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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by linkadge on February 9, 2006, at 18:27:25
I've been quite anxious lately. Mentally, the anxiety has not got to me much, but my stomach can't take it anymore. I'm sure I'm developing an ulcer.
Has anyone had similar symptoms and found something that has been helpful ? SSRI's made the situation much, much worse.
Linkadge
Posted by zeugma on February 9, 2006, at 18:57:50
In reply to Whats best for GI problems, posted by linkadge on February 9, 2006, at 18:27:25
traditionally the TCA's are best for depression with GI disturbances.
The gastroenterologist I saw a few years ago told me that nortriptyline and amitriptyline are the best AD's for GI problems- of course, they cause constipation, but work EXTREMELY well for pain throughout the GI tract. I have suffered constant nausea when not taking nortriptyline. It really seems to stabilize my digestive system.
-z
Posted by linkadge on February 9, 2006, at 19:21:00
In reply to Re: Whats best for GI problems » linkadge, posted by zeugma on February 9, 2006, at 18:57:50
Hmm, clomipramine made things worse, perhaps because it is much like an SSRI.
Linkadge
Posted by Phillipa on February 9, 2006, at 19:25:06
In reply to Re: Whats best for GI problems, posted by linkadge on February 9, 2006, at 19:21:00
Link I have no doubt you will figure it out. Are you due for any important tests now? Could this be adding stress. Fondly, Phillipa
Posted by zeugma on February 9, 2006, at 19:34:43
In reply to Re: Whats best for GI problems, posted by linkadge on February 9, 2006, at 19:21:00
> Hmm, clomipramine made things worse, perhaps because it is much like an SSRI.
>
>
> Linkadge
a poster a while ago reported that clomipramine gave him terrible acid reflux.This is the only case I have read of that a TCA caused GI problems other than constipation, so perhaps it is particular to clomipramine.
Strattera caused terrible stomach pain, too.
If anxiety is driving the GI problems, then a benzo might be another thing that helps.
-z
Posted by TJO on February 10, 2006, at 6:12:28
In reply to Re: Whats best for GI problems, posted by zeugma on February 9, 2006, at 19:34:43
Hi
Pepto-bisomol will coat your stomach if you take a dose 3x a day...maybe that will help temporarily while you check out the other suggestions.Tammy
Posted by James K on February 11, 2006, at 0:51:38
In reply to Re: Whats best for GI problems, posted by TJO on February 10, 2006, at 6:12:28
If you have or are developing a real ulcer, then antibiotics for the H.pylori bacteria might be in order. My wife developed a bleeding ulcer, and although it seems to have been brought on by nsaid's, it took .the antibiotic therapy along with med changes to cure it.
Bad gastritis, may be a different situation in and of itself. Too much drink and too many aspirins can cause this in me, and how it relates to eventually develping a full blown ulcer, I havent had to find out.
If it is more of a reflux situation, (all of these hurt, and can hurt similiarly). I'm not a believer in any of the proton pump inhibitors (or whatever they are called, that sounds like a science fiction weapon) or acid inhibitors. I lived on tums until I had surgery to tighten the valve - Laproscopic Nissan Fundoplikation. The stomach acids are there for a reason, they are one of the body's first lines of defense in immunity. (plus digestion).
All in all this is what I know about gi problems. The only med I remember that flat out hurt my stomach was naltrexone, and I just got off of it. I also have U.C. so may experience may be more varied than the next guy.
james k
Posted by yxibow on February 12, 2006, at 3:55:29
In reply to Whats best for GI problems, posted by linkadge on February 9, 2006, at 18:27:25
> I've been quite anxious lately. Mentally, the anxiety has not got to me much, but my stomach can't take it anymore. I'm sure I'm developing an ulcer.
>
> Has anyone had similar symptoms and found something that has been helpful ? SSRI's made the situation much, much worse.
