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SSRI drugs and chronic severe diarrhea

I took high doses of SSRI's for roughly 5 years.  Chronic severe diarrhea began with the first one (Zoloft/sertraline) and has continued.  It became a little less severe when I was switched to Effexor/venlafaxine, which caused a host of other problems.  I have now been off these drugs and back on my original antidepressant, Wellbutrin, for roughly two years and nine months.  The chronic severe diarrhea has never gone away, although the fecal incontinence is not as severe as it was while I was on the Zoloft/sertraline-- then, it was during the day and at night; now it happens primarily at night.  My body is desperately and constantly trying to flush my system.  I am concerned that long term use of SSRI drugs may permanently damage SSRI receptors throughout the body.   Is anyone else out there experiencing this in conjunction with long term use of high doses of SSRI drugs?  Following long term high doses of SSRI drugs?   Thanks in advance for any information that you can provide.
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Avatar universal
I just found this and have had chronic diarrhea for years.I have also been on ssri drugs for years.I have an appt with GI in 1 week and I am going to insist on a lot of tests.thanks for posting everyone.
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Avatar universal
Hello. I know this is a VERY old thread, but I wanted to share my experience. I had been put on Lexapro years ago. Chronic diarrhea ensued. I stayed on it for a few years and was switched to Cymbalta. The diarrhea stayed. I, like a few of you, was diagnosed with collagenous colitis. No treatment worked. In october 2014, Cymbalta put me in critical care with serotonin syndrome. I was taken off cold turkey. The diarrhea still never stopped. Another doctor decided to test me for something called c diff. It was positive. Nasty nasty gut bacteria. It has taken me a year to fight it with some very unusual treatment. The diarrhea is gone. I go only once per day now. Research has shown that Prozac and Remeron up your risk for this infection extremely. Stands to reason, other SSRI meds would do the same. If you are still having diarrhea, I URGE you to DEMAND to be tested for c diff.
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3 Comments
Hello, bubbasgirl. Would you please provide me with any links you may have of scientific articles that state these antidepressants make people susceptible to C diff.?
I found this question interesting, although I'm not obviously hubbasgirl, and so I did a short internet search.  I found an NIH study that was trying to confirm the one study that apparently found the correlation referred to above, but it appears to me it's impossible to actually do this.  While a correlation might have been found, that isn't the same as causation.  So while the study found that antidepressant use is correlated with this disorder, the disorder itself is caused by use of antibiotics, and so while some correlation has been found between not just antidepressants but also other types of meds it would appear to get it you would have had to also have been on antibiotics.  The fact is, as NIH found but what any of us with anxiety and depression already know, being depressed itself is correlated with a higher amount of all manner of intestinal problems, as is being chronically anxious, and the correlation is found by looking at depressed people, not just those who are known to have taken antidepressants.  The NIH appears to just assume that a population of those who report depression are also going to have a high proportion of people taking antidepressants, but couldn't confirm the original study because they couldn't tell if it was the depression or the med that caused the higher risk of getting c diff.  What is known is that the beneficial organisms that antibiotics kill off used to prevent this disorder but have been hampered by the overuse of antibiotics in doing that, and that these beneficial organisms are also part of our body's way of protecting our mental health.  So at least according to NIH, we have a chicken and egg story here and no definitive confirmation of the one study that found this correlation.  Meaning, you can believe it or not, but the more important thing to do is stop giving antibiotics out so randomly and also try to find out why so many people are reporting depression and why so many are being treated with meds rather than less intrusive methods to see if they work before turning to meds.  Peace.
Also, should add, antidepressants are known to cause all manner of intestinal problems just as depression and anxiety are, so the treatment is often causing a problem the disorder also can cause.  The person you're responding to has an interesting and difficult to understand medical history, as taking Cymbalta at a normally prescribed dose would be incredibly unlikely to cause serotonin syndrome.  Taking one off this med cold turkey is also an incredibly dumb thing to do even if one has that disorder, as doing that can cause so many severe problems that can also cause one to get that disorder.  It's hard to understand why someone who had diarrhea as a side effect of taking an antidepressant would stay on that antidepressant instead of tapering off and trying a different one unless it was extremely effective at treating the depression and the diarrhea wasn't all that bad.  
Avatar universal
I don't know if GPs have a great understanding of inflammatory bowel diseases, so if you have concerns, my advice is to ask for a referral to a GI specialist.  Collagenous/microscopic colitis is something my GP had never heard of, and it is different from ulcerative colitis (of which bloody stool is a side effect).  

