Anti depressants and Flare Up
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Anti depressants and Flare Up
You never know "for sure" what causes a flare up; however, I changed from Cymbalta to Sertaline (generic Zoloft) in November and have had a very difficult time since. I had been off Entecort for several months; however, am back on now for 2 weeks and coming around. I am seeing "Head Dr" Wednesday to figure out a substitute for Sertaline ---- or, my preference, taper off and see if I indeed still need to take anti depressant. Anyone have a similar experience?
We have more than a few members whose MC can be traced back to an SSRI. Often, for cases of drug-induced MC, just avoiding the drug that triggered the disease, (and also avoiding related drugs), is sufficient to maintain stable remission, indefinitely, without additional intervention. That doesn't work for everyone in that situation, but it works for many.
Tex
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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draperygoddess
- Rockhopper Penguin
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- Joined: Mon Aug 29, 2011 6:49 am
- Location: Tennessee
Sallee,
I believe I can trace the downward spiral of my symptoms to when I started taking Zoloft. My symptoms improved dramatically once I stopped taking it. Incidentally, since going GF I have not needed an antidepressant. That won't be everyone's experience, of course, but for me there definitely seems to be a relationship between the anxiety and gluten.
I believe I can trace the downward spiral of my symptoms to when I started taking Zoloft. My symptoms improved dramatically once I stopped taking it. Incidentally, since going GF I have not needed an antidepressant. That won't be everyone's experience, of course, but for me there definitely seems to be a relationship between the anxiety and gluten.
Cynthia
"Can we fix it? YES WE CAN!" -Bob the Builder
"Can we fix it? YES WE CAN!" -Bob the Builder
Hi, I am new to the site. I was diagnosed with CD a year ago. Things got somewhat better with GF diet but I was still losing weight. I was diagnosed with CC earlier this month. I have been sicker since I started tx with Asacol. I first felt better as I scanned your website - seeing others with the same problem, but am discouraged that I may have to go off my Cymbalta which has kept me sane through this last year. It is suspect now that I am aware of when I started it - a few months before CD ramped up. I'm getting so afraid to eat and am worried that I may lose my job if I continue to miss work. Please send me some encouraging words!!!
Patti H
Patti H
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draperygoddess
- Rockhopper Penguin
- Posts: 558
- Joined: Mon Aug 29, 2011 6:49 am
- Location: Tennessee
Patti,
I'm sure Tex will chime in here, but CC is a condition protected by the Americans with Disabillities Act. Have you informed your employer of your diagnosis? He or she is required to make some concessions for your condition.
Wellbutrin is thought to be relatively low-risk as far as GI issues go--maybe your doctor would be agreeable to a switch? Also, the stress of dealing with this disease is enough to put anyone on an antidepressant! As you get it under control, you'll probably have less anxiety, etc.
Have you cut out anything in your diet other than gluten? If you're still having symptoms, you may have other food sensitivities as well--most of us can't do dairy, either. Gluten was at the root of my problems, but dairy made me feel the worst. Might be worth a try!
I know this is discouraging and frustrating, but do know that ALL of us have been there, we do know how you feel right now, and there is light at the end of the tunnel! You can get better! Don't give up, and feel free to complain here, because we are sympathetic!
Hope you feel better soon!
I'm sure Tex will chime in here, but CC is a condition protected by the Americans with Disabillities Act. Have you informed your employer of your diagnosis? He or she is required to make some concessions for your condition.
Wellbutrin is thought to be relatively low-risk as far as GI issues go--maybe your doctor would be agreeable to a switch? Also, the stress of dealing with this disease is enough to put anyone on an antidepressant! As you get it under control, you'll probably have less anxiety, etc.
Have you cut out anything in your diet other than gluten? If you're still having symptoms, you may have other food sensitivities as well--most of us can't do dairy, either. Gluten was at the root of my problems, but dairy made me feel the worst. Might be worth a try!
