<<Disclaimer: Verify this information before applying it to your situation.>>
Hi all - Not trying to spam the list - just trying to tie up all my summary
obligations! :) Here's what I got back from folks about Paxil and SSRIs. I
did talk to someone at SmithKline Beecham a few minutes ago
(1-800-366-8900) and the starch in Paxil is either corn or potato starch -
not wheat starch. BUT - the rep did mention the possibility of
cross-contamination during manufacturing.
If I remember my reading on serontonin correctly, serotonin has a
significant impact on the digestive system, and based on a perusal of
www.mayohealth.org, diarrhea is a rare side-effect of Paxil. So it's off to
my GI for a bit of help with this.
Thanks much to everyone who responded - I haven't been able to respond
individually, as I was a bit overwhelmed!
Chris Silker
Plymouth MN
I'm taking 20 mg Paxil per day, to control migraines. No problems here,
and I called the pharmacist who works with our group, checking out meds.
Steve said it's ok, so I don't worry. And it _does_ work for my migraines!
Evidently it breaks the cycles... thank heavens, 'cause Imitrex and Midrin
quit working quite a while ago. I don't know about any other SSRI's out
there; hope you are able to find one that works (stick with it, though; it
takes a few weeks for enough receptors to make a difference).
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First, I should start by saying that gastrointestinal upset can be a
side-effect for anyone taking SSRIs. Secondly, there are a few issues re:
Paxil that might affect celiacs.
Several weeks ago I called SmithKline Beecham in Canada to enquire about
the source of the sodium starch glycolate in Paxil. A lady from Medical
Information told me that the sodium starch glycolate in Paxil is obtained
from another supplier (food industry??) and that this starch can be derived
from either corn or wheat - it varies. The supplier has assured SmithKline
Beecham that the manufacturing process they use eliminates the gluten. To
make a long story short, I questioned that if the starch was derived from
wheat, how could the supplier guarantee that the sodium starch glycolate
was gluten-free.
Paxil is converted to a sulphate metabolite in the body when Paxil is
taken. I only mention this as some celiacs seem to have a problem handling
sulphates.
Alternatives to paxil (as selective serotonin reuptake inhibitors) include:
Zoloft (Sertraline): contains cornstarch and lactose
Prozac: the starch used in the capsules is cornstarch; Prozac liquid
contains no starch and no lactose [this information I received about a
month ago from Vera in Medical Informmation at Lilly Canada (she had gotten
the information from Lilly headquarters in the US). She also made the
comment that they welcome all inquiries as to specific food intolerances as
this is a basis for Lilly to determine important health concerns]. I would
take this to apply to other drug companies also.
*The above is information I have received from the different pharmaceutical
companies involved so I would urge you to call them to verify this. Don't
know if this will help you, but the toll-free number of Pfizer (Paxil
manufacturer) in Canada is 1-800-463-6001. The CPS (Compendium of
Pharmaceutical Specialties) in Canada provides a list of pharmaceutical
manufacturers that do not use gluten. There is a rider which states that
traces of gluten may be present in the raw materials obtained from other
suppliers. In my estimation, we have come back full circle to the food
industry if there is wheat contamination in a product certified to be
gluten-free. There's a number of food intolerances that don't receive the
recognition that we enjoy. I know it isn't perfect, but at least the
requirements set out by the CPS provides a guideline for us to go by.
It's important for you to know that some patients experience physical
symptoms following discontinuation of treatment, so if there is ANY chance
your doctor suggests discontining this drug, it may be advisable to do so
gradually. Ask your doctor. Also, the washout period of switching from one
selective serotonin reuptake inhibitor to another has not been established.
You already know that it will probably take a few weeks or more to get the
full benefits of any SSRI and that you might have to suffer through the
same symptoms you did when you first started taking Paxil by switching to
another SSRI.
I don't know if you are into naturopathic medicines, but just in
case.....It is not advisable to take tryptophan if you are taking SSRIs.
Doing so may cause very severe symptoms of serotonin-associated side
effects of which you already aware of. The literature also advises that
St. John's Wort (SJW), just like tryptophan, should not be used if you are
on anti-depressant medication.