The problem with collagen lining the intestines is that it's like a layer of fat which keeps the intestines from absorbing anything well -- including liquids and foods.  Hence, the chronic watery diarrhea 20+ times a day (every time I ate or drank ANYTHING.)  I NEVER passed blood, and I was still very, very ill.  My GP would have kept telling me nothing was wrong if I had not persisted myself.  My other doctor would have kept me on SSRIs if I hadn't insisted on stopping.

Just keep in mind that your GP probably has 2000 or more patients and you have but one body to carry you around this earth.  

p.s. After my diagnosis, I left my incompetent GP and asked my GI doc to recommend a new GP.  I'm very happy with his choice.  Also, I've treated my depression with diet and exercise and talk therapy, and it's helped a lot.
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Avatar universal
I see that this thread has been inactive for some time, but I want to share my experience and some information regardless. I will try and keep this as short as possible.

. In 2016 I was prescribed Prozac (fluoxetine) for depression (eventually I found the root cause and addressed it), and it turned out to be quite the mistake in my case. Within a couple days I was passing clear mucus into the toilet. Then, I developed severe, urgent diarrhea every single time I ate or drank anything, even water. My dose was dropped from 20mg to 10mg, but the diarrhea persisted. I was then switched to Celexa (citalopram), which also gave me diarrhea, and finally Wellbutrin XL (bupropion). The Wellbutrin gave me mild diarrhea, but I also experienced other side effects that were very disruptive to my life, so I stopped all SSRIs. I took these drugs over the course of a month, and after discontinuing them the diarrhea seemed to subside. . . or at least I wasn't having diarrhea every time I ate and drank. Unfortunately, I found that some foods would still give me diarrhea that never gave me diarrhea prior to taking the SSRIs. I could always eat whatever I liked without an issue, and I have no family history of IBS. I began cutting out the trigger foods, but for every food I cut out it seemed like I was discovering another new trigger food. Things progressed to the point of me once again not being able to eat a bite of food without becoming very ill. An integrative doctor was able to give me something natural, which almost seemed to reverse my symptoms entirely, or put me in remission? This lasted a couple months before symptoms began to return, unfortunately. I was diagnosed with IBS-D because I kept testing negative for everything else. I didn't realize until more recently that a colonoscopy was the gold standard for ruling out diseases like Crohn's and celiacs. I also had not heard of microscopic colitis until just a few months ago, so I will be attempting to get a colonoscopy soon if it is established that I can undergo the prep without becoming dangerously dehydrated. I can't even drink the most plain electrolyte drink without severe, painful cramping due to the citric acid or magnesium that they all seem to contain.

For the past three years I have been searching the internet for information that connects SSRIs to IBS-D. This year I tried using the search engine duckduckgo.com and found this article: https://rxisk.org/bladder-and-bowel-problems-after-antidepressants/
Dr. David Healy is one of the doctors who runs RXisk.org, and he commented that it is not uncommon for people who have taken antidepressants to then receive a diagnosis of IBS, and that he thinks it is possible that antidepressants may be capable of triggering other GI problems too. After reading Chris Troup's story of developing microscopic colitis, I have to wonder if there are people that have microscopic colitis (collagenous or lymphocytic type) that are being misdiagnosed with IBS post antidepressants. If you think that you may have developed GI problems due to taking antidepressants please, please report it to the FDA and RXisk.org. I currently think there may be many more people going through what we are, but they haven't put two and two together, so it may be very under reported. Maybe if we report our syptoms, it will finally be studied. If SSRI's are the cause, this could lead to finding a treatment, and warnings can be put on labels, so people can make informed decisions prior to taking these drugs.

