Sertraline worsening IBS?

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CathyA
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   Posted 9/17/2008 11:41 AM (GMT -7)   
Hi all,
I haven't been here in awhile. The calcium I take has been keeping my diarrhea at bay.
I was on a low dose of sertraline (zoloft) for 2 weeks, and now I've been at 50mg for 4 weeks. (for depression/anxiety).
At first I got constipated (which was a nice change for awhile!). But after about 3 and 1/2 weeks on the 50 mg, I began getting cramps, diarrhea, and huge amounts of gas (at both ends). Hopefully, its just a short-term intestinal bug......but I'm wondering if any of you have had this kind of side-effect from sertraline?
I know they give people with IBS small doses of sertraline and it helps. I'm wondering if any of you had worsening diarrhea and gas from a higher dose? I hope this isn't a permanent side-effect. Seems like I find a drug that helps one problem, but creates others.
Thanks.

Sarita
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   Posted 9/17/2008 10:44 PM (GMT -7)   
Hi Cathy,
Actually, sertraline can have diarrhea as a side effect. However, it may be temporary - a lot of side effects from the SSRIs go away after a few weeks. If it's helping the root problem (depression/anxiety) it might be worth it to try to tough it out for a few more weeks. Hopefully, like you said, it's just a bug!
Co-moderator - IBS Forum

Please always remember to consult your medical professional regarding your medical questions; this forum is intended to provide patient-to-patient support. Although some of us have healthcare backgrounds, we cannot diagnose or treat patients on the board.


Simzee
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Date Joined Sep 2007
Total Posts : 64
   Posted 9/18/2008 6:30 AM (GMT -7)   
Did you know ALL the IBS pills I've seen on these posts have the side effect of....Diahrrea.  It may be the medication giving you MORE diahrrea.   Please go to the website......."Rx List" to see if your medication is one of them. Happy Day & Peace Out.

CathyA
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   Posted 9/18/2008 8:58 AM (GMT -7)   
Thanks Sarita and Simzee,
I have never allowed myself to look up the side-effects of Sertraline until now. I didn't want to develop any of them, since I'm a little suggestable! lol!
But after I started getting really bad diarrhea, I did a search and it sounds like lots of people get bad diarrhea with Sertraline, and some with the other SSRIs. I sure hope its not the Sertraline. This always happens. I find a drug that helps one symptom really well.........but it gives me another intolerable one. Bummer. The Sertraline was helping a number of other problems, but I sure can't live with this diarrhea and cramping all the time.
One person on the internet said that they actually developed IBS-D from using the SSRIs, and it never went away, even after stopping the drug.
The problem with drugs like this is that since our GI tracts produce neurochemicals too, it might be hard to treat the brain, and not have unwanted affects in the gut. I've made progress with my IBS over the years, and I will be sooooooo upset if this puts me back into never wanting to go out. :(

swtpeach
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Date Joined Sep 2007
Total Posts : 25
   Posted 9/18/2008 7:14 PM (GMT -7)   
I have been on a low dose of  Sertraline and I do not do well on it. I makes my nausea worse (which is my primary compliant and symptom) and I too get diarrhea. For me it did not get better after 2 weeks. I am at my wits end =(
 
Erin

CathyA
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   Posted 9/19/2008 6:54 AM (GMT -7)   
Hi Erin,
I was pretty nauseous for about 3-4 weeks, which ended up helping me lose weight! But I wouldn't want to live like that.
I've been told alot that these SSRIs really take a 6-8 weeks to start working. I guess that might mean it takes them that long to stop with the side-effects. This diarrhea is worse than just my "plain" IBS. I fought being on an antidepressant for many years, because I feared the side-effects. Then I got so anxious, I just had to try something. I sure hope I don't regret this. I'm going to give this 50 mg dose one more week, and if my diarrhea is just as bad, I'm going to go down to a half dose.
what scares me is that I got my IBS under control for several years. Now my gut is doing exactly what it did when I first got IBS........so I'll be really upset if this whole thing sets me back.
Erin, are you still on the sertraline?

swtpeach
Regular Member


Date Joined Sep 2007
Total Posts : 25
   Posted 9/20/2008 5:55 PM (GMT -7)   
Hi Cathy~
I so feel what you are going through. For me the sertraline (at 50 mg) makes me feel like I am pregnant. Waves of nausea and then a several hours later D. The nausea was so bad that I was losing weight, which really wasn't a bad thing, but I was tired of feeling sick and not eating.

