Anxiety related nausea

[Noworryjonny]

So I’ve upped my dosage by 50mg each week and I’ve been on for 4 weeks I’m staying in 150mg but my anxiety is through the roof, and my tummy is in knots who else had the increase in anxiety with sertraline


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[panic_down_under]

So I’ve upped my dosage by 50mg each week and I’ve been on for 4 weeks I’m staying in 150mg but my anxiety is through the roof, and my tummy is in knots who else had the increase in anxiety with sertraline

Probably nearly everyone with an anxiety disorder who has taken a serotonergic antidepressant. It is a very common initial side-effect caused by the immediate increase in serotonin activity. Despite the popular myth, serotonin is not a 'feel good' neurotransmitter. The tummy and gut can be especially affected because the gut is by far the most serotonergic organ of the body making and using about 60 times more serotonin than the brain.

The heightened anxiety and other side-effects usually begin to diminish once plasma levels of the med stabilize to a steady-state and the brain and other affected organs respond by down-regulating serotonin synthesis and expression, though they may reoccur for a short period after dose increases. Talk to the prescribing doctor if the anxiety become intolerable as there are ways of easing it.

[Noworryjonny]

Thank you so what I’m feeling in my stomach is to be expected considering the dosage increase and the short amount of time I’ve been on it


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[panic_down_under]

so what I’m feeling in my stomach is to be expected considering the dosage increase and the short amount of time I’ve been on it


Unfortunately, yes. The side-effects usually begin to diminish after a few weeks, though they can linger for some and may return for a while after dose increases, but stomach and gut issues are common and not anything to worry about. The usual remedies for upset stomach, etc, may help.

[Tyke]

I've just increased my Sertraline dose from 50mg to 100mg and am experiencing similar problems. I wasn't coping on 50mg but increasing the dose has led to stomach issues and increased anxiety as a result. I know this should only be temporary, but it is so hard. Has anyone on the forum got positive results of this kind of increase? If so, how long did it take for the meds to kick in? Do you feel much better on the higher dose? Taking increasingly higher doses really scares me, I never wanted to be dependant on medication just to make me feel normal. It just makes me feel less in control of my own body. I then get scared it will stop working and I'll have to go for a higher dose still. Where will it end?

[panic_down_under]

I wasn't coping on 50mg but increasing the dose has led to stomach issues and increased anxiety as a result. I know this should only be temporary, but it is so hard. Has anyone on the forum got positive results of this kind of increase?

50mg is the usual sertraline starting dose for depression (<=25 mg for anxiety) and the minimum therapeutic dose. Most need to take 100-150mg to get a good response so your experience is pretty much the norm.


Taking increasingly higher doses really scares me, I never wanted to be dependant on medication just to make me feel normal. It just makes me feel less in control of my own body.

Would you feel this way if you had say epilepsy, or an autoimmune disease like rheumatoid arthritis? Anxiety disorders [1] share much the same benzodiazepine binding site deficiencies as epilepsy [2], and are, with depression, the symptoms of atrophy (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC60045/) of parts of the hippocampal regions of the brain caused by high brain stress hormone levels, mostly of cortisol, which kills brain cells and inhibits the growth of new ones, i.e. essentially an auto immune response. High cortisol levels are also associated with immune system disorders such as multiple sclerosis. Antidepressants (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3025168/) (ADs) and therapy (http://tiny.cc/h0xzaz) work by turbo charging the growth of new hippocampal cells (as can to lesser extents exercise (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1413959/) and Omega-3/fish oil (http://www.ncbi.nlm.nih.gov/pubmed/23746276) supplements). The therapeutic response is produced by the new cells and the interconnections they forge, not the meds directly.


I then get scared it will stop working and I'll have to go for a higher dose still. Where will it end?

It is possible that you may need a higher dose, it all depends on how well sertraline meshes with your DNA and how quickly you metabolize the med, however, most people do not need to continually increase AD doses over time. I've been on the same AD dose for about 25 years, even though as a rapid metaboliser I have always needed to take near the maximum dose of the ADs I've been on and in some cases well above the recommended maximum.



References:

[1]
Altered cerebral benzodiazepine receptor binding in post-traumatic stress disorder.
Transl Psychiatry. 2018 Oct 4;8(1):206 (Abstract (https://www.ncbi.nlm.nih.gov/pubmed/30287828) | Full text (https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/30287828/))

Hasler G, Nugent AC, Carlson PJ, et al. (2008)
Altered cerebral gamma-aminobutyric acid type A-benzodiazepine receptor binding in panic disorder determined by [11C]flumazenil positron emission tomography.
Arch Gen Psychiatry. Oct;65(10):1166-75 (Abstract (http://www.ncbi.nlm.nih.gov/pubmed/18838633))

Geuze E, van Berckel BN, Lammertsma AA, et al. (2007)
Reduced GABAA benzodiazepine receptor binding in veterans with post-traumatic stress disorder.
Mol Psychiatry. 2008 Jan;13(1):74-83 (Abstract (http://www.ncbi.nlm.nih.gov/pubmed/17667960))

