727 replies to this topic

[frog]

I've been having persistent GI issues throughout these months which are not improving whatsoever. Sometimes it feels like they've gotten worse? When I spoke to my new primary care doctor a few weeks ago she said my symptoms all sounded like IBS. I'm basically running to the bathroom practically after every meal and it's really taking a toll on my mental state, which otherwise feels nearly back to normal much of the time. I've had some bloodwork and tests done to rule out any cancer or other nasty things like that and everything came back fine. I've tried doing the low FODMAP diet the past couple weeks and haven't seen any improvement in symptoms. Maybe I wasn't strict enough with the diet so this week as a mea culpa I am eating the lowest possible FODMAP foods, keeping it super simple and bland to see if anything comes of it, but I'm not feeling too hopeful. 

 

My one lingering thought is that either the Seroquel (50mg at night) or Gabapentin (300mg at night) are irritating my gut. These things are always nearly impossible to figure out from online searches but I found at least a few handfuls of comments of people complaining of getting horrible diarrhea from Gabapentin. Has anyone been on it and had this experience? 

 

Second question, the only way to confirm if it's the Gabapentin would be to get off it, which is of course generally the plan anyway. I've been taking a little break since the last taper. It's been about two weeks so I could potentially tackle the gabapentin if there's hope that it'll relieve the stomach problems. I was hoping to get some advice on a tapering schedule for gabapentin from 300mg. I take 3 capsules of 100mg each. I haven't opened one yet but I'm assuming it's powder inside. Is it ok to just drop 100mg at a time or is that too much? Etc... any help as always greatly appreciated!!!

[fishinghat]

I am not really surprised by the GI issues although that is a little longer than most. I would think it is much more likely to be withdrawal than Seroquel but you can never tell. Besides the diarrhea do you have a lot of bloating and associated stomach pain? Have you tried Imodium D? It helped me a lot. Usually a half dose would "slow" things down.

 

As far as the Seroquel is concerned I would suggest a 3 to 4 month taper. Many have done it in 2 months but I noticed they usually have more withdrawal symptoms.

[fishinghat]

FYI - The FDA says that 2.4% report diarrhea as a side effect of Seroquel.

[frog]

I don't have bloating at all and not much pain really either. It's mostly just churning, and many meals send me running for the bathroom so I feel like I always have to be near one. If anything I feel like taking imodium seems to create some belly pain. I've been taking imodium more consistently over the past couple weeks (half a pill every other day or so) and like I said it feels like I've got more cramping and pain but still having diarrhea. When I take a full pill it helps with the diarrhea but it lasts for many days which I don't like and makes it difficult to create a consistent dosing schedule. 

 

I didn't see a lot of things online about Seroquel causing diarrhea, but I did see some potential issues with Gabapentin. Did you see anything about that one at all? And what would be your recommended taper schedule for Gabapentin? Dropping by 100mg at a time seems like the easiest since they're packed in 100mg pills, but dropping 30% at a time might be too fast? 

[invalidusername]

I didn't see a lot of things online about Seroquel causing diarrhea, but I did see some potential issues with Gabapentin. Did you see anything about that one at all? 

 

Placebo controlled trials saw 6% (n=336) of the control group having diarrhea and 4% constipation, with nausea and vomiting making up for 7%.

 

Going by a 50% logic of combined symptoms, this will give you almost a 1 in 10 chance that Gabapentin can cause GI issues. 

[fishinghat]

That is tough if the Imodium is like you say. I don't know of another anticholinergic to try. In the ebook there is a list of what to do to settle a GI tract. Don't drink anything hot or cold, hot pad on stomach, etc, You might review that. Those items and a change in diet solved my IBS in time.

 

As far as gabapentin is concerned the FDA reports that 5% complain of diarrhea. That may be a better choice to wean off of Seroguel, especially if you include the data IUN just posted. As far as weaning of the gabapentin I would again recommend about a 3 or 4 month wean.

[frog]

We've been attempting the low FODMAP elimination process for a couple weeks and I've seen 0 improvement. I know this approach helps most people with IBS symptoms so I want to make sure we're giving it a really solid attempt before throwing in the towel so this week we're going to be even stricter with the diet. Basically only sticking to foods that have 0 or very trace amounts of FODMAPs but I'm not feeling encouraged by the results so far which is why I'm finding myself looking for possible outside factors. I'll see how this week goes and I'm talking to my doctor again next week, but I think the next step might be a Gabapentin taper but I'm not sure how to approach. Do I open the capsules and try to weigh out the powder? I'm thinking I want to reduce by 50mg increments every 10 days or so, which would be about 2 months. It's a low enough dose to begin with that I'm hoping it won't give me much trouble. 