>
> Linkadge
Its worth noting that the vast majority of serotonin receptors are located in the stomach, in fact by some counts almost all. If you have an intense anxiety disorder, it is quite likely that you will have gastric upset. The chances of developing an ulcer are fairly low in this situation since ulcers are now known to be caused by H. pylori by Nobel Prize scientists.
If your insurance can afford it, a radical idea of using ondansetron (Zofran) or granisetron (Kytril) which are 5HT3 blockades could determine whether it is a serotonin issue or whether you indeed have a true ulcer, which is treated with a combination of antibiotics and proton pump inhibitors.
Meanwhile as others have said, stock up on pepto bismol. Its an old aid, but it does work, for whatever reason, it has both a mild antibiotic and anti-inflammatory action.
It is also worth noting that TCAs have been used successfully in IBS situations.My 2c
-- Jay
Posted by yxibow on February 12, 2006, at 4:21:33
In reply to Whats best for GI problems, posted by linkadge on February 9, 2006, at 18:27:25
> I've been quite anxious lately. Mentally, the anxiety has not got to me much, but my stomach can't take it anymore. I'm sure I'm developing an ulcer.
>
> Has anyone had similar symptoms and found something that has been helpful ? SSRI's made the situation much, much worse.
>
> LinkadgeCheaper options I forgot to mention are the phenothiazines Compazine (yuck, I know), Promethazine, Tigan, which have some 5HT3 blockade. Ativan may also have some results.
Posted by linkadge on February 13, 2006, at 20:11:08
In reply to Re: Whats best for GI problems » linkadge, posted by yxibow on February 12, 2006, at 4:21:33
I've been using ginger root, which does have 5-ht3 antagonistic affinity. It has been fairly usefull, but not completely curative.
It feels like there is a dumb little circut from my brain to my stomach. Most of the time it is just a thought that causes these sharp surges. If my brain waited a few seconds and thought it through, it would probably realize that a shot of gastric juice is not really the way to best remedy the situation.
Linkadge
Posted by yxibow on February 14, 2006, at 2:23:05
In reply to Re: Whats best for GI problems, posted by linkadge on February 13, 2006, at 20:11:08
> I've been using ginger root, which does have 5-ht3 antagonistic affinity. It has been fairly usefull, but not completely curative.
>
> It feels like there is a dumb little circut from my brain to my stomach. Most of the time it is just a thought that causes these sharp surges. If my brain waited a few seconds and thought it through, it would probably realize that a shot of gastric juice is not really the way to best remedy the situation.
>
> Linkadge
Interesting -- I checked this out, you're right, it contains a mild 5TH3 affinity antagonist called galanolactone. I'm one of these odd people that likes chewing raw ginger actually, and its cheap as dirt from Trader Joes. I do use it for nausea sporadically if there is a medication change. So this proves then that it probably is not an ulcer because there would be other complications and it wouldn't respond to 5TH3 inhibitors.As I noted, almost all of the serotonin receptors in your body are located in the stomach region. Why the evolutionary reason I haven't the faintest idea. Very few serotonin receptors make it to the brain. As I speak I have a very mild gastric sense, and I have an anxiety disorder. Maybe like thinking.
It is also probably the reason that SSRIs havent responded for the most part because a number of them are "unclean" and have 5HT3 agonist properties that may go away over time.
Posted by linkadge on February 14, 2006, at 9:17:49
In reply to Re: Whats best for GI problems » linkadge, posted by yxibow on February 14, 2006, at 2:23:05
The thing about ginger is that it also contains some benzodazapine like properties which may also affect its ability to reduce nausia, and GI upset.
Linkadge
Posted by tizza on February 14, 2006, at 17:00:08
In reply to Re: Whats best for GI problems, posted by linkadge on February 14, 2006, at 9:17:49
have you been checked for irritable bowel syndrome, or is it further up. I have heard that ozexapam has been rx'ed for IBS which is usually stress related so it kills two birds with one stone. IBS causes terrible stomach and bowel cramps and you generally alternate from the runs to constipation very, very quickly, sometimes within the day. I hope this was of some help.
