Reglan caused severe anxiety and depression

[RZ67]

Please help me, my doctors can't seem to.  I started having panic attacks twenty years ago and ever since then I take Imipramine and use Xanax only when I feel panic. I used to think my panic attacks way back then were severe until now.  Now I would say they were moderate.  Two months
ago my GI doctor prescribed Reglan for my IBS/Constipation, and after five weeks I started feeling unusally panicky, depressed and I couldn't find enjoyment in my usual activities. Those symptoms increased every week and pretty soon I couldn't even drive. The medication information I got from the pharmacy listed anxiety as a side effect and said to contact the doctor immediately if you experience depression.  Within the next few days after stopping the Reglan, my anxiety and depression became extreme and I had thoughts of suicide.  I also had a headache for two days and had hot and cold flashes.  I spoke with my psychiatrist and two pharmacists and they all claim that the Reglan is out of my system and not causing the anxiety and depression. I know they are wrong, this is so different! It has now been almost two weeks since I've stopped the medication and I am no better than I was right after I've stopped. My psychiatrist wants to try me on different antidepressants but I am afraid because I've tried many and I had bad reactions to them. I searched my side effects with the medication on the internet and found numerous people that had the exact same symptoms as me for months after stopping Reglan. The FDA website warns doctors about perscribing Reglan to people with a history of anxiety and depression and have reported a suicide from Reglan. I am only looking for reassurance that this will go away and I will get better. Please help.

[RCA7591]

Did your GI doctor know that you were prescribed Tofranil (Imipramine)?

Reglan is a Dopamine antagonist, it targets D2 receptor sites in the brain, and thus provides an anti-emetic effect. This is Reglan's primary indication. It is sometimes used for GERD as well, but is generally ineffective. It has no useful indication for IBS. For IBS, Librax is a good choice. Donnatal is also a good choice. For IBS presenting with anxiety (or IBS that is provoked by anxiety), Librax is the most effective.

Tofranil targets primarily the re-uptake of Norepinephrine, and to a lesser extent, Serotonin. It also possesses mild Dopamine antagonist properties. The possibility exists that the two drugs (Tofranil and Reglan) interacted, causing your adverse reaction. The concomitant use of the two drugs would increase Dopamine antagonism, which in theory, could lead to a heightened state of anxiety or a worsening of clinical depression.

There is no discontinuation syndrome from Reglan per se, however you may have had a hypersensitivity reaction to it. All symptoms should vanish rapidly after discontinuation of the Reglan (which has been implemented).

If for some reason these symptoms persist, you could ask the psychiatrist to increase the Tofranil dosage by another 25 mg for a few months (provided your daily dosage is less than 150 mg).

In the mean time, you could also inquire about Librax, 5/2.5 strength, t.i.d.

Hopefully, this sheds some light on the subject.

Ryan