Are these symptoms because of an SSRI “poop out”?
I’m a 29 year old female, diagnosed with panic disorder 10 years ago. Was on Paxil 40mg for 8 years. No problems with it & found it to work well for my anxiety and panic. Last summer, I switched to Lexapro because it is safer for women to take if they choose to get pregnant. I have been taking the Lexapro for about a year at 20mg. I was doing fine up until 3 weeks ago. I left for a trip (first time on a plane in 10 years) suffered some major anxiety during the trip (used lorazepam to help) and haven’t stabilized since. I’ve had moderate diarrhea for almost the entire month since our return (except the week when my doc put me on Cipro) and my anxiety is getting worse. My psych is increasing Lexapro to 30 mg. I’m not seeing much change. When a SSRI "poops out", can you begin to experience diarrhea as a side effect or even a withdrawal symptom? I’m working closely with a general practitioner to see if it’s a stomach issue and my psych to see if it’s an anxiety issue.
I also have no appetite and am experiencing a lot of the same symptoms I first had before I was diagnosed with panic disorder. Anyone have insight or can relate to this?
Very interesting note about the lorazepam. I did think of that as a possibility of the diarrhea. I did wean myself off of it with my doc’s help, and the amount of time I was on it didn’t seem to cause withdrawal. I get my stool sample results back today or tomorrow.
I haven’t taken any over-the-counter meds since this all started. No vitamins either.
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A question I would be asking is: "If they aren’t working, why am I using them?"
THERAPISTS: It depends to a certain extent on what your tentative diagnosis is: people with Borderline Personality Disorder, for example, need to be challenged from time to time, by therapists using DBT. A good therapist will get you to examine the appropriateness of your actions, or thought patterns, and offer the occasional suggestion.
Some therapists, however, work from an "I know best" basis, and, even though they may actually do know best, their approach often isn’t as conducive to progress as others, who take more of a middle position. On the other hand, there are those who try to be your friend, when what you really need is expert help. I suggest that you try at least 3 new therapists, and initially select one you feel most comfortable with, because a good degree of rapport (which takes time to build) can help a lot, with therapy.
Closely examine the http://1-800-therapist.com/ website, and use the locators, in section 1, at http://www.mercola.com Yakult, from supermarkets is good, but I take it with iced coffee, or flavoured yoghurt. Temporarily, increase low fat cheese consumption. You could also get Imodium from a pharmacy, short term.
August 17th, 2009 at 7:33 pmCould very well be. The diarrhea, absolutely not though. That can be a side effect of some SSRIs (zoloft is notorious), but that sort of side effect doesn’t spontaneously pop up after a year or so(Granted, there is almost never 100% certainty with such things). The SSRI poop out wouldn’t cause it in and of itself.
What I would look at first is some sort of infection. When your immune system starts kicking up dirt it can mess with your mood, not to mention your meds. Depending on where you traveled to, you can pick things up. Airports are notoriously contaminated with Norovirus(Which admittedly lasts a day or two, but there’s others). Second, when you up a dose it can take several weeks to see the effect, much like when you got on them the first time.
Have your GP do a blood draw and a white blood cell count. It’s an inexpensive, quick test assuming they have a lab in house, and it is pretty definitive if you’re fighting a bug of some sort.
August 17th, 2009 at 7:33 pmIt could be a bug/infection picked up during your holiday.
It might it be linked to the onset of lorazepam medication. If the medication was used for a week… that would be enough time for lorazepam withdrawal to be a possibility, and that would include diarrhea and all sorts of psychiatric symptoms…. " Symptoms reported following discontinuation of benzodiazepines include headache, anxiety, tension, depression, insomnia, restlessness, confusion, irritability, sweating, rebound phenomena, dysphoria, dizziness, derealization, depersonalization, hyperacusis, numbness/tingling of extremities, hypersensitivity to light, noise, and physical contact/perceptual changes, involuntary movements, nausea, vomiting, diarrhea, loss of appetite, hallucinations/delirium, convulsions/seizures, tremor, abdominal cramps, myalgia, agitation, palpitations, tachycardia, panic attacks, vertigo, hyperreflexia, short-term memory loss, and hyperthermia." (Lorazepam/Ativan leaflet)
Lorazepam paradoxical side-effects also include various psychiatric symptoms.
Did the situation deteriorate (apart from the diarrhea) on/after Cipro? "Antibiotics for some reason, sometimes seem to aggravate withdrawal symptoms. However, one class of antibiotics, the quinolones, actually displace benzodiazepines from their binding sites on GABA-receptors. These can precipitate acute withdrawal in people taking or tapering from benzodiazepines." [Prof. Ashton, Intro, Ashton Manual]
?
PS Did you start/take any over the counter medicines/supplements that would tie-in time wise e.g. St John’s Wort, any diet-type pills, any cold/flu products that contained dextromethorphan…? There are quite a lot of products that combined with the Lexapro might accidentally have produced an adverse response.
August 17th, 2009 at 7:33 pm