Posted by Christian10 on February 16, 2006, at 18:57:38
In reply to Re: Whats best for GI problems, posted by tizza on February 14, 2006, at 17:00:08
I developed a GI problem after taking paroxetine for almost three years. Now every time i want to start treatment with it again (because it was one of the best things i tried for my social anxiety along with Klonopin) my guts get so damn swell that i have to stop it inmediately.
Do you think that taking paroxetine along with a 5ht3 blocker would be of any benefit for my situation?? Thanks
Posted by yxibow on February 17, 2006, at 2:40:35
In reply to Re: Whats best for GI problems, posted by Christian10 on February 16, 2006, at 18:57:38
> I developed a GI problem after taking paroxetine for almost three years. Now every time i want to start treatment with it again (because it was one of the best things i tried for my social anxiety along with Klonopin) my guts get so damn swell that i have to stop it inmediately.
>
> Do you think that taking paroxetine along with a 5ht3 blocker would be of any benefit for my situation?? Thanks
If the same drug attacks 5HT3, which is known with SSRIs because they're not completely perfect and clean and will hit 5HT3 as well as the other 5HT receptors (most all your serotonin receptors are in your guit), in you, several times, one might consider a change to another drug. Effexor has been approved for Social Anxiety Disorder and it might be worth a try.If you really want to try Paxil again, you're going to have to go for the long haul... the problems with 5HT3 will dissappear, they may come back again. But it sound suspicious after 3 years that it is developing -- are you absolutely sure you don't have an ulcer related disorder instead ?
I would experiment with a copious amount -- i.e. an entire root (they're not particularly harmful) (your taste buds may be different from mine) of raw ginger, easily gotten from your local Trader Joes or supermarket. It has a mild 5HT3 blockade. If that does nothing at all, I would look with your GP to something else other than the Paxil as the cause.
Have you tried Prilosec OTC for 14 days ? That may be another test that it is not 5HT3.
Also a trial of Zantac or similar OTC would be another test.
Usually the GI troubles with SSRIs and SSNRIs start in the first few weeks and go away after a while or with dosage adjustments.
I hope your tummy feels better-- Jay
Posted by Happy Girl on February 20, 2006, at 18:13:28
In reply to Re: Whats best for GI problems, posted by Christian10 on February 16, 2006, at 18:57:38
Hi;
I have the exact problem as yours, ... after having on psycho.meds., particularly 'Lithium' and 'WB sr' aggravating my acid reflux problem.For this, I took Prilosec OC for about a week, however Prilosec making me more manic state. Also, I tested Nexium and Prevacid.
In my opinion through the experience, Mexium has most 'milder' effect on psycho. meds. I've been on. However, on the other end, Mexium is NOT quite potent like other 'P' like Prevacid.
Overall, there are one way or other, all of GP meds. have interaction, the the best way to beat GI problem is 'diet' not eat acidic foods along with other dietary precautions. Unlike 'non-mental' folks, it's NOT much remedy for GI problem. However, some folks have success on other GI meds., like Zantac and similar class GI meds. to consider.
You may post other site, GI sites asking your problem.
H.G.
Posted by Jaynee on February 21, 2006, at 21:13:17
In reply to Re: Whats best for GI problems, posted by tizza on February 14, 2006, at 17:00:08
If you find a solution, please, please let us know. I just started back on Cipralex(lexapro) and I am having unbelievable stomach problems. The gas gets so bad it feels and looks like I am 5 months pregnant. The only thing that ever helped me was ativan, but of course doctor's won't give that out. I used to get it on the internet, but last time I ordered it, I got ripped off. So here I am suffering, to the point, I am thinking about quiting work, because I just can't take the pain.
This is the end of the thread.
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