I know this is discouraging and frustrating, but do know that ALL of us have been there, we do know how you feel right now, and there is light at the end of the tunnel! You can get better! Don't give up, and feel free to complain here, because we are sympathetic!
Hope you feel better soon!Cynthia
"Can we fix it? YES WE CAN!" -Bob the Builder
"Can we fix it? YES WE CAN!" -Bob the Builder
Hi Patti,
I'm sorry you're having these problems, but welcome to our internet family of people dedicated to getting our life back from microscopic colitis.
Many of us are sensitive to all NSAIDS - they trigger MC symptoms. Almost everyone who is sensitive to NSAIDs, is also sensitive to mesalamine, (the active ingredient in Asacol). Not only that, but even for many of us who are not sensitive to mesalamine, there is enough lactose in Asacol to make many of us react, because as Cynthia pointed out, most of us who are sensitive to gluten, are also sensitive to all dairy products, (not just lactose, but we're sensitive to the primary protein, casein, as well). Everyone who has enteritis, (intestinal inflammation), becomes lactose intolerant, because of the inflammation - your GI doc should know that, but apparently most of them either don't, or they just ignore that fact. Also, at least half of us are sensitive to soy, and all or most members of the legume family, (including soy oil, soy lecithin, beans, peas, lentils, etc.).
Since you have already been avoiding gluten for approximately a year, if only dairy or soy are your remaining dietary problems, then eliminating them from your diet should show some significant improvement within a week or two. If that doesn't do the job, then the Cymbalta is probably the reason, but it could also be other food-sensitivities. In general, SNRIs are not as risky as SSRIs, as far as triggering MC is concerned, but part of the problem may be that they are newer drugs, and so they haven't had as much time to establish a track record. As time goes on, they may turn out to be just as bad as SSRIs, but at the moment, the jury is still out.
The good news is that while it may be difficult and stressful to wean off Cymbalta, once you get your MC symptoms under control, you may not need such medications. Many, many members have found that controlling their MC either significantly reduces, or completely eliminates other issues that have been bothering them for years.
No one truly understands this disease unless they actually have it, so you can rest assured that we understand how you feel, and most of have been down the same path that you're now on. We can't cure MC, but we can definitely control the symptoms, and we can get our life back.
If you need some additional encouragement, please read some of the posts in this section:
http://www.perskyfarms.com/phpBB2/viewforum.php?f=71
Again, welcome aboard, and please feel free to ask anything.
Tex (Wayne)
I'm sorry you're having these problems, but welcome to our internet family of people dedicated to getting our life back from microscopic colitis.
Many of us are sensitive to all NSAIDS - they trigger MC symptoms. Almost everyone who is sensitive to NSAIDs, is also sensitive to mesalamine, (the active ingredient in Asacol). Not only that, but even for many of us who are not sensitive to mesalamine, there is enough lactose in Asacol to make many of us react, because as Cynthia pointed out, most of us who are sensitive to gluten, are also sensitive to all dairy products, (not just lactose, but we're sensitive to the primary protein, casein, as well). Everyone who has enteritis, (intestinal inflammation), becomes lactose intolerant, because of the inflammation - your GI doc should know that, but apparently most of them either don't, or they just ignore that fact. Also, at least half of us are sensitive to soy, and all or most members of the legume family, (including soy oil, soy lecithin, beans, peas, lentils, etc.).
Since you have already been avoiding gluten for approximately a year, if only dairy or soy are your remaining dietary problems, then eliminating them from your diet should show some significant improvement within a week or two. If that doesn't do the job, then the Cymbalta is probably the reason, but it could also be other food-sensitivities. In general, SNRIs are not as risky as SSRIs, as far as triggering MC is concerned, but part of the problem may be that they are newer drugs, and so they haven't had as much time to establish a track record. As time goes on, they may turn out to be just as bad as SSRIs, but at the moment, the jury is still out.