[fishinghat]

Most people weight out the powder. Just my humble opinion but I still think that is too fast a weaning process. Remember you are still highly effected by the Cymbalta withdrawal. A person needs to start a withdrawal from appoint of strength not weakness if possible.

[frog]

Do you recommend doing it more slowly or waiting longer before starting? 

[invalidusername]

Both... ideally.

[fishinghat]

Agreed

[frog]

I reached out to my psych NP just to cover my bases and asked if he thought it was possible that this could still be side effects from Cymbalta withdrawal or maybe being on gabapentin. I already knew the answer he was going to give based on all our previous interactions lol. He said he has never seen anyone have major GI side effects from gabapentin or from low-dose Cymbalta (not sure what he's referring to there? the 7 bead taper? when I asked this I was implying the original discontinuation last year). He did say he's been fielding a lot more complaints from patients about GI issues flaring up related to stress and anxiety. 

 

Of course given the awful timing of my recovery stress and anxiety seamlessly turning into pandemic stress and anxiety, it's hard to tell where one ends and one begins so he may be right. IBS is also known to flare up with stressful conditions but since I've been stressed for 7 months now, it's hard to pinpoint the exact cause.

 

I was keeping it together decently well for the last month or so but this week I've just been really depressed. I'm trying to just let myself cry and be upset and sad about everything but I also get worried that I'll just start getting worse and worse if I do that. 

 

Hope everyone else is doing well

[invalidusername]

Absolutely. Always difficult to pinpoint the cause.

 

But as my therapist has told me before, by worrying where it is coming from, you are amplifying the worry further. 

 

Stress begets stress my dear green one.

[Mxpro32]

I reached out to my psych NP just to cover my bases and asked if he thought it was possible that this could still be side effects from Cymbalta withdrawal or maybe being on gabapentin. I already knew the answer he was going to give based on all our previous interactions lol. He said he has never seen anyone have major GI side effects from gabapentin or from low-dose Cymbalta (not sure what he's referring to there? the 7 bead taper? when I asked this I was implying the original discontinuation last year). He did say he's been fielding a lot more complaints from patients about GI issues flaring up related to stress and anxiety. 

 

Of course given the awful timing of my recovery stress and anxiety seamlessly turning into pandemic stress and anxiety, it's hard to tell where one ends and one begins so he may be right. IBS is also known to flare up with stressful conditions but since I've been stressed for 7 months now, it's hard to pinpoint the exact cause.

 

I was keeping it together decently well for the last month or so but this week I've just been really depressed. I'm trying to just let myself cry and be upset and sad about everything but I also get worried that I'll just start getting worse and worse if I do that. 

 

Hope everyone else is doing well

 

I think surrender and feel is the way to go, but I understand what you mean when you worry about it just making things worse.  I go through periods where I'm depressed and cry a lot and it doesn't feel helpful, but other times it feels cathartic.  I think the key is to not ruminate on the negative thoughts, but let yourself feel whatever comes up.  I've been having strong emotional upwellings that result in happy tears, or uncontrollable laughter, with the occasional appropriate sadness crying.  Its intense, but I'll take it any day over the persistent depression and sad crying.  that said, I feel a little depression trying to creep in today.  I'm going to try and not worry or dwell on it and just let it be.  

[invalidusername]

" I'm going to try and not worry or dwell on it and just let it be. "

 

Right on.

[frog]

Hi team, 

Checking in on my own thread. 

I'm speaking to a dietitian on Wednesday to hopefully help me figure out more of my IBS triggers. I don't really think FODMAPs specifically are my problem because everything I read about them says FODMAPs are responsible for gas and bloating neither of which are the main source of my problem. I also haven't exactly seen a night and day difference since cutting them out weeks ago. I think whatever's bugging me might be a little more nuanced than just plain ol FODMAPs. Stay tuned.

 

The other update is that I decided to take this time working from home to make another attempt at dealing with the Seroquel. I'm going to have to come off it at some point, and if I'm going to have to potentially deal with sleep problems I'm better off doing it while I don't have to contend with commuting and being in an office all day on top of it. 

 

To recap I'm on 50mg nightly and last time I tried to drop by half a pill and didn't sleep for 2 nights. 

 

This time I'm going slower! I dropped by a quarter of a pill and took melatonin and... SUCCESS! I've done this for 3 nights in a row and fell asleep with no problem each night. The plan is to hold for 7-10 days and then drop another quarter pill. FDA says the half life of Seroquel is only 6 hours so I feel like it's safe to say that if I haven't had any issues after 3 nights, I doubt something new will pop up now?? 

