Dealing with upset stomach from fluoxetine

[elgrego]

I was prescribed fluoxetine and been taking 20 mg every morning with food.After 4 weeks i do feel it helping me with increased energy and better mood.
The only bad side effect is i have a very upset stomach for the next 6-10 hours.A feeling between extreme anxiety indigestion ,nausea and having eaten something "not clean".I'have a scheduled visit with my doctor in 2 weeks but I'm hoping for for some improvement until then.
How can this be treated ? Antacids ? Proton pump inhibitors ? Ginger ?

What causes this feeling ? Is the production of stomach acid/enzymes inhibited by fluoxetine ?

Thanks for any help

 

[Kittycat5]

The GI side effects of fluoxetine, like its intended effect, are related to serotonin. Both the brain and GI tract have serotonin receptors that when activated can lead to all your symptoms.

For most people these adverse reactions will abate on their own in a few weeks. You are on week four, but still may be a bit premature to see if they will resolve spontaneously. Give it 2 more weeks if you can.

I am assuming, however, that they are not something you want to wait a couple more weeks with no relief. These side effects are dose dependent. One solution may be simply reducing the dose to one that works but limits the side effects. This is obviously easier said than done.

As far as pharmacological options, ondansetron (Zofran) would be your best bet. It blocks the receptors in both CNS and GI tract that can lead to nausea, vomitting, and dyspepsia. If you cannot get a prescription for this otc options such as Pepto-Bismal or Emetrol may work. Ginger may be useful as well.

 

[Keif' Richards]

Ondansetron (Zofran) does work like a charm in preventing nausea and emesis. As far as prescription options go, it's probably the gold standard although you might benefit from something like Promethazine (Phenergan) as well. Everyone is different.

I've been going through a nasty Methadone withdrawal recently and discovered something that I've never tried before called "Nauzene". It comes both in liquid, I believe and in pills that are basically like Tums in appearance. The active ingredients are Sodium Citrate/Dextrose/Fructose. They also start working in less than 10 minutes and aren't likely to interact in any significant way with other medications, although it's always best to verify.

 

[Kittycat5]

Ahh, sorry Keif for what you going through. Hang in there my friend. Nauzene and Emetrol are nearly the same and you are correct in saying the chance of a drug-drug interaction is slim.

 

[elgrego]

Thank you for your answers.
I have a history of peptic ulcer/internal bleeding.Is this feeling I get just a feeling or does fluoxetine actually increase the possibility of internal bleeding ? It feels just the same and this worries me a lot.
I had the very same (if not worse) feeling from venlafaxine a few years back which I stopped using because unlike fluoxetine It made my stomach feel sick but didn't make me feel generally better and more energetic.
I'll try ginger and ondasetron.