I have since cut back to 25 mg and not doing a whole heck of a alot better. I have been on it for a year, though the last 6-8 months I have not been consistent with taking it (take when I get the funny dizzy feeling in my head). What I like about it is it keeps my "crabbiness" (lack of a better word) and anxiety in check. So I keep taking it and deal with the crappy appetite and D.

I have dealt with nausea for so many years and frankly I am so sick of it. My family have come to know when I am quiet that my tummy is bothering me. I hate that my daughter sees me like this (she is worry wart as well) and has since been complaining of some stomach upset. I often wonder if I simply taught her that or if she is taking after me, God help her!

Anyway, all that to say, yes I am still on sertraline. =)

CathyA
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Date Joined Mar 2005
Total Posts : 1431
   Posted 9/22/2008 12:02 PM (GMT -7)   
Hi Erin,
Has your doc mentioned trying a different med? I know my internist, when I first asked him for an antidepressant, told me not to get upset if the first one didn't work well, that there were many others to try.
I suppose it helps to be fairly used to diarrhea from my IBS, but this isn't the same thing. I just can't go out anywhere, without taking tons of pepto bismol. My calcium doesn't seem to have any effect. I started eating Activia again (it usually constipates me), and Vitamin D (usually constipates me), and quit taking any magnesium........but man, this stuff just explodes out when it decides it wants to! I can't imagine being out and about and having these attacks. I'll give it a couple more weeks, and then I'll try going down on it, and then if I'm still having this diarrhea, I'll try switching meds.
I seemed to get alot of emotional relief the first few weeks I was on it, and also constipation.......so maybe this is just too much drug for me. Sometimes I wonder if I went up on it, if it would help the diarrhea??? It doesn't make alot of sense to me, but you never know.
Thanks Erin.....and seriously, why don't you consider trying a different SSRI?
I have to admit, for the first time in my life, I'm not hungry 24/7!! I LOVE this side-effect from it! I was nauseous for the first couple weeks, but I'm not anymore........just not driven to eat all the time. Its great! Its just too bad it all comes exploding out of me shortly after I do eat!!

swtpeach
Regular Member


Date Joined Sep 2007
Total Posts : 25
   Posted 9/22/2008 10:40 PM (GMT -7)   
Hi Cathy~
Yes, the exploding part we can both do without! I was in Kohls a few months ago and got the famaliar "rumble" in my tummy. I already have big issues with pooping in public bathrooms so this sent me into a tizzy. I was so happy there was a family restroom (one room with bathroom and sink) and did not have to worry about someone walking in during my explosive moments! Ugh!

I have tried different SSRI's. I was on Paxil CR and it crapped out my sex life. I was on Lexapro and gained toooo much weight. I have been on Prozac and it did not really help much. Yes, I am a mess =)

I do like not having a huge appetite, but I hate feeling nauseous. I feel nauseous enough on my own, never mind adding a drug to magnify it!

CathyA
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Date Joined Mar 2005
Total Posts : 1431
   Posted 9/23/2008 6:13 AM (GMT -7)   
I'm just curious what causes the diarrhea with these drugs. Like I said, I'm taking all the stuff that would usually turn me to cement, and it makes absolutely no difference.
I just told my husband this morning (after a sudden explosion) that maybe I should start carrying around a back-up pair of clothes with me all the time. Really, I'm afraid to go anywhere. I'm also wondering if the couple of meds I take don't even have time to get absorbed because of the diarrhea.
It seems through my whole life, I find something that works on one symptom, and I get really happy.........and then the side-effect happens and makes it impossible to stay on the drug......whether its diarrhea, irregular heartbeats, totally dry mouth, etc., etc., etc.
People with "normal" systems just don't know how lucky they are!
Have you ever tried something like Wellbutrin? That supposedly doesn't cause sexual dysfunction. For me though, it dried my mouth out horrible and gave me irregular heartbeats. Life can be a challenge!

