<<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). --------------------- 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! ----------- 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 ------- 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. ---------- 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.