My personal thoughts are that somehow some people's gut microbiomes are incompatible with SSRIs as well as other drugs, and perhaps they develop dysbiosis that triggers IBS, colitis, or other digestive problems. I couldn't find too much on these topics, so I decided to email a scientist who works at Yale to request any information he may have on the topic. I explained that I thought somehow the SSRIs I took may have altered my gut microbiome and perhaps in turn triggered a severe case of IBS I developed. He didn't have any specific articles regarding SSRIs and microbiome interaction triggering IBS, but he did say that he agreed with what I was saying.  He also said that many laboratories are currently studying how drugs and the gut microbiome interact with each other, and that these are the early days of this type of research. Here is an article that he sent me: https://media.nature.com/original/magazine-assets/d41586-020-00196-0/d41586-020-00196-0.pdf

I could write you a very long list of all of the things I have tried to make this problem more manageable, but everything I have done has only gotten me so far. I still can't eat more than about 6 different foods, and I can only drink water and Simply brand almond milk (unsweetened). I still try and live the healthiest lifestyle possible regardless. I get sufficient sleep, eat my 6 whole foods, take high doses of probiotics (no prebiotics as those make my diarrhea worse), take Andrew Lessman's Multi 1 vitamin (it's the only vitamin I have been able to tolerate in years) , exercise weekly, reduce stress, keep a schedule, drink as much water as I can, spend time outdoors, spend time with animals, etc. and just try to do everything that I can to be healthy.

I will say that seeing an integrative doctor was very helpful to me though. She really listed to everything I had to say, spent adequate time with me, didn't dismiss me, didn't tell me, "Well,  you look fine.", which is what my gastroenterologist told me. She noticed that I had a hormonal imbalance when other doctors didn't. Between the HRT and the remedy she gave me I was able to finally kick my depression. That has been the one good thing that has resulted from all of this. If only I had found her before trying antidepressants, but I also wasn't as open to trying natural treatments years ago.

I think that the only truly promising potential treatment for this chronic diarrhea may be FMTs, but these are not approved here in the USA for any other condition besides Cdiff. It will probably take years before FMTs are available to IBS patients and  for scientists to refine FMTs to the point that they yield consistent results. I am registered at Clinical Trials.gov and check their site periodically so see if they are recruiting in the USA. They are currently recruiting for a study in Norway.

Anyway, I'm not a doctor and these are just my personal thoughts and experiences on the matter. Thank you for listening to my long ramble!

If you have any questions please feel free to send me a message.

Leia V.

valentina.***@****
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Avatar universal
I did not see any mention on this thread - concerning fecal incontinence - about 'sacral nerve stimulation' via a device by Medtronic called InterStim - http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/Recently-ApprovedDevices/ucm249208.htm - a pacemaker-type device with leads hooked up to the sacral nerve plexus at the base of the spine to help control bowel functions [or bladder functions where indicated]. Also more info at - https://www.austinurogynecology.com/interstim-fecal-incontinence/ - with links to further information. The device has a good reputation for effectively controlling bowel or bladder function, but it involves a somewhat expensive surgery and correct placement of the electrode in the sacral nerves. Good graphics here: https://www.austinurogynecology.com/interstim-faqs/

There is a small failure rate with some risk involved; my impression is that success involves the competency of the surgeon in placing the electrodes properly.
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Avatar universal
Thanks for the advice. I have been waking up to diarrhea and having to change the sheets! My GP put me on Lexapro and the diarrhea started about two weeks later. She switched me to Prozac then ordered a blood test. They found that I am a poor metabolizer of CYP2D6 *4/*5. So she switched me to Zoloft and I'm having the same outcome, yep diarrhea! The blood test is called CYTOCHROME P450 2D6 GENOTYPING. I have approval to see the GI doc so I'll find out more later. As someone else stated it would be great if this thread was updated.  
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Avatar universal
Hi, I was on Celexa for almost 14 years...and I should have had counseling that first year and weaned off pills but I didn't really know that's how it's done. We all need to address what's really bothering us and get off these pills quick if possible by making positive lifestyle changes. These pills probably do more harm than good and don't make that big of a difference I found.  I had a horrible time getting off of Celexa and had anxiety attacks like never before.  Started to feel more normal if that's possible after the pills have messed with my body and brain, but I still had too much anxiety.  Also, I was getting bad ringing in the ears from the Celexa besides gaining 20-30 lbs. while on it, so if I wasn't depressed before I sure am now!  Well, I decided to try Zoloft and took one pill, then I couldn't sleep soundly last night, and then today I had diarrhea all day long.  Actually I didn't mind loosing the extra 3 lbs. but I don't want diarrhea to last a lifetime either, so I won't take anymore after reading all these posts.  I ordered some herbal supplements people have said work for anxiety.  I'm sure my depression stems partially from going into menopause, having had poor relationships, my job change, finances, weight gain from bad eating habits, and too much stress in my environment.  It's not just a "lack of serotonin in the brain" as they want you to think - pills don't take away problems without giving you new ones I've learned.  Good luck to everyone in finding something natural which works better and practice gratitude for the good you do have in your life.
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480448 tn?1426948538
If you've been going non stop for hours, you need to let your doctor know.
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Avatar universal
Took my first ever Zoloft pill about 4 hours ago and I have been on the toilet for the last 2 hours. My stomach is all cramped up and I'm worried I'm going to crap myself of I go to sleep.
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480448 tn?1426948538
You would be better off starting your own new thread as this one is very old.  You'll get more replies.

