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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Massive Nausea And Depression While On Aropax?

I have been on Aropax for 14 years and it has nearly always worked very well, just a few relapses. Due to increased stresses in my life and a longer relapse than normal, my GP has increased my dose from 40 mg to 60 mg but I m doing this gradually. 2 weeks on 5 mg, then another 5 for a week and another 5 the following week. Still 5 mg to go...but I m feeling much worse. Am I doing this to quickly? I have massive agitation, nausea, depression etc. Although I recall this happening in the past, I just want some re-assurance. I know it also takes time to really kick in, approx 4 - 8 weeks? Longer? Thanks.
Mon, 26 Mar 2018
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General & Family Physician 's  Response
Hello,

SSRI antidepressants are the first line of treatment and therefore you are receiving the right care. Nausea is the most common side effect of SSRIs! Usually, it appears at the start of treatment, it is related to dose (as in your case) and usually is temporary.

You are doing the right thing to apply the gradual increasing of the medicament dose because it is the general recommendation in these cases. In order to reduce the risk of nausea, you can also try to take the medicine with food.

Because you are concerned about massive nausea, you can also use an antiemetic (anti-nausea) drug for a short period of time. Other side effects include an increase in anxiety, suicidal thoughts and reduce of libido and sexual desire, all symptoms of depression. However, they are present only in the first weeks of treatment start (does increase in your case) and should resolve in the long run.

The effects of the new dose should be visible in 4-8 weeks but sometimes several months are needed for the full benefiting effects to be settled. So, please be patient! Also, please be vigilant for the so-called "serotonin syndrome", which is very likely when using SSRIs. Symptoms include shivering, sweating, tremor, diarrhea, and in such cases, you have to contact immediately your doctor.



Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Ervin Toçi
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What Causes Massive Nausea And Depression While On Aropax?

Hello, SSRI antidepressants are the first line of treatment and therefore you are receiving the right care. Nausea is the most common side effect of SSRIs! Usually, it appears at the start of treatment, it is related to dose (as in your case) and usually is temporary. You are doing the right thing to apply the gradual increasing of the medicament dose because it is the general recommendation in these cases. In order to reduce the risk of nausea, you can also try to take the medicine with food. Because you are concerned about massive nausea, you can also use an antiemetic (anti-nausea) drug for a short period of time. Other side effects include an increase in anxiety, suicidal thoughts and reduce of libido and sexual desire, all symptoms of depression. However, they are present only in the first weeks of treatment start (does increase in your case) and should resolve in the long run. The effects of the new dose should be visible in 4-8 weeks but sometimes several months are needed for the full benefiting effects to be settled. So, please be patient! Also, please be vigilant for the so-called serotonin syndrome , which is very likely when using SSRIs. Symptoms include shivering, sweating, tremor, diarrhea, and in such cases, you have to contact immediately your doctor. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ervin Toçi