Various antidepressants trigger or stop flare ups. Anyone notice this?

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TriedEveryDrug
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Date Joined Feb 2009
Total Posts : 2
   Posted 2/15/2009 8:23 AM (GMT -7)   
Hi,

I've had CD for about 18 years now. It is mostly under control with 6-mercaptopurine and Pentasa. I have the occasional flares, but mostly I'm pretty good.

I also have ADD, inattentive-type, for which my doc has tried various stimulants and other psych drugs.


One of the first drugs I tried, desipramine, actually seems to improve my crohn's. The doc thinks it is because it is constipating, but I'm sure there is more to it because pain and blood go away too. In fact, a colonoscopy I had after I had been on this drug for a while looked very good, according to my gi doc. Unfortunately, I have a hard time staying on this drug because it makes me moody and angry and makes my heart pound. Has anyone else had this experience with desipramine? Focalin XR (a stimulant similar to ritalin) also seems to help my crohn's, to a lesser degree.


Also, some of the drugs I've tried seem to trigger flares. Remeron, which seems to be great for anxiety, sets me off. As does Effexor XR, Pristiq and Wellbutrin XL. (I have not noticed this with the wellbutrin SR, but it may have happened too. It makes me wonder though if it is something about the extended-release polymer they use in these drugs that may set off flares. I looked up the one for wellbutrin xl and it is designed to release in the colon.) How it starts is I have bad diarrhea from these drugs and then it progresses to a flare up.

I have tried to find information online about how pysch drugs interact with crohn's but found little. There was one clinical trial using wellbutrin as a treatment for crohn's (the theory is wellbutrin is a tnf inhibitor), but I don't know the results of that.

mtgman
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Date Joined Mar 2005
Total Posts : 1289
   Posted 2/15/2009 8:48 AM (GMT -7)   
hi there. we have a family friend on the east coast who has had crohn's for a long time...years ago ahe started taking zoloft and feels it basically "cured" her...i've tried to inquire a bit with others/research but have not heard that anywhere else...

LMills
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Date Joined Apr 2008
Total Posts : 1753
   Posted 2/15/2009 10:54 AM (GMT -7)   
Mistake me if I'm wrong, but doesn't that have to do with the effects of seratonin?
20 years old, Diagnosed with moderate to severe Crohn's and Colitis in May of 2008.
Currently taking:
Prednisone 5 mg, pentasa 2 pills 4x a day, bentyl as needed, omeprazole in the morning, prenatal multivitamin, humira every other week, and good probiotics.
Surgery for ectopic pregnancy most likely the result of severe Crohn's inflammation in July of 2008.
Attempting a diet without refined sugars, high fat content, bleached or bromated flour, most dairy, red meat, and avoiding anything spicy like the plague. Also refuse to eat anything with trans fat or high fructose/corn syrup.
"He who has a why to live for can bear with almost any how."


Rider Fan
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Date Joined May 2008
Total Posts : 1445
   Posted 2/15/2009 2:01 PM (GMT -7)   
Interesting. Someone posted here once about Wellbutrin helping.
32 y/o male. Dx'ed in 1999. No surgeries.

Current meds: 25mg Methotrexate. 8mg prednisone. Udo's Choice Probiotics (30 billion).

Tried SCD, didn't work, now avoiding gluten and dairy.


Jen77
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Date Joined Mar 2006
Total Posts : 2691
   Posted 2/15/2009 2:24 PM (GMT -7)   
Well my doctor said that it might help with diarrhea for me, so yes he certainly believes there is some connection. I use mine for anxiety.
~Jennifer
 
Diagnosed with Crohn's Disease 2/06, and Health Anxiety/OCD 12/08 Taking Asacol, Questran, Toprol XL, and Lexapro.


MMMNAVY
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Date Joined Jul 2006
Total Posts : 6927
   Posted 2/15/2009 2:30 PM (GMT -7)   
Some of the SSRI's can make the GI tract worse...but I have heard the reverse as well.  Wellbutrien is also used for cessation of smoking, which can help some people's crohns.


Forum Co-moderator - Crohn's Disease:_All comments have the caveat contact your local health care provider.

I will find a way or make one. –Phillip Sidney 1554-1586

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Rider Fan
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Date Joined May 2008
Total Posts : 1445
   Posted 2/15/2009 2:40 PM (GMT -7)   
It's also an anti-TNF possibly.

http://clinicaltrials.gov/ct2/show/NCT00126373
32 y/o male. Dx'ed in 1999. No surgeries.

Current meds: 25mg Methotrexate. 8mg prednisone. Udo's Choice Probiotics (30 billion).

Tried SCD, didn't work, now avoiding gluten and dairy.


bookworm21
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Date Joined Mar 2008
Total Posts : 1766
   Posted 2/15/2009 6:30 PM (GMT -7)   
Some studies have shown the fluexotine (Prozac) has helped IBD and IBS symptoms. But I've also been told that ADD/ADHD meds cause or worsen GI symptoms.

