Coping With Nausea While on Antidepressants

Gastrointestinal Side Effects Common With SSRI Drugs

Ginger and nausea
Ginger is one of the more common home remedies for treating nausea. Graham Day/Getty Images

Nausea and vomiting are two of the more common side effects of antidepressants, and it may take some time to get over these symptoms when you first start treatment. In fact, nausea is often the number one side effect of many selective serotonin reuptake inhibitors (SSRIs) used to treat major depression and anxiety disorders.

Research issued by the U.S. Food and Drug Information suggests that the risk of SSRI-associated nausea ranges from significant to high:

In some cases, nausea and vomiting can become so severe or persistent that a person has no other option but to stop treatment.

Coping With Nausea and Vomiting

In most cases, the nausea and vomiting associated with antidepressants will improve after a week or two. However, as many as 32 percent of people may experience some degree of nausea of up to three months.

If nausea persists, there's are a number of things you can to manage the symptom. Among them:

  • Take your antidepressant with food.
  • Eat smaller, more frequent meals.
  • Sucking on sugarless hard candy whenever you're nauseous.
  • Use an antacid or bismuth subsalicylate (such as Pepto-Bismol).
  • Sip ginger tea or slightly flattened ginger ale.
  • Take your antidepressant at bedtime.
  • Takes Zantac (ranitidine), an over-the-counter antacid, when needed;
  • Take a slow-release form of your antidepressant.
  • Ask your doctor to temporarily lower your dosage.

Your doctor can also be able to prescribe anti-nausea medications such Zofran (ondansetron) or a proton pump inhibitor such as Prilosec (omeprazole).

If your doctor prescribes a proton pump inhibitor, take it as directed.

Proton pump inhibitors may increase the blood concentration level of certain SSRIs and, in some cases, require the lowering of the antidepressant dosage.

Always advise your doctor if you are taking any over-the-counter medication or supplement to treat nausea or vomiting.

When Side Effects Become Intolerable

If your nausea or vomiting becomes intolerable, your doctor may have no other choice but to change treatment to another antidepressant with a lower nausea risk ((such as Celexa, Paxil, or Symbrax).

It is important, however, never to stop treatment or reduce your dosage without first consulting your doctor. If you do so, you run the risk of returning or worsening of depression symptoms.

Moreover, you may experience withdrawal symptoms commonly referred to as antidepressant discontinuation syndrome (ADS). ADS is often flu-like when it  first begins but can quickly progress to more debilitating symptoms, such as:

  • Nausea
  • Vomiting
  • Fatigue
  • Muscle pain
  • Insomnia
  • Dizziness
  • Anxiety
  • Irritability
  • Heavy sweating
  • Blurred vision
  • Tingling or electric shock-like sensations
  • Vivid dreams
  • Hallucinations

Your doctor can help avoid these symptoms by gradually tapering you off your medication or transitioning you to a different medication.

Sources:

Gjestad, D.; Westin, A.; Skoqvoll, E. et al. "Effect of Proton Pump Inhibitors on the Serum Concentrations of the Selective Serotonin Reuptake Inhibitors Citalopram, Escitalopram, and Sertraline." Ther Drug Monit. 2015; 37(1):90-97.

Kelly, K.; Posternak, M.; and Jonathan, E. "Toward achieving optimal response: understanding and managing antidepressant side effects." Dialogues Clin Neurosci. 2008; 10(4):409-418.

Renoir, T. "Selective serotonin reuptake inhibitor antidepressant treatment discontinuation syndrome: a review of the clinical evidence and the possible mechanisms involved." Front Pharmacol. 2013; 4:45.

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