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I've been taking 5mg for 9 days, and my stools continue to be loose. Not quite diarrhoea, but definitely looser than normal, a bit uncomfortable. My diet hasn't changed.
Is this a normal side-effect that I can expect to pass soon? Because if not, it will be a problem.
Yes, it is a common initial side-effect of serotonergic ADs, although they can cause constipation in some too. The most serotonergic organ of the body isn't the brain, but the gut and the mini brain, the enteric nervous system (ENS) which controls its functions (and *much else too). The ENS makes about 50 times as much serotonin as the brain and can initially be more effected by ADs than the brain is. The diarrhoea should diminish as the body responds to the extra serotonin activity by down-regulating serotonin synthesis and expression, but it may return for a while after dose increases. The diarrhoea med loperamide (Imodium) is usually very effective. You should be able to buy it from any chemist/pharmacy. In Australia it can be purchased at most supermarkets, so try the one in your area first as it's likely to be cheaper there.Quote:
Originally Posted by Waldenpond
* in addition to the gut the ENS is also linked via the vagus nerves to the heart, lungs and the brain and can effect their function too. Common anxiety symptoms such as rapid pulse and shortness of breath may owe as much to the ENS than the brain and adrenaline. It also seems to be the dominant party in its exchanges with the brain. Electronic valgus nerve stimulators which interfere with the ENS-brain link have been proven very effective at easing depression (though not anxiety).
In turn the mix of microbes in the gut may effect ENS response. What we eat and poop literally affects how we think. ADs may also, at least in part, do their thing via their effect on the mix of gut bacteria. A pretty strong case could be made for us being merely a life support systems for the gut biome (they have us out numbered for there are more microbes in the gut than cells of the human body :ohmy:). So look after your gut, or it could make your life miserable!
See also:
Gut bacteria, the vagus nerve and the brain (PDF)
Gut bacteria and the brain: Are we controlled by microbes?
Gut communicates with the entire brain through cross-talking neurons
Gut microbes may talk to the brain through cortisol
Glad to know it's not out of the ordinary. I hope it improves soon.