Cameron OG, Huang GC, Nichols T, et al. (2007)
Reduced gamma-aminobutyric acid(A)-benzodiazepine binding sites in insular cortex of individuals with panic disorder.
Arch Gen Psychiatry. Jul;64(7):793-800. (Abstract (http://www.ncbi.nlm.nih.gov/pubmed/17606813))

Bremner JD, Innis RB, Southwick SM, et al. (2000)
"Decreased benzodiazepine receptor binding in prefrontal cortex in combat-related posttraumatic stress disorder."
Am J Psychiatry Jul; vol 157(7):1120-6 (Abstract (http://www.ncbi.nlm.nih.gov/pubmed/10873921))

Bremner JD, Innis RB, White T, et al (2000)
"SPECT [I-123]iomazenil measurement of the benzodiazepine receptor in panic disorder."
Biol Psychiatry Jan 15; vol 47(2):96-106 (Abstract (http://www.biologicalpsychiatryjournal.com/article/S0006-3223(99)00188-2/abstract))

Malizia AL. (1999)
"What do brain imaging studies tell us about anxiety disorders? "
J Psychopharmacol Dec; vol 13(4):372-8 (Abstract (http://jop.sagepub.com/content/13/4/372.abstract))

Morimoto K. 1999
Benzodiazepine receptor imaging in the brain: recent developments and clinical validity
Kaku Igaku. May;36(4):307-13. (Abstract (http://www.ncbi.nlm.nih.gov/pubmed/10390953))

Malizia AL, Cunningham VJ, Bell CJ, et al. (1998)
"Decreased brain GABA(A)-benzodiazepine receptor binding in panic disorder: preliminary results from a quantitative PET study."
Arch Gen Psychiatry Aug; vol 55(8):715-20 (Abstract (http://www.ncbi.nlm.nih.gov/pubmed/9707382))

Tokunaga M, Ida I, Higuchi T, Mikuni M. (1997)
"Alterations of benzodiazepine receptor binding potential in anxiety and somatoform disorders measured by 123I-iomazenil SPECT."
Radiat Med May-Jun; vol 15(3):163-9 (Abstract (http://www.ncbi.nlm.nih.gov/pubmed/9278373))

Uchiyama M, Sue H, Fukumitsu N, et al. (1997)
"Assessment of cerebral benzodiazepine receptor distribution in anxiety disorders by 123I-iomazenil-SPECT: comparison to cerebral perfusion scintigraphy by 123I-IMP."
Nippon Igaku Hoshasen Gakkai Zasshi Jan; vol 57(1):41-6 (Abstract (http://www.ncbi.nlm.nih.gov/pubmed/9038062))

[2]

Vivash L, Tostevin A, Liu DS, et al. (2011)
"Changes in hippocampal GABAA/cBZR density during limbic epileptogenesis: relationship to cell loss and mossy fibre sprouting."
Neurobiol Dis. Feb;41(2):227-36. (Abstract (http://www.ncbi.nlm.nih.gov/pubmed/20816783))

Morimoto K. (1999)
"Benzodiazepine receptor imaging in the brain: recent developments and clinical validity."
Kaku Igaku May; vol 36(4):307-13 (Abstract (http://www.ncbi.nlm.nih.gov/pubmed/10390953))

Savic I, Pauli S, Thorell JO, Blomqvist G. (1994)
"In vivo demonstration of altered benzodiazepine receptor density in patients with generalised epilepsy."
J Neurol Neurosurg Psychiatry. Jul;57(7):797-804. [Abstract (http://www.ncbi.nlm.nih.gov/pubmed/8021664)]

[Phill2]

50mg worked just fine for me for 3 years but I just didn't like Sert in general so I swapped to 10mg Lexapro and all is good

[Tyke]

Gee thanks for that guys. And thanks for all the useful information and references Panic_Down_Under.

I do love the international feel to this forum, we're all in the same boat with these issues, wherever we are. I'll raise a glass to all of you down under regardless of who wins the Ashes!!!

I'm having a better day today. The stomach problems and increased anxiety are still there, but I feel I can accept it more easily now.

You're quite right with your comparisons with medication and other health problems Panic_Down_Under. The brain is after all, just another part of the body that needs help in functioning correctly sometimes.

Best wishes to you all.
Tyke

[panic_down_under]

I'll raise a glass to all of you down under regardless of who wins the Ashes!!!

I fear we lost it when we didn't take full advantage of the first innings collapse in the last test. I blame our selectors. I've made myself available for selection to open both the batting and bowling every year for the last 55, but, inexplicably, never received the call. Clearly, there has been skulduggery afoot all these years, despotism and rampant corruption leavened only by gross incompetence! :emot-shakehead:


I'm having a better day today. The stomach problems and increased anxiety are still there, but I feel I can accept it more easily now.

Sounds promising. You might not be out of the woods yet, but it seems you're headed in the right direction at last. :)


The brain is after all, just another part of the body that needs help in functioning correctly sometimes.