The good news is that while it may be difficult and stressful to wean off Cymbalta, once you get your MC symptoms under control, you may not need such medications. Many, many members have found that controlling their MC either significantly reduces, or completely eliminates other issues that have been bothering them for years.
No one truly understands this disease unless they actually have it, so you can rest assured that we understand how you feel, and most of have been down the same path that you're now on. We can't cure MC, but we can definitely control the symptoms, and we can get our life back.
If you need some additional encouragement, please read some of the posts in this section:
http://www.perskyfarms.com/phpBB2/viewforum.php?f=71
Again, welcome aboard, and please feel free to ask anything.
Tex (Wayne)
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Cynthia and Tex,
Thank you for the kind words and encouragement!!
I got a message from my GI a little while ago to decrease the Asacol to once a day and to continue with the Lomotil and to let him know how I'm doing by the end of the week. Coincidentally, I have an appt, made a month ago, with my PCP tomorrow so will discuss switching the antidepressant. I have had a 30 yr battle with depression and have been on meds more than off. I am also hypothyroid and have had problems getting that stable. When I went GF I also stopped lactose in the general form of dairy. As one of you mentioned, it is in so many things. Before the CC dx, my D had leveled off to an almost predictable 2-4 bathrrom visits per evening but I was still losing weight. Now I'm in there all day, sometimes without control. I tthink the Asacol is a big part of that. The GI mentioned a steroid as the next possible step.
So,soy is the next thing I should try to eliminate? Will try that.
Thanks again - so good to know there are others out there!
Patti
Thank you for the kind words and encouragement!!
I got a message from my GI a little while ago to decrease the Asacol to once a day and to continue with the Lomotil and to let him know how I'm doing by the end of the week. Coincidentally, I have an appt, made a month ago, with my PCP tomorrow so will discuss switching the antidepressant. I have had a 30 yr battle with depression and have been on meds more than off. I am also hypothyroid and have had problems getting that stable. When I went GF I also stopped lactose in the general form of dairy. As one of you mentioned, it is in so many things. Before the CC dx, my D had leveled off to an almost predictable 2-4 bathrrom visits per evening but I was still losing weight. Now I'm in there all day, sometimes without control. I tthink the Asacol is a big part of that. The GI mentioned a steroid as the next possible step.
So,soy is the next thing I should try to eliminate? Will try that.
Thanks again - so good to know there are others out there!
Patti
If you decide to try a corticosteroid, be sure that it's Entocort EC, and not prednisone, because Entocort will do pretty much anything that prednisone will do, (for most people with MC), with only a fraction of the risk of side effects, plus the option to use it for a much longer period of time, without having to worry about major withdrawal symptoms. It's a much, much safer drug, (though many doctors don't seem to realize that).
Just reducing the dose of Asacol will probably not be sufficient to stop you from reacting, if you are sensitive to it.
Good luck with the diet tria, avoiding soy.
Tex
Just reducing the dose of Asacol will probably not be sufficient to stop you from reacting, if you are sensitive to it.
Good luck with the diet tria, avoiding soy.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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draperygoddess
- Rockhopper Penguin
- Posts: 558
- Joined: Mon Aug 29, 2011 6:49 am
- Location: Tennessee
I agree with Tex--if the Asacol is causing you problems, then just reducing it won't help. It's not doing what it's supposed to do, anyway. Most people have good results with Entercort. I was fortunate in that, once I stopped the Zoloft, I was able to get my symptoms under control with diet alone, but many of us have needed meds to get control, at least initially.
Tex is right that there is a link between depression and gluten--it's one of my more prominent symptoms. That said, I know how scary it is to think of going off your antidepressant in the middle of such a stressful time, so definitely try the other things first!
Hang in there and keep us posted!
Tex is right that there is a link between depression and gluten--it's one of my more prominent symptoms. That said, I know how scary it is to think of going off your antidepressant in the middle of such a stressful time, so definitely try the other things first!
Hang in there and keep us posted!
