Hello,
My Mom had a bout of Collogenous Colitis in 2014 and after a few months of treatment with Budesonide ... has essentially been stable since. She had been on Cymbalta for many years prior to 2014 and up until a couple of months ago ... with no aggravation of MC symptoms. A couple of months ago she was switched first to Zoloft, and then to Lexapro (after the Zoloft started giving her GI issues ... nowhere near the severity of MC, but we had it switched because we were fearful it would progress). The reason for the switch was because her cardiologist said that there is cardiac risk associated with Cymbalta.
She was started on Lexapro about a month ago (5mg/day) and is currently on Lexapro 15mg/day. This past week, she has been complaining of more frequent than normal "normal consistency" BMs, feeling gassy, and one episode where she had diarrhea that she couldn't control (i.e. couldn't wait till she got to the bathroom).
I have seen reputable websites that speak to a possible relationship between MC and Zoloft and Paxil (although never substantiated via any studies), but not other SSRIs or SNRIs. My question is ... what is the collective experience of the group with Lexapro and MC symptoms? For that matter, are there any particular SSRIs or SNRIs that people have found they are able to tolerate without causing symptoms or flareups?
Thanks so much in advance for your help!
Lexapro and SSRIs/SNRIs
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Hi Larry,
Unfortunately we have found that all SSRIs, SNRIs, tricyclic antidepressants, etc., can cause MC reactions. And if any of them cause the problem for an individual, then there is a very good chance that all of them may cause the problem. Wellbutrin (buproprion) is sometimes prescribed to treat the same issues. For some people it does not work as well for specific issues, but it is the least likely antidepressant to cause undesirable side effects in general, and that especially applies to MC patients. You might ask her doctor for her or his opinion on Wellbutrin.
In case you are not aware of this, virtually all depression patients are magnesium deficient. And research shows that magnesium supplementation treats depression. Here is a quote from part of an abstract of a research article (that can be seen at the link below). Notice especially the sentences that I have highlighted in red:
I can show you links to many other articles on this topic if you need additional information. But also note that if she has not changed her diet then her food sensitivities are almost certainly causing inflammation and inflammation is a also a major cause of depression (because of that, depression is very common with untreated celiac disease and microscopic colitis).
Is Depression a Disease—or a Symptom of Inflammation?
And also please note that either or both a magnesium deficiency and a vitamin D deficiency will prevent the immune system from being able to properly fight inflammation in the body. Also, if vitamin D or magnesium are deficient, certain medications, including budesonide, will not work very well, depending on the degree of the deficiency. So if she is not going to change her diet (which I assume is still true), then it is especially important for her to keep her vitamin D and magnesium levels up so that budesonide will be more effective. Also, since you were last here, published research is now available to show that budesonide can be safely used for long-term treatment, if needed, and the American Gastroenterological Association Institute recognizes that in their latest guidelines for treating MC.
I hope that some of this is helpful.
Tex
Unfortunately we have found that all SSRIs, SNRIs, tricyclic antidepressants, etc., can cause MC reactions. And if any of them cause the problem for an individual, then there is a very good chance that all of them may cause the problem. Wellbutrin (buproprion) is sometimes prescribed to treat the same issues. For some people it does not work as well for specific issues, but it is the least likely antidepressant to cause undesirable side effects in general, and that especially applies to MC patients. You might ask her doctor for her or his opinion on Wellbutrin.
In case you are not aware of this, virtually all depression patients are magnesium deficient. And research shows that magnesium supplementation treats depression. Here is a quote from part of an abstract of a research article (that can be seen at the link below). Notice especially the sentences that I have highlighted in red:
Rapid recovery from major depression using magnesium treatmentCase histories are presented showing rapid recovery (less than 7 days) from major depression using 125–300 mg of magnesium (as glycinate and taurinate) with each meal and at bedtime. Magnesium was found usually effective for treatment of depression in general use. Related and accompanying mental illnesses in these case histories including traumatic brain injury, headache, suicidal ideation, anxiety, irritability, insomnia, postpartum depression, cocaine, alcohol and tobacco abuse, hypersensitivity to calcium, short-term memory loss and IQ loss were also benefited. Dietary deficiencies of magnesium, coupled with excess calcium and stress may cause many cases of other related symptoms including agitation, anxiety, irritability, confusion, asthenia, sleeplessness, headache, delirium, hallucinations and hyperexcitability, with each of these having been previously documented. The possibility that magnesium deficiency is the cause of most major depression and related mental health problems including IQ loss and addiction is enormously important to public health and is recommended for immediate further study. Fortifying refined grain and drinking water with biologically available magnesium to pre-twentieth century levels is recommended.
I can show you links to many other articles on this topic if you need additional information. But also note that if she has not changed her diet then her food sensitivities are almost certainly causing inflammation and inflammation is a also a major cause of depression (because of that, depression is very common with untreated celiac disease and microscopic colitis).
