sericat: GI issues, histamine intolerance... a big mess...

[sericat]

I've made a huge mess of everything and I'm now in a bad state and not sure how to get out.

I came off venlafaxine 3 years ago. I experienced some symptoms withdrawing but I didn't want to go back on so tried to get through them. Insomnia, anxiety, depression, sensitivity to sound, suceptibility to stress.. They started to improve but after a year after a stressful event I began getting pain in my body, and tingling and burning pains in my limbs and down my spine. I then had a severe heartburn reaction to codeine for which I was put on ppis and amitryptiline for the pain. Cutting this all short... I tried coming off the ppi but the rebound made me go back on and I ended up being on them long term since then. I stopped amitryptiline as I felt it was making things worse for my digestion. I started getting a lot of bloating and constipation aswell. I had some investigations, I have a hiatal hernia and weak les. I thought I may have SIBO and saw a nutritionist, had positive test and then some negative ones, the question of what dysbiosis is going on or SIBO has got me caught up in that stuff for years. I have some weird reactions to some foods and creams, headaches, tight head, energy drain, tingling, weak legs, nerve pain. These neuro reactions are largely controlled by my restricted diet

I tried going on fluoxetine but it caused a heartburn reaction so I didn't continue. It was half the dose they gave me so probably 10mg. My digestive symptoms have just got worse and worse and I'm now on a lot of acid suppression. I tried reducing it several times and got the rebound so went back on. I started getting swallowing problems sometimes with pills getting stuck. I think I've gone about things quite badly. I'm clearly sensitive and now I am quite anxious of medications. My oesophagus appears to have become quite reactive, I get heartburn increase to a lot of supplements I have tried and to medications. I'm having a lot of problems with my digestive system and have now got to a very restrictive diet and its getting unmanageable and I'm under weight. I am waiting on test results to see if I have delayed gastric emptying. I don't seem to be getting very far with medical help and I've not got very far with nutritionists or a functional doctor so far.

 

I have been reluctant to try antidepressants again after trying the fluoxetine. I am scared they will make things worse. I have been suggested mirtazipine but I feel very reluctant to try this one. I was going to try citalopram but they said it has possible interaction with lansoprasole and famotidine so they steered me away from it. I have ended up not trying any and trying to go the natural route healing my gut but this is not getting very far.

 

Someone has suggested I look into MCAS and histamine intolerance. I think I may well have histamine intolerance predating coming off venlafaxine but flared up significantly when I came off... They have got better from theirs by taking some MCAS medications. I don't know if taking antidepressants help or make histamine intolerance worse.. I seem to be sensitive to many things. If I was to try antidepressants again should I try the one I came off 3 years ago, venlafaxine? Or is mirtazipine worth a go? I am concerned about the histamine element with mirtazipine and the side effects and possible difficulty coming off it. Should it be at a much smaller starting dose?

I have an appointment soon with my functional doctor who is also a GP and was going to ask about MCAS and histamine intolerance but maybe I just need to try the antidepressants again. Its basically my digestive issues that are the worst and the histamine intolerance and no idea how to improve it. I can't work or eat well enough.

 

[sericat]

😔

[Altostrata]

Welcome, @sericat

 

It seems you have had some bad experiences with antidepressants. But you also have some kind of gastrointestinal condition.

 

Which of your symptoms do you attribute to withdrawal?

 

If you want to reduce your PPI, you can do it slowly to prevent acid rebound, see Tips for tapering off stomach acid blockers or PPIs...

 

[sericat]

Hello altostrata

 

I only had IBS prior to coming off venlafaxine and it was very well managed.

 

Since coming off I have had insomnia, irritated senses - sensitive to sound, smell etc, anxiety, depression, suceptibility to stress. These were quite bad for a year. I then developed pain and nerve problems in my arms, neck and spine and legs. I had reactions to medications such as codeine and fluoxetine. The digestive issues started after a year of being off venlafaxine and was in reaction to taking codeine. 
 

I still have insomnia though it is not as severe as before, I sleep on average 5 hours a night. I used to sleep 8. My senses have calmed down. I still have the pain and the digestive issues just keep getting worse. I am sensitive to some medications and foods. I have tried tapering the ppi a few times but have been unable to. 

I don't know if my symptoms are due to the antidepressant or not. The sensitivity, insomnia etc certainly are. It feels like my body just does not work properly since being off them. I have been thinking it may be possible that being on/coming off the antidepressants has lead to sibo and mcas or just a sensitive nervous system which is causing the subsequent digestive and pain symptoms. Or else these conditions were prexisting and withdrawing from antidepressants and the stress has triggered them. 

 

[Altostrata]

Very possible making many drug changes and going on and off psychiatric drugs has caused adverse drug effects and rounds of withdrawal that may have destabilized your prior IBS condition.

 

Even if they've been exacerbated by withdrawal syndrome, we don't have any way to alleviate your IBS or SIBO or other gut issues.

 

It's a good sign that your sleep has improved and your hypersensitivities have calmed down some. We expect an arc of very gradual, often frustrating, recovery from adverse drug effects and withdrawal. See The Windows and Waves Pattern of Stabilization

 

If I were you, I might minimize drug switches and combinations, adding only one thing at a time to see what it does, and avoid psychiatric drugs altogether, no matter how much you're told they're miracle drugs.