Cynthia
"Can we fix it? YES WE CAN!" -Bob the Builder
"Can we fix it? YES WE CAN!" -Bob the Builder
Patti,
There was a very interesting show on Talk of the Nation on NPR yesterday. I found this link to it where you can either read the transcript or listen to the actual show. It talked about how traditional antidepressants like Prozac that are used to treat depression by boosting serotonin levels, may not be the best solution. I found it fascinating and would encourage you to listen. Both my girls have had depression issues and have had all little success and lots of intestinal issues because of it. My oldest is now taking what is classed as an anti-seizure med and it has worked wonders for her. They are both GF now. http://www.npr.org/2012/01/31/146149337 ... ow-promise
There was a very interesting show on Talk of the Nation on NPR yesterday. I found this link to it where you can either read the transcript or listen to the actual show. It talked about how traditional antidepressants like Prozac that are used to treat depression by boosting serotonin levels, may not be the best solution. I found it fascinating and would encourage you to listen. Both my girls have had depression issues and have had all little success and lots of intestinal issues because of it. My oldest is now taking what is classed as an anti-seizure med and it has worked wonders for her. They are both GF now. http://www.npr.org/2012/01/31/146149337 ... ow-promise
Resolved MC symptoms successfully w/L-Glutamine, Probiotics and Vitamins, GF since 8/'09. DX w/MC 10/'09.
An update of sorts.... I stopped the Asacol and got back to my "normal" almost immediately so that was definitely a factor in how I was doing. Also have decreased my Cymbalta (with PCP's blessing) in an effort towards going off completely or switch to bupropion down the road. My GI has prescribed Endocort and after spending a small fortune on it, I have surprising gone without D for more than 24 hrs, without even taking it!
Not sure what to do, but have routine followup with GI on Monday.
Patti
Not sure what to do, but have routine followup with GI on Monday.
Patti
Hi Patti,
That's an interesting development. If I were in your shoes, I would continue to hold off taking any Entocort if you don't have D, because it will definitely cause constipation, if you don't need it, or if you take too much of it. If the situation should change in the future, you can always begin taking it if needed.
Thanks for the update, and good luck with the followup appointment.
Tex
That's an interesting development. If I were in your shoes, I would continue to hold off taking any Entocort if you don't have D, because it will definitely cause constipation, if you don't need it, or if you take too much of it. If the situation should change in the future, you can always begin taking it if needed.
Thanks for the update, and good luck with the followup appointment.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Hi Patti,
I see that you haven't posted here for a while but hoping you are still active. Would like to hear how you are doing, living with CC as I am, 5 months down the road.
I am a newbie that was diagnosed with CC back in 1997 after 2 years of D. I was on Zoloft at the time and have since tried Paxil, Prozac, and Welbutrin.....all of them with bad results thus I have learned how to deal with my depression on my own, taking the good with the bad. 7 months ago I was prescribed gabpentin for nueropathy...that was a disaster. I was running to the bathroom every 30 minutes, day and night.
I, too, am hypothyroid along with crohnic herpes, back issues, and headaches from concussions,etc. I have had my gall bladder and 7" of my colon removed, along with a hysterectomy and a C-section before that. I noticed that you have had problems with weight.....keeping it on, I believe. I am 5' 7" and my lowest weight was 119 pounds a couple of years ago. I now hold steady at 149 pounds so I must be doing something right.
I am currently on sulfasalazine and lomotil which really do seem to help me at least keep the D down to 2 - 3 trips to the potty instead of the normal 15 and, actually, no D for over 24 hours but I'm only eating chicken.
Hope to hear that you also have good news on your current status.
Best regards,
Carol
I did a rather dumb thing last Wednesday night. I had multiple bowls of Cheerios with milk!!! I paid dearly for it but believe that it taught me a good lesson. I've feel more certain now about intolerances to dairy and gluten.
I see that you haven't posted here for a while but hoping you are still active. Would like to hear how you are doing, living with CC as I am, 5 months down the road.
