Side Effects of Anxiety Medications and Gastrointestinal Treatments - Gastroenterology and Hepatology

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I would like to ask the doctor, I am currently taking an anti-anxiety medication (Cymbalta) and during a visit to the gastroenterologist last week, I was diagnosed with mild gastroesophageal reflux disease.
The doctor prescribed "Esomeprazole" to be taken on an empty stomach before breakfast.
Initially, I had no issues for the first week, but over the past three days, I suddenly started experiencing severe diarrhea, similar to the side effects of taking antibiotics.
Is this a normal side effect?

Han, 20~29 year old female. Ask Date: 2023/10/25

Dr. Chen Shidian reply Gastroenterology and Hepatology


Medication can be discontinued for observation; if improvement occurs, the medication can be restarted.
If diarrhea recurs, consider switching to a different medication.

Reply Date: 2023/10/25

More Info


When it comes to understanding the side effects of anxiety medications and gastrointestinal treatments, it's essential to consider both the medications you are taking and the symptoms you are experiencing. In your case, you are currently on an anxiety medication known as "Sinzac" (which is commonly known as venlafaxine or Effexor) and have been prescribed "逸潰錠" (which is likely a proton pump inhibitor or similar medication for gastroesophageal reflux disease, GERD).
Firstly, let's discuss the potential side effects of Sinzac (venlafaxine). This medication is primarily used to treat depression and anxiety disorders. Common side effects include nausea, dizziness, insomnia, and gastrointestinal disturbances such as diarrhea or constipation. The gastrointestinal side effects can sometimes mimic those caused by antibiotics, particularly if the medication affects gut motility or alters gut flora.
In your situation, experiencing diarrhea after starting the new medication could be a side effect of either the Sinzac or the "逸潰錠." Proton pump inhibitors (PPIs) can also lead to gastrointestinal side effects, including diarrhea, especially if they disrupt the natural balance of stomach acid and gut bacteria. It's worth noting that while diarrhea can be a common side effect, if it becomes severe or persistent, it is crucial to consult your healthcare provider to rule out any other underlying issues or to adjust your medication regimen.

Moreover, the interaction between your anxiety medication and the gastrointestinal treatment should be considered. While there is generally no direct interaction between venlafaxine and PPIs, individual responses to medications can vary significantly. If you are experiencing new or worsening symptoms after starting a new medication, it is essential to communicate this with your healthcare provider. They may need to evaluate your current treatment plan and consider alternative medications or additional interventions to manage your symptoms effectively.

In addition to medication side effects, it's also important to consider lifestyle factors that may contribute to gastrointestinal issues. Stress and anxiety can exacerbate digestive problems, leading to symptoms like diarrhea, bloating, and discomfort. Engaging in stress-reducing activities, such as mindfulness, yoga, or regular exercise, may help alleviate some of the gastrointestinal symptoms you are experiencing.

In summary, while experiencing diarrhea after starting a new medication can be a common side effect, it is essential to monitor the severity and duration of your symptoms. If the diarrhea persists or worsens, or if you experience any other concerning symptoms, please reach out to your healthcare provider for further evaluation. They can help determine whether your current medications are the cause and suggest appropriate adjustments or treatments to improve your overall health and well-being. Always remember that open communication with your healthcare team is vital in managing your medications and any side effects effectively.

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