Has anything changed?  Have you increased your dose of the Zoloft recently?  I find it odd that your diarrhea just started.  If you weren't having those symptoms on the Zoloft until now, I would doubt that the Zoloft is the cause.

One thing to check is if the pharmacy has changed the brand they've been giving you.  I know people have reported new symptoms (like diarrhea) when they were switched to a different brand.  If that hasn't changed, I'd look for other causes before assuming it's the Zoloft and making any changes right away.

Good luck to you!
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Avatar universal
Holy crap! I've been taking Zoloft since September (3.5 months) and the last week and a half has been a diarrhea nightmare. Thankfully I've been home on leave from work since I have only seconds to make it to the bathroom. Immodium is not helping at all. It's worse than having the flu! Tonight I'd almost had an accident in my car; by the grace of God I was able to park the car and run through a Starbucks to their bathroom and just made it. I expect to have an interview next week and I don't think an offer will be forthcoming if I $#!t myself during it. I can't live like this, I'd rather be depressed. Will begin weaning myself down from 200mg starting tomorrow and get some magnesium and B6 as well. And to think people call these "happy pills!"
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Avatar universal
I am a 17 year old boy, I was diagnosed with possible IBS about 2 years ago, ever since then i have been put through tests and seen about 20 doctors, none have given me any good advice or given me a straight answer on what is actually wrong with me, i now take loperamide as i found it is the only tablet which stops my diarrhea but for the last year i have been feeling really depressed which has made my stomach really bad, I went to the doctors about it and they prescribed the anti depressant Lustral which after 2 hours of taking my first tablet has given me really bad diarrhea and the only time i've had it this bad is when i had to take laxatives before a colonoscopy, i would just like to know if anyone could give me any advice or ways to stop my diarrhea from being so bad, i am going to stop taking the lustral tomorrow but today has been torture already, i should also add that taking loperamide is not helping the diarrhea at all, any help will be appreciated
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Avatar universal
Oops! I forgot to tell that I take magnesium and b6 pills 4 times a day. I read that you can take up to 1000 mg of magnesium a day.
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Avatar universal
Hi Annie,
I am still taking my SSRI (zoloft 100 mg) . Magnesium and B6 have eased my diarrhea. Although it is not completely gone. I just need to go to the bathroom once a day or every over day. In my case it's a huge improvement. My bloating is under control, but I really need to pee more than usual. I guess it's a good sign. I take 400 mg of magnesium and 60 mg of B6 a day
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Avatar universal
Hi!  Am having chronic diarrhea/bloating taking Prozac.  Just wondering, your post says that magnesium and B6 has helped.  Are you still taking your S.S.R.I and these two supplements have helped or have you gone off of your S.S.R.I and have eased your diarrhea taking the two supplements you'd mentioned?  Am so hoping you reply...just for curiosity's sake, which S.S.R.I are you taking/were you taking?  Thanks, Annie.B.H.  
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Avatar universal
SSRI user with chronic Diarrhea for two years, I might have found the cure : Magnesium and B6 vitamin. I guess the SSRI depletes your body of magnesium and B6, that might have been the cause all along.
It really does the trick. I have no more diarrhea and I can eat everything. My bloating is also gone I lost 9 pounds in two weeks, all water.
It works for me
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Avatar universal
I'm in a similar situation right now. What did you find out?
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Avatar universal
I'm glad I ran upon this. I've been experiencing the same problem now for a long while. They have been changing up my meds trying to find something to help me. I'm currently on Lexapeo and have been having major bowel problems. I just recently went to the Dr about the problem actually and had to take back 5 stool samples. I've not gotten any results back yet, but I guess I will see what he has to say and keep pushing the issue until something is figured out. I don't know how much more my sore bottom can take.