Sarita
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Date Joined Mar 2005
Total Posts : 2486
   Posted 9/23/2008 7:20 AM (GMT -7)   
Well, the SSRIs increase the availability amount of the neurotransmitter serotonin in the brain, which helps our mood. Our gut also has bazillions of serotonin receptors, so there is increased availability to the gut as well. Hence, increased peristalsis, etc. That's why SSRIs have that effect!
Co-moderator - IBS Forum

Please always remember to consult your medical professional regarding your medical questions; this forum is intended to provide patient-to-patient support. Although some of us have healthcare backgrounds, we cannot diagnose or treat patients on the board.


CathyA
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Date Joined Mar 2005
Total Posts : 1431
   Posted 9/23/2008 8:16 AM (GMT -7)   
Thanks Sarita,
Can't they work on making it work on just the brain receptors?? If people get severe diarrhea with the SSRIs, does that say anything about what's going on, or is there another drug that would be more appropriate? I'd hate to think I just can't get my serotonin up in my brain, without living with constant liquid diarrhea! I guess I just can't get all my systems happy at the same time!

Sarita
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Date Joined Mar 2005
Total Posts : 2486
   Posted 9/23/2008 10:03 AM (GMT -7)   

Medicine just isn't that far advanced yet.  Imagine how much work it took just to get to this point, where we even know that neurotransmitters exist!  I think there is a lot of hope for the future, though...we are learning so much about the gut these days.

It's probably not just the SSRI causing your diarrhea.  There is usually a combination of factors for most afflictions and while it could be exacerbating things, it is unlikely to be the main cause.  Does taking Immodium help?


Co-moderator - IBS Forum

Please always remember to consult your medical professional regarding your medical questions; this forum is intended to provide patient-to-patient support. Although some of us have healthcare backgrounds, we cannot diagnose or treat patients on the board.


CathyA
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Date Joined Mar 2005
Total Posts : 1431
   Posted 9/23/2008 1:46 PM (GMT -7)   
Hi Sarita,
I just bought some immodium today and will try it. For some reason, I was thinking it didn't work as well as pepto does. I'll try it soon.
I don't take stuff if I'm staying home, because I don't want to over-use it. I don't know the exact mechanism, but 4 weeks after I started the sertraline, the diarrhea started up suddenly, so I'm pretty convinced its that..........unless I got some weird parsite from my chickens, or cat, or dog or water gardens or garden. Nothing else really bothers me, so it must be a malfunction of something in my gut.......more than "just" my IBS. Its hard to believe that this will pass, as my body incorporates the changes that the sertraline is causing. The doc says it will.........but I'm very skeptical.

7Lil
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Date Joined Apr 2005
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   Posted 9/24/2008 6:34 PM (GMT -7)   
Cathy,
Probiotics should help with the D. Imodium for sure should help as well. I find it works much better than Pepto. The thing with Pepto is that you have to take more to get the same results, AND the Pepto turns your stool black. I hate that.
BTW - What kind of Imodium did you get - AD? The extra strength has the power of Superman - watch that you don't take too much or you'll be backed up for days.
Good luck!
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CathyA
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Date Joined Mar 2005
Total Posts : 1431
   Posted 9/25/2008 2:48 PM (GMT -7)   
Hi Lil,
I've been taking probiotic pills and eating yogurt, and they don't seem to have any effect on the diarrhea. And I'm talking liquid diarrhea for 2 weeks now.
There's absolutely no indication that its getting better. The doctor told me to wait it out, but I don't think its going to change. Maybe people with normal GI tracts would get over it eventually, but I'm thinking since I have IBS, I won't. No fun.
I think I got the regular strength Imodium. I haven't tried it yet, since it says it might make me drowsy, and I wanted to run errands. I'll take it sometime when I'm home, so I know what to expect. I doubt anything will back me up for days, at this point. Pepto bismol usually does, and so does Activia, but they seem to have little effect now.
Thanks for your help.

