Declan, posted by ed_uk on September 26, 2005, at 16:30:19
There was a bloke ages ago posted about Remeron. He was on 30 or 15. Anyway he was worried, saying that it was doing something serious to his brain/mind. I felt a tiny bit of that. Drugs like benzos, opiates, stimuants, the drugs of abuse and the illegal ones are pretty pleasant and straightforward by comparison to psych drugs (not trying to start anything here). Not all good for you of course.
I have found that drinking really affects the quality of my sleep. 60mls of whisky last night and I was OK.
I'm just not a very cooperative patient, I guess.
Declan
Posted by ravenstorm on September 27, 2005, at 12:53:26
In reply to Re: I wouldn't take remeron! » ed_uk, posted by Declan on September 26, 2005, at 17:43:34
Remeron made me HATE everyone. I thought I wanted to get a divorce until I went off the remeron and reallized I did really love my husband. It also made me really really angry and has now ruined my stomach so that I can't take further psych drugs.
Posted by Declan on September 27, 2005, at 22:12:31
In reply to Re: I wouldn't take remeron!, posted by ravenstorm on September 27, 2005, at 12:53:26
And for all we know there's a correlation between the integrity of the gut lining and mental state. There is with allergies, and have I heard of a correlation between allergies and depression?
Declan
Posted by ravenstorm on September 28, 2005, at 12:09:24
In reply to Re: I wouldn't take remeron! » ravenstorm, posted by Declan on September 27, 2005, at 22:12:31
Which is actually another way remeron screwed me up! After being on that extreme hisatamine receptor block, I have horrible allergies! My receptors seem to get permanently screwed from these drugs. Or at least it takes forever for them to up or down regulate again or whatever they have to do. I believe this is also what is affecting my stomach to a degree, because if I take pepcid or zantac (which work on a histamine receptor) rather than my usual prilosec, my stomach seems to improve) however I can't tolerate them for more than a few days. SUCKS!! Certainly wish after the hell of paxil withdrawal I'd just gone back on another SSRI (not that I didn't try) so that I would have just continued to screw up the same receptors rather than adding a few more into the mix to mess up!
Posted by Declan on September 28, 2005, at 14:28:57
In reply to Re: I wouldn't take remeron!, posted by ravenstorm on September 28, 2005, at 12:09:24
Well, I think I've probably got leaky gut syndrome, and if you've destroyed (did you say destroyed?) your stomach (and gut?) lining you might have it too.
Declan
Posted by ravenstorm on September 29, 2005, at 9:03:49
In reply to Re: I wouldn't take remeron! » ravenstorm, posted by Declan on September 28, 2005, at 14:28:57
And how do you solve leaky gut syndrome?
Although I think it is really telling that taking an acid blocker that works on histamine helps after being on remeron with the extreme histamine block. Something is definitely out of wack with my histamine system now.
This is the end of the thread.
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