Citalopram and GI disturbances (epic flatulence)

[Emphyrio]

Hello,

I have been on 5mg of citalopram for just over 3 weeks now (I know its a low dose, but I'm very sensitive to meds). Prior to that I was on 25mg of sertraline for around 4 weeks which I had to stop because it gave me visual disturbances and had negative effects on cognition and vigilance.

I'm feeling less anxious and depressed than I was before I went back on meds in late March. Citalopram appears appears to be working quite well - I feel calm, can think clearly, and remain motivated enough to carry on with my studies. However, there is one side effect that I'm finding it hard to manage.

The epic flatulence.

My diet has not changed in any way, but I'm finding that I'm getting a lot (and I mean a lot) of gas, the majority of which rears its ugly head in the evenings. I've gone from tooting a handful of times a day to 40 or 50 (thankfully they don't smell too badly). The last couple of days have also been accompanied by intense stomach bloating and frequent bowel movements, which I hope is not the start of a new, unwanted side effect. I can't afford to double my bog roll consumption.

The question for you all is - did you notice any GI disturbances on citalopram, and if so, did they disappear over time? I've heard some worrying stories online about the gas and gut disorders being one of the side effects of citalopram that don't fade with time...

[keithwms]

I definitely had GI disturbances. It took about two weeks for that to subside enough to be comfortable. Three weeks in, I still feel bloated and whatnot, and my diet is certainly not 100%. I just tried to modify my diet and took calming / anti-gas tablets, avoided caffeine and sugar and any other such things that might contribute to belly-based anxiety!

Did you try any anti-gas remedies? There are many... plus, one good thing about gas is that you can normally predict when its coming and... evacuate!

I hope you feel improvement soon. But it's great that you're getting other benefits... many would feel jealous of that after such a short time!

[Emphyrio]

Hi Keith,

Many thanks for your reply.

I guess I could be doing more to minimise the gas/bloating, but its hard! Fermentable sugars appear to cause the most grief to people with IBS, but its a hard diet plan to stick to (I would have to cut out milk, wheat, a lot of fruit and veg). In addition, I had terrible gut pains for the 11 days I tried clomipramine (an older, tricyclic medication) last year (I stopped taking it due to this and other factors).

In the past I've had issues with flatulence which I now believe was a side effect of another SSRI medication. It basically just came on halfway through taking it - I thought it was something more serious, but when I tapered off the medication, the flatulence/bloating also improved. In that time I tried lots of possible remedies - activated charcoal, digestive enzymes, peppermint, fennel tea etc. I don't recall anything really helping to be honest!

I guess the benefits are not solely from the citalopram - I did start to feel like the sertraline was kicking in just when I decided to come off it - I was clenching my teeth a lot which is a sign of increased serotonin. I typically find antidepressants to kick in around 4.5 weeks after I've started taking them. I guess the citalopram has just maintained the positive benefits since then.

As I feel I can generally cope with life at the moment, I'm not going to increase my dosage until the GI issues go away - if they ever do that is!