Is Depression a Disease—or a Symptom of Inflammation?
And also please note that either or both a magnesium deficiency and a vitamin D deficiency will prevent the immune system from being able to properly fight inflammation in the body. Also, if vitamin D or magnesium are deficient, certain medications, including budesonide, will not work very well, depending on the degree of the deficiency. So if she is not going to change her diet (which I assume is still true), then it is especially important for her to keep her vitamin D and magnesium levels up so that budesonide will be more effective. Also, since you were last here, published research is now available to show that budesonide can be safely used for long-term treatment, if needed, and the American Gastroenterological Association Institute recognizes that in their latest guidelines for treating MC.
I hope that some of this is helpful.
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.
Thank you for the response!tex wrote:Hi Larry,
Unfortunately we have found that all SSRIs, SNRIs, tricyclic antidepressants, etc., can cause MC reactions. And if any of them cause the problem for an individual, then there is a very good chance that all of them may cause the problem. Wellbutrin (buproprion) is sometimes prescribed to treat the same issues. For some people it does not work as well for specific issues, but it is the least likely antidepressant to cause undesirable side effects in general, and that especially applies to MC patients. You might ask her doctor for her or his opinion on Wellbutrin.
In case you are not aware of this, virtually all depression patients are magnesium deficient. And research shows that magnesium supplementation treats depression. Here is a quote from part of an abstract of a research article (that can be seen at the link below). Notice especially the sentences that I have highlighted in red:
Rapid recovery from major depression using magnesium treatmentCase histories are presented showing rapid recovery (less than 7 days) from major depression using 125–300 mg of magnesium (as glycinate and taurinate) with each meal and at bedtime. Magnesium was found usually effective for treatment of depression in general use. Related and accompanying mental illnesses in these case histories including traumatic brain injury, headache, suicidal ideation, anxiety, irritability, insomnia, postpartum depression, cocaine, alcohol and tobacco abuse, hypersensitivity to calcium, short-term memory loss and IQ loss were also benefited. Dietary deficiencies of magnesium, coupled with excess calcium and stress may cause many cases of other related symptoms including agitation, anxiety, irritability, confusion, asthenia, sleeplessness, headache, delirium, hallucinations and hyperexcitability, with each of these having been previously documented. The possibility that magnesium deficiency is the cause of most major depression and related mental health problems including IQ loss and addiction is enormously important to public health and is recommended for immediate further study. Fortifying refined grain and drinking water with biologically available magnesium to pre-twentieth century levels is recommended.
I can show you links to many other articles on this topic if you need additional information. But also note that if she has not changed her diet then her food sensitivities are almost certainly causing inflammation and inflammation is a also a major cause of depression (because of that, depression is very common with untreated celiac disease and microscopic colitis).
Is Depression a Disease—or a Symptom of Inflammation?
And also please note that either or both a magnesium deficiency and a vitamin D deficiency will prevent the immune system from being able to properly fight inflammation in the body. Also, if vitamin D or magnesium are deficient, certain medications, including budesonide, will not work very well, depending on the degree of the deficiency. So if she is not going to change her diet (which I assume is still true), then it is especially important for her to keep her vitamin D and magnesium levels up so that budesonide will be more effective. Also, since you were last here, published research is now available to show that budesonide can be safely used for long-term treatment, if needed, and the American Gastroenterological Association Institute recognizes that in their latest guidelines for treating MC.
I hope that some of this is helpful.
Tex
Larry
Hi Kalanit,
The Mayo Clinic has the top rated gastroenterology department in the U.S. See the Risk Factors on the page at the following link:
http://www.mayoclinic.org/diseases-cond ... c-20192322
Tex
The Mayo Clinic has the top rated gastroenterology department in the U.S. See the Risk Factors on the page at the following link:
http://www.mayoclinic.org/diseases-cond ... c-20192322
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.
Re: hi tex,
There are no studies. But I can give you at least a little anecdotal evidence. My Mom was on an SNRI for many years and was doing fine with it. Had a bad initial episode of Collogenous Colitis back in 2014 that was resolved with budesonide. Stayed on the SNRI all through this and has been fine until 2016. In 2016, her cardiologist determined that he wanted her to come off the SNRI and find another option because the SNRI had cardiac ramifications. We tried two SSRIs ... Zoloft and Lexapro. Neither worked well from a depression perspective, but of more interest here ... both caused some CC symptoms (although not a full on relapse) of "explosive expulsion" before being able to get to the toilet. We took her off the SSRIs and put her back on the SNRI (Cymbalta) and she has been absolutely fine ever since. Unfortunately, this doesn't solve the cardiac issues with the SNRI, but ...kalanit wrote:so you think anti depression cuase mc?
can you send me studies of it?
thanx
Larry