Some more than others, as my shrink likes to tell me while raising one eyebrow. But then his shrink probably has the same dark thoughts about his! :D

[Noworryjonny]

I’ve been on 150mg for 7 weeks and I had a few good days but the last four days the stomach issues have come back in full force the anxious tummy and diarrhoea have been horrible doctor said it’s normal when I saw him today as I’m on a High dose


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[panic_down_under]

I’ve been on 150mg for 7 weeks and I had a few good days but the last four days the stomach issues have come back in full force the anxious tummy and diarrhoea have been horrible

It is unusual for these side-effects to return after 7 weeks at the same dose, although not unheard of. Could it be the the flu, or the after effects of a dodgy curry? Remedies containing loperamide should help with the diarrhoea.

[Noworryjonny]

No doctor said it’s normal it takes 12 weeks to level,

It really is bothering me, but he says it will sort it’s self out


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[will351]

I started 5 days ago. I have stomach cramps and gas and I’m very tired

[Noworryjonny]

Does anybody else suffer with morning anxiety?
Literally in the evenings I feel good and chilled out so issues but every morning I wake up anxious knot in my stomach and urge to poo and this continues until about 4/5pm and then settles down once I’m home.

I’m 10 weeks on sertraline and my anxiety levels have been very high I’m just so fed up with it


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[LF87]

Yeah mine is so bad in the mornings too. I'm also waking up a lot during the night at the minute too with intense anxiety so that's not very fun. Mine starts to settle later in the day too. I wonder why x

[ankietyjoe]

It's normal. Cortisol rises in the morning to wake us up and it's common to feel bad as soon as you wake up. The best thing to do is get up and walk about for a bit. If you focus on the 'why', it'll probably hang about all day.

[Noworryjonny]

Yea I’ve heard that cortisol thing, it’s just so frustrating I had 6/7 really good days and bang just like that I feel crappy again, I’m so tired of it all


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[ankietyjoe]

That's the pattern. Try focusing on the good days rather than the constant re-confirmation that you don't like feeling bad. Nobody likes feeling bad.

[Noworryjonny]

I know and I have made huge improvements in trying to be better but when it’s tough it’s very tough, my bowel movements are relatively normal and my appetite is good it’s just the morning anxiety and feeling of needing to poo


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[BlueIris]

Most people here have been where you are, but as far as possible, you have to try not to dwell on it. It's all a question of redirecting your thoughts.

[Noworryjonny]

Thank you I know I’ve tried to stay off here as I know I was getting on some peoples nerves but last two days have been a struggle after such a good improvement


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[BlueIris]

It's okay, everybody has setbacks. I had a massive panic attack on Sunday after months without, and it really threw me. You just have to remind yourself it's just a blip, nothing more.

[Noworryjonny]

Yea it’s just my stomach, like waking up with a knot in it and then concentrating so hard on it, the evenings are so good and I have no tummy trouble and when I get in bed it’s even better, my appetite has returned and I’m back at work full time and going out socialising just can’t get over this tummy feeling


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[Worrywort80]

I didn’t realise others felt the same way! I most often feel worse in the morning, even though I’ll have gone to bed the night before feeling fine. In fact I feel awful today having been looking for my blind spots again in the car drive in and freaking myself out!

Perhaps I’ll be kinder to myself and look forward to the evenings!



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[nicole97]

I get that too in the morning. It’s miserable!!

[Noworryjonny]

I’ve started to make improvements on my anxiety and I’m 11 weeks into sertraline, but last few days I’ve had waves of horrible nausea, one minute I feel fine next I feel sick to my stomach is this a normal symptom of anxiety


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[KK77]

You know the answer, Jonny.

I take meds too and get severe waves of nausea almost daily, but difference is, I pay little attention to it because I know it passes just as quickly as it appears.

[lebonvin]

Try peppermint tea

[MrLurcher]

Hi Jonny, just to let you know I'm going through this now. But I'm having long episodes of feeling nauseous. Very frustrating and depressing.

[Noworryjonny]

You know the answer, Jonny.

I take meds too and get severe waves of nausea almost daily, but difference is, I pay little attention to it because I know it passes just as quickly as it appears.

I try to pay little attention but it’s so hard, Is it down to the tablets or anxiety


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[Noworryjonny]

So I’ve been feeling very nauseous for over a week and doctor has said it’s 100% anxiety, it comes in waves one minute feel good next minute I feel sick. I’m sweating lots and feel dizzy but it’s reassuring to know It’s just anxiety!

I’m 11 weeks into sertraline too, anybody else suffer with nausea from sertraline


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[Elen]

Hi

This is just a courtesy reply to let you know that your thread was merged with another of your threads.

Please when posting on similar topics add it onto your previous post rather than starting a new one.

It is nothing personal it is just to make it easier for people to follow your story and to give you advice as a whole.

Elen

[Kayleigh0910]

Hi how long after going onto 150 did u notice side effects wearing off

[Noworryjonny]

This nausea is too much, last night I felt great but woken up this morning and I feel awful how can anxiety do this


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