SSRI drugs and chronic severe diarrhea

[Llyn]

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.

[ParamedFlorena]

This is something I've heard of before. It's not easy investigating something not knowing where to start!

What I've heard of has been SSRI-induced IBS (irritable bowel syndrome). I don't know much more than that the body does get used to the reuptake inhibitor, so when you take that away, the body doesn't know quite what to do... That's why it is so important to taper off slowly too I guess.

I'm with you, waiting out an explanation! If you should find that and a possible way to treat it without antidepressants, please keep us up to date!

Florena

[Llyn]

Well, I'm glad you have heard of it before!  It makes me feel a bit less whacked.  My theory is that if serotonin uptake receptors are blocked long enough and strongly enough, they start to malfunction or disappear.  Since roughly 90% of them are in the gut, not the brain, this means GI tract has to be affected by SSRI drugs as well as brain/nervous system-- no accident that many SSRI's have GI side effects.   I was diagnosed 30 years ago with IBS but until the Zoloft, it was a problem I experienced only under high stress when I ate foods that I am mildly allergic to-- I have no strong food allergies but am a "generally allergic to the world" person-- and I NEVER had fecal incontinence prior to the Zoloft.   I am a skilled researcher (Ph. D.) and have been all over the net on this question.  I know that sometimes SSRI's are prescribed FOR IBS, although my guess is that they are prescribed more for IBS-Constipation rather than IBS-Diarrhea.  After the GI doc suggested I take Imodium daily this spring, it made no change in my problem in a three week trial, so I stopped it.  I then tested highly lactose intolerant; eliminating milk products for a number of weeks also made no difference in my problem.   Since February I have had many, many tests to try to diagnose this problem and thus far the only aberrant result was on the lactose intolerance test.  Today I am collecting urine for a 5-HIAA test.  I have made a resolution to force my docs to stay on this until they figure it out, because for many, many years, the side effect was simply written down when I reported it, and no doc did anything about it until I demanded action, even though I had been reporting fecal incontinence for years.   Just goes to show that "Other people's side effects aren't nearly as serious as your own."

[ChrisTroup]

While I can't relate to your "long-term" use of SSRIs, I must share with you my harrowing tale of SSRI-induced chronic diarrhea.

Where shall I begin?  Suffering from depression, I was prescribed Zoloft by a psychiatrist.  The first few weeks of it were heaven -- I could focus, I could sleep, I was my best self.  And then the diarrhea started.  This wasn't just an icky visit to the bathroom now and again -- this was a life-altering reaction.  After two to four weeks, losing time at work and losing 10 lbs., the doc took me off Zoloft and put me on Lexapro.  It worked like a charm -- for about four weeks.  Then the diarrhea started again.  He switched me to Cymbalta -- another six or eight weeks, same result.  Immodium made no difference.  (I stopped going to that doctor and stopped taking the Cymbalta.  Big, big mistake -- had awful, terrible agony from stopping Cymbalta cold turkey -- felt like electric jolts in my brain.)  Only this time the diarrhea didn't stop when the medication stopped.  It's abated some since then -- August 2007 -- but has never fully gone away.  I went to a family doctor who put me on Wellbutrin, which I had tolerated well once before.  Eight weeks, same result.  New family doctor, who put me on Zyprexa -- which is used for schizophrenia! -- and it made my brain feel like paste.  He also sent me to a GI doc who barely looked at me and said I had IBS.  I, too, have had the nervous stomach thing, but never as chronic as this.   I asked for a second opinion.  This new GI doc seems a little more with-it.  He also diagnosed me with IBS, but sent me for blood tests.  He said my thyroid level was off.  My family doc retested my thyroid and found nothing wrong.  Also, seeing the diagnosis of IBS, this family doc says the Zoloft-diarrhea thing is a coincidence.  He put me back on Zoloft --  and within 2 weeks I was (excuse my coarseness) shitting myself silly.  

So, here I am now.  I have an two unfilled scrips -- one for Seroquel, and one for Effexor.  I still have depression, and now I feel like I've been victimized twice -- once by the lying pharmeceutical companies, and once by my doctor who insists there is NO connection between SSRIs and my chronic diarrhea.  I am, to put it bluntly, mad as hell and I'm not going to take it anymore!  

Dr. Daniel Amen, of the Amen Clinics, is someone you should check out.  He says that diagnosing someone with depression is like diagnosing someone with chest pain.  Depression can be a symptom, not a disease, and the disease -- not the symptom -- is what needs to be treated.  I'm wondering if you and I both share an underlying condition that would cause this certain reaction to SSRIs.  I, too, am lactose intolerant.  Have you had your thryoid tested?  

Here are my next steps -- I'm going back to the GI doc in August and asking more questions about my thyroid.  I'm insisting that they do more tests, and if I need to go to an endocrinologist, then so be it.  I've just begun taking SAM-e, which is a more natural way to help the seratonin levels.  I've put a fiber supplement into my diet, which helps a bit.  I try not to eat any processed or unhealthy foods.  I try to stay away from sugar.  

I would appreciate it if you could keep me updated on your journey to finding answers.  Please do email me.  Perhaps you and I could piece this thing together!  

[ChrisTroup]

Just wanted to update my last post.  

I've since done some research and found a link between SSRIs and Lymphocytic Colitis.  I phoned the GI doc, and he's scheduled some tests.  I will update again if I find out anything else.  

[Naplis]

Hello.  I am very interested in what you found out about your condition. I too developed severe diarrhea about 6 weeks into taking Lexapro for anxiety. It started out manageable but progressed to incontinence. Imodium didn't help. I became a prisoner of my home after some humiliating experiences in public. I am now weaning myself off the Lexapro to get some relief from the diarrhea. I am down to 2.5 mg every other day (from 10mg daily) and still have the incontinence problem. I am so scared that this will not go away. BTW: I had ulcerative colitis 30 years ago. I was cured by surgery that removed my colon and created an internal pouch from small intestine that was connected to the exit/anus. This  pouch has functioned perfectly for 30 years. About 20 years ago it took on all the functioning characteristics of a colon. (i.e. fecal