I am a newbie that was diagnosed with CC back in 1997 after 2 years of D. I was on Zoloft at the time and have since tried Paxil, Prozac, and Welbutrin.....all of them with bad results thus I have learned how to deal with my depression on my own, taking the good with the bad. 7 months ago I was prescribed gabpentin for nueropathy...that was a disaster. I was running to the bathroom every 30 minutes, day and night.
I, too, am hypothyroid along with crohnic herpes, back issues, and headaches from concussions,etc. I have had my gall bladder and 7" of my colon removed, along with a hysterectomy and a C-section before that. I noticed that you have had problems with weight.....keeping it on, I believe. I am 5' 7" and my lowest weight was 119 pounds a couple of years ago. I now hold steady at 149 pounds so I must be doing something right.
I am currently on sulfasalazine and lomotil which really do seem to help me at least keep the D down to 2 - 3 trips to the potty instead of the normal 15 and, actually, no D for over 24 hours but I'm only eating chicken.
Hope to hear that you also have good news on your current status.
Best regards,
Carol
I did a rather dumb thing last Wednesday night. I had multiple bowls of Cheerios with milk!!! I paid dearly for it but believe that it taught me a good lesson. I've feel more certain now about intolerances to dairy and gluten.
Don't Forget to Laugh Today!
Hi Laine,
For some of us, yes, any SSRI can trigger an LC reaction, though sertraline seems to be mentioned more often than others. The association between SSRIs and LC is usually listed at around 15 to 18 percent. Here is how SSRIs can cause D for those who are susceptible to the drugs:
One of the prominent features of SSRIs and SNRIs is the tendency to enhance the availability of serotonin. Roughly 90% of the body's supply of serotonin is located in the digestive tract, especially in the intestines, and one of the reasons why serotonin is there in the first place, is to help regulate intestinal motility. If you would like to read some background information on serotonin, here's a link to an article with more details.
The Other Brain Also Deals With Many Woes - NYTimes.com
It's known that pathogenic amoebas produce serotonin, for example, which causes diarrhea if the intestines are infected. So we know that an increase of serotonin levels tends to cause diarrhea for many people, and as a result, it's no wonder that the SSRIs and SNRIs are capable of triggering the development of MC for some people, especially after relatively long-term use. For many of those individuals, just discontinuing the use of the drug will typically bring remission. For others, unfortunately, additional intervention may be required before remission can be attained, especially if the problem is allowed to continue for an extended period of time.
The quickest way to find out if an SSRI is triggering LC symptoms is to discontinue the drug. If it's the problem, remission will typically occur within a few days, sometimes as soon as the next day after the drug is discontinued.
Tex
For some of us, yes, any SSRI can trigger an LC reaction, though sertraline seems to be mentioned more often than others. The association between SSRIs and LC is usually listed at around 15 to 18 percent. Here is how SSRIs can cause D for those who are susceptible to the drugs:
One of the prominent features of SSRIs and SNRIs is the tendency to enhance the availability of serotonin. Roughly 90% of the body's supply of serotonin is located in the digestive tract, especially in the intestines, and one of the reasons why serotonin is there in the first place, is to help regulate intestinal motility. If you would like to read some background information on serotonin, here's a link to an article with more details.
The Other Brain Also Deals With Many Woes - NYTimes.com
It's known that pathogenic amoebas produce serotonin, for example, which causes diarrhea if the intestines are infected. So we know that an increase of serotonin levels tends to cause diarrhea for many people, and as a result, it's no wonder that the SSRIs and SNRIs are capable of triggering the development of MC for some people, especially after relatively long-term use. For many of those individuals, just discontinuing the use of the drug will typically bring remission. For others, unfortunately, additional intervention may be required before remission can be attained, especially if the problem is allowed to continue for an extended period of time.
The quickest way to find out if an SSRI is triggering LC symptoms is to discontinue the drug. If it's the problem, remission will typically occur within a few days, sometimes as soon as the next day after the drug is discontinued.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.