------
I contacted the manufacturer of Paxil, and found that although they list it
as gluten-free, they use wheat starch as a non-medical ingredient. As soon
as I stopped taking the Paxil, I stopped having chronic abdominal pain and
diarrhea that has been with me for the last year or so. I had taken Paxil
for 3 years, so it is a little odd that I only started reacting to it in
the last year.... a change of supplier, perhaps? Anyway, I switched to
Zoloft, after some research, but I am finding some gastro problems with
it.... this time the problem is constipation. I hope that is helpful.
---------
Hi, yes I do take Paxil, I have taken it for about 1 and a half years. I
have recently developed digestive problems. I have had a negative biopsy
for Sprue, but have been researching it heavily and strongly believe I have
sprue. I have been going wheat free for almost 2 weeks and have noticed a
strong improvement in how I feel. Please let me know anything you know
about any relationship between paxil and sprue!
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I've been using Paxil for a year with no discernible problems either now
or before I was diagnosed with celiac, three months ago.
-----------
Maybe Stokes Pharmacy could research this for you if you give them the
brand name...their contact info is:
phone-800-754-5222
fax-800-440-5899
internet-www.stokesrx.com
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I have been on Zoloft for a bout a year , felt I needed it, and then was dx
with Celiac. I felt so good on the GF diet (since January) that I went off
the Zoloft becasue I was CONSTANTLY getting reactions to it. It was the
most obvious thing to trace back to. It was almost immediate. I woudl
like to be back on the Zoloft, as I have a long family historyof
depression, and depression is spiraling in on me again... But I cannot
deal with the idea of constantly beig contaminated. I would like to find a
way to have it custom compuonded, but the pharmacist here in West Michigan
who is the expert on custom compounding has never done it. does your Paxil
have to be specially formulated? Thanks any info would be wonderful.
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I have had no trouble with paxil. I have been on it for about 1 year. I
take it for my fibromyalgia. The only side effect that is troublesome for
me is sexual disfunction. I am only taking it 5 days per week, which helps
with fuctioning on the two off days. Hope this helps.
---------
I took several SSRis before I was diagnosed and they all made me a maniac,
rapid heartbeat, headache, arms that felt like they were going to explode,
diahrrea, dry heaves,a feeling of going crazy. I actually rolled around on
the floor after taking Zoloft. I cannot tolerate any form of
antidepressant, even St. John's W ort, which made me so tired that I could
hardly wake up. I don't know if this helps you, but I thought I would
reply. They do have a lot of side effects, which, of course, everyone does
not get.
You should check with your doctor or pharmacist. Most antidepressants are
known to have digestive
------------
Zoloft appears to be g-f, and I didn't check Prozac, as they don't make it
in small enough doses for me.
------------
i have taken paxil for the last year and a half and have not noticed any
problems with it.
----------
I've been taking Paxil for several months now, and it definitely is g-f. I
don't know about digestion being speeded up, but I lost 5 pounds after
starting Paxil.
--------
I started on Paxil for sleep disturbance about 8 months ago. I had no
gastrointestinal effects and checked that it is GF.
----------
Forgot to mention in my other reply one of the reasons I went off of it is
that I believed it contributed to weight gain.
---------
I hope that you will be summarizing your responses. I tried taking Serzone
last fall and had a HORRIBLE reaction to it. I was having mild allergy and
GI symptoms (including the most putrid gas) for about 1 1/2 weeks. My doctor
insisted these were normal side effects and adamantly told me to stay on it
and my body would become used to the drug. A few days later, I had a full
blown allergic reaction including hives all over my body, asthma attack and
throat beginning to swell. I may just be allergic to the actual drug, but I
wonder if anyone else has tried Serzone and reacted. (I am both a celiac and
allergic to wheat, rye, barley and milk.) I am still suffering with
depression, but I have been quite reluctant to try another antidepressant.
-----------
Ive been on zoloft for a couple of years and have experienced no
gastrointestinal problems.
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