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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by ben on May 18, 2001, at 9:31:06
I started going of Celexa 5 weeks ago. I tappered gradually (from 60m) down during two weeks (my doc made this procedure several times). After 10 days i felt nervousness, flu like symtoms and an awfull nausea. My doc suggested to start with Zoloft (because of the same mechanism) to overcome this withdrawl symptoms. Now, three weeks later I am on 75 mg Zoloft and the nausea is still coming and going. I am very nervous and have anxiety too. A gastrointestinal observation (cause of the nause) was okay. So whats with the nausea ??? My doc doesnt know if its from discontinuation of the Celexa, from the Zoloft or is it part of my depression ? I didnt feel nausa during my illness, so I think its from the meds. I feel sick of this feeling and want finally to get rid of.
Posted by shelliR on May 18, 2001, at 14:24:06
In reply to NAUSEA !!! Please help !!!, posted by ben on May 18, 2001, at 9:31:06
> I started going of Celexa 5 weeks ago. I tappered gradually (from 60m) down during two weeks (my doc made this procedure several times). After 10 days i felt nervousness, flu like symtoms and an awfull nausea. My doc suggested to start with Zoloft (because of the same mechanism) to overcome this withdrawl symptoms. Now, three weeks later I am on 75 mg Zoloft and the nausea is still coming and going. I am very nervous and have anxiety too. A gastrointestinal observation (cause of the nause) was okay. So whats with the nausea ??? My doc doesnt know if its from discontinuation of the Celexa, from the Zoloft or is it part of my depression ? I didnt feel nausa during my illness, so I think its from the meds. I feel sick of this feeling and want finally to get rid of.
Ben, maybe you could substitute prozac for zoloft to see if the elimination of the zoloft helps the nausea. If not, then you could probably figure its still from the discontination of celexa.Just an idea......not well versed in ssri reactions.
shelli
Posted by ben on May 18, 2001, at 15:01:36
In reply to Re: NAUSEA !!! Please help !!! » ben, posted by shelliR on May 18, 2001, at 14:24:06
> > I started going of Celexa 5 weeks ago. I tappered gradually (from 60m) down during two weeks (my doc made this procedure several times). After 10 days i felt nervousness, flu like symtoms and an awfull nausea. My doc suggested to start with Zoloft (because of the same mechanism) to overcome this withdrawl symptoms. Now, three weeks later I am on 75 mg Zoloft and the nausea is still coming and going. I am very nervous and have anxiety too. A gastrointestinal observation (cause of the nause) was okay. So whats with the nausea ??? My doc doesnt know if its from discontinuation of the Celexa, from the Zoloft or is it part of my depression ? I didnt feel nausa during my illness, so I think its from the meds. I feel sick of this feeling and want finally to get rid of.
>
>
> Ben, maybe you could substitute prozac for zoloft to see if the elimination of the zoloft helps the nausea. If not, then you could probably figure its still from the discontination of celexa.
>
> Just an idea......not well versed in ssri reactions.
>
> shelliThanks Shelli
Should I go on with the Zoloft or trying another AD? I feel anxious and nervous (from Zoloft or celexa discontinuation). I tried Remeron 7.5 mg to augment the 80 mg of Celexa but I felt a heavy sedation and heaeache (caused by the combination ? -- > too much serotonine ?) Remeron could have some antiemetic effects ?! So I am thinking to try the Remeron for the second time. I think that 50 mg Zoloft = 20 mg Celexa concerning the serotonine reuptake efffect?
That would mean I could bear the Remeron better with 50 mg Zoloft than 80 mg of Celexa like before ?!
Posted by shelliR on May 18, 2001, at 16:03:13
In reply to 50 mg Zoloft = 20 mg Celexa ?, posted by ben on May 18, 2001, at 15:01:36
.
Posted by Cam W. on May 18, 2001, at 18:21:47
In reply to NAUSEA !!! Please help !!!, posted by ben on May 18, 2001, at 9:31:06
Ben - Sorry not respond earlier but I haven't been reading all the posts lately, to stay out of the latest kurfuffle.
Anyway, what is probably happening to you is, is that your body is readjusting to life without artificially raised serotonin levels. In your case, the nausea you feel may be caused by serotonin-3 (5-HT3) receptors in your gastrointestinal tract. The stimulation of 5-HT3 receptors by serotonin when you start SSRIs causes the initial start up side effects of nausea. The reverse may be happening to you. Now that the 5-HT3 receptors aren't being stimulated as much (because of the withdrawl of the SSRI Celexa™ - citalopram) they have probably rebounded in number and concentration in your gut or have become hypersensitive. This should begin to dissipate in a week or two and should be totally gone by the end or 3 or 4 weeks.