Female, Age 20
9 Asacol, Rowasa1000 mg Canasa, Proctofoam, Rifaximin 2/day
Digestive Advantage (Crohn's & Colitis)1 Florastor, 50 mg 6MP,1 Primadophilus reuteri, Remicade (6 infusions), 2.4 g Lialda, Forvia, 6 Colazal, 1 Anucort, Culturelle, Fish Oil, Calcium/Vit D supplement, 20 mg Prozac, VSL #3
 


TriedEveryDrug
New Member


Date Joined Feb 2009
Total Posts : 2
   Posted 2/15/2009 6:45 PM (GMT -7)   
bookworm21 said...
Some studies have shown the fluexotine (Prozac) has helped IBD and IBS symptoms. But I've also been told that ADD/ADHD meds cause or worsen GI symptoms.


For me at least, Adderall (amphetamines) seemed to have no effect. And Focalin/Ritalin (methylphenidate) seemed to improve my symptoms. As you probably know, most of the ADD drugs (except Strattera) increase dopamine release, which somehow ends up with norepinephrine reuptake being blocked. Strattera and despiramine block the reuptake of norepi, plus desipramine is an agonist for tons of other neurotransmitters - it is a very "dirty" and on-selective anti-depressant. As I guess all of that class are.

bookworm21
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Date Joined Mar 2008
Total Posts : 1766
   Posted 2/15/2009 6:54 PM (GMT -7)   
I'm glad that Adderall and Ritalin don't make things worse for you. I was told that Strattera would be the safest for those of us with GI symptoms.

BuzyBum
Regular Member


Date Joined Feb 2004
Total Posts : 122
   Posted 2/15/2009 7:04 PM (GMT -7)   
I was on Prozac three separate times and three times I flared up. I didn't actually connect it to the Prozac until some time later, but then realised that everytime I had flared up, it was about 6 weeks after taking Prozac. I think it was possibly Prozac that Triggered my Crohns in the first place, but can't be too sure. I've never read about anyone else being affected by it, which is why I wasn't sure, but now I'm even more convinced it had something to do with it after reading this thread. I am now scared to go back on any anti depressant if I ever needed them again in future.
37yr old woman UK. Diagnosed with crohns in 95. Currently on 2400mg asacol, 100mg Azathioprine. Been on Remicade once which worked well for me, but they took me off it. Flared up again. Took Humira but it didn't seem to agree with me, but thinking it was now an infection rather than side effects from Humira. Now back on Remicade, had 3 infusions so far and no reactions as yet. Consultant wants me to have a colostomy bag fitted, I've refused and want to try as many options as possible. On Elemental 028 extra diet for 6 weeks.


snohare
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Date Joined Oct 2004
Total Posts : 2088
   Posted 2/15/2009 7:47 PM (GMT -7)   
I've never associated any particular antidepressant with causing a flare (and I spent a good decade and more trying out one after the other, mainly over winter) but I certainly found that Prozac did me a power of good when I went on it.
It didn't get rid of my stomach pains entirely, nor stop the bleeding entirely, but it did turn the gas ring down to a simmer rather than full heat, if you see what I mean. It was so dramatic and clear a difference that I ended up asking my GP (PCP) if I could stay on it over summertime. He said he saw no reason why not, it did have a reputation for calming stomach problems of the IBS/IBD type. I was rather tentative in making this suggestion, because when I first went on Prozac basically it rewired my personality through disinhibition, and I was left in no doubt that this was a drug that made major impacts on the Central Nervous System.
Unfortunately, what happened then was that after having several years of being on Prozac for a few months at a time, with summers off, being on Prozac non stop for a couple of years caused some kind of change in my brain chemistry. In essence, it stopped working at all on my mood, and the side effects, particularly poor cognition and memory, became absolutely diabolical. (I don't remember if it stopped working on my gut. I don't think so.)
It all sounded a bit similar to what research on Ecstasy abusers seemed to indicate. I am inclined to think that my CNS serotonin/oestrogen receptors changed as a result of the long term change in chemistry caused by the fluoxetine, and that this is not reversible with the current state of knowledge.
None of the other SSRIs that I have tried since have been effective in treating either SAD or flare-related depression or gut symptoms. Quite the opposite, they have tended to increase mood swings. cry Back to the light box and fractured sleep patterns... nono but noticeably improved cognition, albeit still not to previous standards.

karendee
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Date Joined Mar 2007
Total Posts : 1642
   Posted 2/16/2009 10:56 AM (GMT -7)   

For me, I have anxiety problems and I think when I take a med to help control it (I take just effexor now) I have less stress that can aggravate my CD. Most Doc's will say stress won't cause CD but I know for sure stress will make it worse. So when I am on drugs to help control my Anxiety I have less CD problems. Just my 2 cents.

Karen


 ...

Karen (Karendee)

Diagnosed w/ Crohn’s Disease  March 2007 Started Humira June 2008 (have been on other cd meds)

Diagnosed w/  Fibromyalgia May 2007 on Soma and Lyrica

 

 


mtgman
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Date Joined Mar 2005
Total Posts : 1289
   Posted 2/16/2009 12:21 PM (GMT -7)   
there's an interesting post on the UC forum talking about low dose naltrexone...it looks like the reason it works is becasue it increases seretonin production- endorphins...i'm going to look into this...looks like a very high percentage of Crohn's patients see a nice effect...
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