7Lil
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Date Joined Apr 2005
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   Posted 9/25/2008 8:26 PM (GMT -7)   
Drowsiness? Really? I have never heard that. I'm not doubting what you read, I'm just surprised. I went around and took a pole of my household and not any of us (5 of us) have ever been drowsy from Imodium. Anyway, that's not to say it won't happen to you... I'm just thinking it has got to be rare.
Keep up the probiotics and yogurt - it can't hurt. :-)
Co-Moderator IBS Forum
 
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CathyA
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Date Joined Mar 2005
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   Posted 10/2/2008 7:05 AM (GMT -7)   
Hi Lil,
Well, its a week later and I'm still having liquid diarrhea 3-4 times a day. I haven't tried the Imodium yet, since I just need it when I'm going out and was afraid of the drowsiness......but since reading what you wrote about it, I'll not worry about that possible side-effect. You know how they have to do it with posting the side-effects........they have to mention every one that anyone has ever gotten with it!
I called the doc's office and left the message that I'm going to slowly go down on the Sertraline (zoloft). My depression was improving at a lower dose, and I didn't have the diarrhea at that dose, so maybe I'm just extra sensitive to it, and am sort of over-dosing on the "normal" dose of it. Too bad these drugs take a few weeks to show the changes.

And I'm also wondering if all this diarrhea is messing up the probiotics I'm taking, and maybe even messing up the absorption of the meds I'm taking.
This is a real bummer. I've read of people who have diarrhea with all the SSRIs.........so I hope that's not the case with me.
Thanks again Lil!

Simzee
Regular Member


Date Joined Sep 2007
Total Posts : 64
   Posted 10/3/2008 7:30 AM (GMT -7)   
I find that most medications make the "runs" worse if they work at all. I use natural herbs for me. Like Catnip & Fennel for gas. This works in about 20 minutes. I also have NO nausea. (Can't mention why) I control what & how much I eat. The less you eat the less you run. No, you should not starve but should eat logically. ALL medications have risks & side effects, no matter what you take. Do I still "run"? Yes but nowhere near as much as before.  Happy Day to all & Peace Out!!!

Sarita
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Date Joined Mar 2005
Total Posts : 2486
   Posted 10/3/2008 12:06 PM (GMT -7)   
The Imodium should not cause any side effects other than stopping you up a bit! It's totally safe.
Co-moderator - IBS Forum

Please always remember to consult your medical professional regarding your medical questions; this forum is intended to provide patient-to-patient support. Although some of us have healthcare backgrounds, we cannot diagnose or treat patients on the board.


CathyA
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Date Joined Mar 2005
Total Posts : 1431
   Posted 10/3/2008 1:13 PM (GMT -7)   
The diarrhea I've had is controlled for several hours, if I take 3-4 doses of pepto before I go out. What's very interesting is that I've taken a lower dose of the zoloft for 3 days now, and I haven't had any diarrhea at all today, and its 4p.m.! So I'm very hopeful that just cutting back on the zoloft will take care of it. But......I can already tell that some of my other symptoms (the brain ones) aren't as well controlled. Hopefully, once I'm on the lower dose for awhile, my brain (depression/anxiety) will still be helped some. Haha........now I probably won't poop for 2 weeks!!
Several very nice things that the higher dose of zoloft did for me was it helped my ADD. I could focus much better. Also, I've been hungry 24/7 my entire life, and after I started the zoloft, for the first time in my life, I wasn't hungry all the time!! I sure don't want to lose the progress that I've made in those areas.
I've been reading that all the different SSRIs can cause this diarrhea.....just because of how the gut neurochemical receptors respond. I sure wish I could have it all...........no diarrhea, but get all the good benefits of the zoloft. This diarrhea was more than I could live with though........and I'm not sure I would want to live taking pepto/imodium every day forever.
Thanks for your help and your suggestions!
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