I do have one concern with your cases, and please, anyone, tell me if I am out in left field with this. You may have to watch for a return of depressive symptoms over the next 6 months. The overstimulation of the 5-HT3 receptors (if indeed, that is what is happening) makes me think that you were either tapered to fast from the Celexa or your body isn't producing enough serotonin on its own. If either of these are true, it would mean that your body is not readjusting to the lower levels of serotonin. If the body doesn't catch up and produce more serotonin, then you may be at risk for another depressive episode. This is only a hunch and you should probably monitor your moods for the next few months. Like I say, I could be wrong on this, but I have seen a similar case result in a relapse.
Also, flat, sugared ginger ale (ie stir the bubbles out & the sugarfree one doesn't seem to work as well). Also, you can suck peppermints or drink peppermint tea or ginger tea. You could also try ginger capsules. These are probably the safest remedies for nausea.
Hope this helps - Cam
Posted by SalArmy4me on May 18, 2001, at 23:19:21
In reply to NAUSEA !!! Please help !!!, posted by ben on May 18, 2001, at 9:31:06
I was thinking you might do will with some over-the-counter Emetrol for the nausea.
> I started going of Celexa 5 weeks ago. I tappered gradually (from 60m) down during two weeks (my doc made this procedure several times). After 10 days i felt nervousness, flu like symtoms and an awfull nausea. My doc suggested to start with Zoloft (because of the same mechanism) to overcome this withdrawl symptoms. Now, three weeks later I am on 75 mg Zoloft and the nausea is still coming and going. I am very nervous and have anxiety too. A gastrointestinal observation (cause of the nause) was okay. So whats with the nausea ??? My doc doesnt know if its from discontinuation of the Celexa, from the Zoloft or is it part of my depression ? I didnt feel nausa during my illness, so I think its from the meds. I feel sick of this feeling and want finally to get rid of.
Posted by ben on May 19, 2001, at 8:56:17
In reply to Re: NAUSEA !!! Please help !!! » ben, posted by Cam W. on May 18, 2001, at 18:21:47
> Ben - Sorry not respond earlier but I haven't been reading all the posts lately, to stay out of the latest kurfuffle.
>
> Anyway, what is probably happening to you is, is that your body is readjusting to life without artificially raised serotonin levels. In your case, the nausea you feel may be caused by serotonin-3 (5-HT3) receptors in your gastrointestinal tract. The stimulation of 5-HT3 receptors by serotonin when you start SSRIs causes the initial start up side effects of nausea. The reverse may be happening to you. Now that the 5-HT3 receptors aren't being stimulated as much (because of the withdrawl of the SSRI Celexa™ - citalopram) they have probably rebounded in number and concentration in your gut or have become hypersensitive. This should begin to dissipate in a week or two and should be totally gone by the end or 3 or 4 weeks.
>
> I do have one concern with your cases, and please, anyone, tell me if I am out in left field with this. You may have to watch for a return of depressive symptoms over the next 6 months. The overstimulation of the 5-HT3 receptors (if indeed, that is what is happening) makes me think that you were either tapered to fast from the Celexa or your body isn't producing enough serotonin on its own. If either of these are true, it would mean that your body is not readjusting to the lower levels of serotonin. If the body doesn't catch up and produce more serotonin, then you may be at risk for another depressive episode. This is only a hunch and you should probably monitor your moods for the next few months. Like I say, I could be wrong on this, but I have seen a similar case result in a relapse.
>
> Also, flat, sugared ginger ale (ie stir the bubbles out & the sugarfree one doesn't seem to work as well). Also, you can suck peppermints or drink peppermint tea or ginger tea. You could also try ginger capsules. These are probably the safest remedies for nausea.
>
> Hope this helps - Cam
>
Hi Cam, I still have depressive symptoms ! I had to give up the celexa because it didnt give me a remission after one year of use. So my doc wanted to change my medication. Since then it worsened. I am very sensitive to side effects, so the celexa was at first a good decision. I had a good response to Effexor, but I gained weight, headache and dust in the brain. Lithium failed because I had awful nausea and Surmontil (Trimipramine) made me to sedated. And all of them hadndt reliefed all my symptoms.
Posted by ben on May 23, 2001, at 10:28:33
In reply to NAUSEA !!! Please help !!!, posted by ben on May 18, 2001, at 9:31:06
I still experience nausea espacially in the morning. Is it the Zoloft or still a discontinuation symptom ? After 2 weeks on Zoloft (50 mg) i felt a week better and then crashed again. I believe its worser than before. Should I try to increase the Zoloft ?
> I started going of Celexa 5 weeks ago. I tappered gradually (from 60m) down during two weeks (my doc made this procedure several times). After 10 days i felt nervousness, flu like symtoms and an awfull nausea. My doc suggested to start with Zoloft (because of the same mechanism) to overcome this withdrawl symptoms. Now, three weeks later I am on 75 mg Zoloft and the nausea is still coming and going. I am very nervous and have anxiety too. A gastrointestinal observation (cause of the nause) was okay. So whats with the nausea ??? My doc doesnt know if its from discontinuation of the Celexa, from the Zoloft or is it part of my depression ? I didnt feel nausa during my illness, so I think its from the meds. I feel sick of this feeling and want finally to get rid of.
This is the end of the thread.
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