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Avatar universal
i had complete uncontrollable diarrhea in my car. why my car doesn't smell is beyond me. i am just recovering from pneumonia and the antibiotic induces diarrhea was out of control, had to use puppy pads and go w/o lower clothing
as it is i have lots of icky soiled clothes. i use too much toilet paper, am afraid of stopping up the toilet, so piles are thrown in the trash. i bring extra clothing
when i am in the restroom trying to clean myself i have to take off my blouse because i cannot contain the poop. have been on zoloft 16 years and its just getting worse. chewable immodium, prep h wipes always with me.am looking at adult diapers but they look, feel and sound like baby diapers. i wake up with anal incontinence, not a lot but i wipe in my sleep and wake up with soiled and stinky hands. i am weaning myself off zoloft--
will try to manage depression w/exercise, sunlight and zanax.i want to feel clean again.
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Avatar universal
So glad to have found this site. I have been having diarrhea attacks for four weeks since upping my dosage of sertraline. Twenty times a day is not unusual. Obviously does not do wonders for social life.  It seems from what posters have experienced that this chronic severe diarrhea results in long-term gut problems. Has anyone found a way of healing their gut naturally rather than taking more, counter-balancing drugs which cause other side effects? Thanks for any advice.
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Avatar universal
Thanks Chris! this is very enlightening
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Avatar universal
I am a 34 year old female. I have suffered with microscopic colitis for 2 years and have been on Bupropion SR(wellbutrin) for 10 years.  I have diarrhea episodes 3-5 times morning and night, and anytime I eat.  Therefore, I am exhausted, stressed, and under my comfortable weight.  
Doctors don't have anything to say about the colitis.  Pepto Bismal was my gatrologist's recommendation after my colonoscopy. I don't have insurance. The gastrologist's office visit was $100, they did the procedure for $300, and when I got the lab bill I was able to have them discount it by 1/3 of the price.
Recently, I decided to try some new vitamins with B-12 and ginsing. My anxiety was crippling, so I have successfully stopped taking the wellbutin. I'm hoping to heal my stomach by adding sauerkraut and Greek yogurt to my diet.  My diarrhea is slowing down, and I am feeling more myself for the first time in years. Trying to understand the connection of colitis and anti-depressant.  Still smoking cigarettes. The anxiety from Wellbutrin seemed to make me want one more. Good luck to us all!
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Avatar universal
Yes, demand these tests, and then make sure you have a bazillion bucks to pay for them all, because that's what it's gonna cost you. i don't have that kind of money and am one of the trillion americans that cannot afford to pay $650 per month for medical insurance, because i don't make that much money to begin with. Yes...if you have insurance..go for it. i wish i had that option.
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Avatar universal
I have had opposite issues.  After discontinuing antidepressants (prozac) after many years of use, I began experiencing diarrhea, am only, but causing me to run to the bathroom 4 - 5 times over a period of 2 - 3 hours each morning.  I could not make the 15 minute drive to my office without a stop in a gas station bathroom and when none could be found it meant a return home to change clothes!  I since began taking antidepressants again due to the death of my parents, and the diarrhea has continued.  I hate taking any medications but had hoped that at least my diarrhea would end with the antidepressants (my sister takes zoloft and becomes constipated with use).  I have decided to go off the antidepressants again and try acupuncture and other natural means.  I do have an appointment coming up with a new GI but an tempted to cancel because they DO NOT LISTEN!  I don't know how to stress to them what a disability this is...perhaps I should make my appointment for early am - then they would get the picture......
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