Which antidepressants cause gastroparesis?

When it comes to antidepressants, there are many different things that people worry about. Will it work? Can I afford it? Is it going to make me gain weight? One thing that doesn’t get talked about as much is whether or not a specific medication can cause gastroparesis.

This condition occurs when your stomach takes too long to empty its contents into the small intestine. Symptoms include feeling full after eating just a few bites, nausea and vomiting, bloating and abdominal pain.

So which antidepressants are more likely than others to cause gastroparesis?

First let’s talk about what causes gastroparesis

Gastroparesis can be caused by several factors such as:

  • Damage to the vagus nerve
  • Medications like opiods or anticholinergics
  • Some autoimmune disorders such as lupus or scleroderma
  • Parkinson’s disease

What types of antidepressant medications can lead to this problem?

There have been reported cases where all classes of drugs used for depression management could potentially result in delayed gastric emptying. The following three major groups stand out though:

Tricyclic Antidepressants (TCAs)

These drugs assist communication between brain cells by affecting certain neurotransmitters’ levels in the brain. They’ve been utilized since 1950s but due their high anti-cholinergic1 effects they’re becoming less popular now.

Some TCAs include:

Name Anti-Cholinergic Rating
Amitriptyline (Elavil) Very High
Imipramine (Tofranil) Moderate-High
Nortriptyline (Pamelor) Moderate

Amongst these Amitriptyline happens to also impair serotonin metabolism which leads frequent attacks hence weren’t you warned before that too much serotonin can never be a good thing ?

Selective Serotonin Reuptake Inhibitors (SSRIs)

These medications are relatively new and generally very effective against depression. If you’ve heard of Prozac, Zoloft or Paxil then you’ve also heard of SSRIs.

Some SSRIs include:

Name Anti-Cholinergic Rating
Fluoxetine (Prozac) None
Citalopram (Celexa) Very Low-Moderate
Paroxetine (Paxil) Moderate

While SSRI’s may have less negative side effects compared to TCAs / Monoamine oxidase inhibitors2 but they still have the ability cause stomach problems in some users.

Monoamine Oxidase Inhibitors (MAOIs)

MAOI refers to any drug group that inhibits activity of monoamine oxidases, an enzyme responsible for breaking down monoamines neurotransmitters such as dopamine and serotonin. The use these drugs became more restricted during 2000s however they’re used when other antidepressants don’t work.

Some MAOIs include:

Name Anti-Cholinergic Rating
Generics Moderate-high
Phenelzine-Nardil High

Conclusion

In conclusion, it’s important to understand the potential side-effects associated with all forms of medication related therapy. While gastroparesis is not one that everyone talks about constantly like weight gain or loss people should still treat it with same level of concern especially those who suffer from GI issues already.

When choosing between multiple classes ensure doctor prescribes them based on individual cases rather than personal interactions3 in order reduce chances developing this problematic condition.

1 Acetylcholine receptor blocking chemical
2 Class consisting both non-selective and selective inhibitors
3 Genetic factors among many others

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