 

Does this all make sense? 

 

The last question I had was regarding melatonin. I know our bodies naturally produce it anyway, but should I be concerned about my body getting dependent on the supplement? Do I need to take breaks every so often? 

[fishinghat]

Great plan for the Seroquel. I think you will make it this time.

[frog]

Thanks FH! Any thoughts about the melatonin?

[fishinghat]

Melatonin is fine. You build up resistance to it so every now an d then you need to take a break from it. Do not exceed 1 mg dose as it can interfere with sleep. The higher the dose the more it interferes.

[frog]

Ok perfect. I'll try to take a couple days off at the end of each taper phase. Fingers crossed I'm able to fall asleep without it by that point

[fishinghat]

on y6our days off the melatonin you can use Benadryl (diphenhydramine, 50 mg otc).

[frog]

A while back in like December probably when the insomnia first came up, I tried Benadryl one night and it seemingly made my heart pound so much that I couldn't fall asleep at all. I'm a tiny bit wary after that experience, although that was a different time of course. 

[fishinghat]

That is a common side effect for people who are sensitive to it so you should probably stay away from it.

[invalidusername]

Melatonin is fine. You build up resistance to it so every now an d then you need to take a break from it. Do not exceed 1 mg dose as it can interfere with sleep. The higher the dose the more it interferes.

 

Yes - and don't forget the depression that a lot of people get from slightly high doses, or too frequent...

[frog]

Couple of updates on my status:

 

Seroquel taper - so far so good! I did my second drop Saturday night so now I'm at 37.5mg. In the first drop I supplemented with melatonin for the first 6 nights and then took 3 nights off. I was nervous and the first night without it I had issues falling asleep, but coincidentally I was having a fair amount of anxiety that same evening so I think that played a role. The rest of the nights off were completely fine. Last night and tonight I'm back on melatonin for the new drop. I've had no issues falling asleep but I'm waking up feeling extremely unrested and tired. Not sure if that's the effect of the Seroquel itself or the drops. Fortunately I don't have to commute to work so it's not a huge issue. 

 

IBS - the FODMAP diet was pretty much a bust. I had some improvement but I think it was kind of coincidental because it was inconsistent. What has REALLY worked though was adding Citrucel (soluble fiber) supplements daily. I've seen improvement basically overnight. No more diarrhea at all, but now I'm leaning more toward the constipated side. I started with a tablespoon twice a day but that backed me up pretty quickly so I've backed off to half a tbsp twice a day. Going to give that a couple days to see if that balances things out. I'm speaking to a registered dietitian on Thursday hoping for some more guidance. I'm still getting very anxious around my gut and hypervigilant about every cramp, gurgle, etc. Hoping that goes away soon as things are getting better. 

[frog]

I think I may have spoken too soon. 

The past few days my resting anxiety has been steadily rising. I also have been waking up each morning feeling incredibly unrested and exhausted. Yesterday I went to the optometrist for an appointment and I was so wound up I was basically hyperventilating while I was sitting there filling out paperwork, just feeling like I wanted to run away. I stuck with it and made it through and felt a bit better toward the end but it was a crazy response. Today I was also feeling very anxious and restless, the anxiety felt worse than it has in a while. It's pretty unsettling especially after feeling like things had been improving bit by bit. The only thing I can possibly attribute to is the Seroquel taper? It seems hard to believe though since it's such a tiny dose. The most recent drop was Saturday night so this is the 4th day, the levels should definitely already be balanced out. Doesn't make a lot of sense..

[fishinghat]

The levels of Seroquel have balanced out but the nerves have become sensitive due to the withdrawal and have to have time to recover/ with Seroquel it usually takes a few weeks to recover. However fast you were dropping before you will need to drop slower in the future. I would suggest about half as fast.

[frog]

I gave the last drop about 9 days before moving on. I didn't have any issues with the last drop so I felt comfortable moving forward. 

Now I'm falling asleep fine but waking up earlier than I'd like and feeling more agitated when I do. I think the exhaustion from days in a row like this might be affecting the anxiety too. 

Do you think the sleep will improve again soon? Prior to this drop I was sleeping at least 8 hours a night and waking up feeling fairly relaxed

[fishinghat]

It will return. The exhaustion that occurs during a benzo withdrawal is usually called 'benzo fatigue' and is quite common.

 

Never mind. Senility again.

[frog]

Seroquel is not a benzo though, no?