Sertraline, stomach upset 3 weeks into higher dose. Anyone find it settled down?

[ShadesOfPemberley]

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DD went up to a higher dose of Sertraline almost 3 weeks ago. (75mg, she is 13 and has severe OCD)

Diarrohea (mild) started after about a week. She had a little of this when she first started on a lower dose so I thought it would settle.
Diarrohea in the last couple of days has been really bad. (Think her period is due too which may be an issue)

I know Sertraline acts on the gut but does anyone have experience of whether it eventually settles at these higher doses? The dose is starting to work for her psychologically so we REALLY don’t want to reduce if we can avoid it, life was intolerable before.

I assume 3 weeks into the new dose might be peak stomach upset as it really starts to kick in about that point? But then might it settle?

We have a meds review in a couple of weeks so will ask then but just wanted to get opinions and ideally reassurance!
huge thanks in advance

My DS was taken off Sertraline in his late teens due to D&V, it was so severe the GP said he probably wasn’t keeping enough down/in him for it to work. We had been warned about this side effect, and were prepared to ride it out. GP switched to Citalopram, which was much more gentle on stomach.

13 is very young for anxiety meds OP, so I hope you find something that suits. Perhaps ring the prescriber before the meds review, which might reassure you. We were told take at night with a snack. DS tried this, settled stomach very slightly, but the lucid dreams, almost hallucinating, were the final straw.

Thank you. V helpful to hear.

I’m not thrilled about the meds at her age but we have no choice 😔 she was simply not functioning without them.

Feeling pretty panicked about what might happen if we have to stop them tbh 😔 Good to hear you found an alternative but I don’t know if Citalopram is one that targets OCD? I will speak to psychiatrist when we see them soon.

Fairly normal in our experience. Shouldn't last long and Coke helps. Try to limit fibrous foods. Always take Sertraline with protein as it works better. My dc was put on it for severe ocd at 15, now on a much higher dose and it's been lifesaving. Good luck!

Oh that is a great tip! Interestingly she’s been having less protein than normal as one of her OCD fears is getting ill from undercooked chicken or meat. I will think of ways to maybe tackle the protein issue. She takes in the morning at the moment with a small breakfast of toast and marmite so not much there.

Did you find it improved after 3-4 weeks, Tiredpigeon or was it quicker than that? It’s just that it’s got really bad in the last 2 days, dashing to the bathroom-type bad 😳 which isn’t what happened 3 weeks after previous increases.

Citalopram and Sertraline are both SSRIs @ShadesOfPemberley , so work in the same way. Perhaps try adding protein like PP says, you can get protein shakes and bars if she is afraid of uncooked protein like chicken, good luck.

Citalopram worked within two weeks for DS, less anxious, full effect about a month later. I’m on Citalopram too, and works for me quickly.

Sertaline is very widely used in younger people, if they can tolerate it. Citalopram can cause a big dip in mood in under twenty five year olds. I’d try more protein, and speak to prescriber.

Thank you Middlemarch

Yoghurt or protein drinks at breakfast are worth a try. Her stomach should adjust but the jump to 75mg can be tough re side effects. We found you need at least 5 weeks after each dose increase for it all to calm down and the improvement start to be seen. The jumps after 75mg have all been much more manageable.

Also, well done Op, caring for a dc with ocd is unbelievably hard. Look after yourself, too.

Sorry, I didn't answer your question...the stomach issues only ever lasted around 4 or 5 days here but other side effects took longer to settle.

Thank you so much. Yes it’s horrendous in all honesty. Feel very guilty about the medication and worry about side effects the longer she uses it. But I don’t know what else we can do. Therapy is helpful but painfully slow. She’s just about clinging on at school but has missed so much. The Sertraline is really the only thing that dragged us out of months of hell so I’m just not sure what else we can do.

I know exactly how you feel, but Setraline is a godsend. It has been so helpful for my dc and really helps them engage with therapy. I expect them to be on it for years but we are all ok with that now, as it has made such a difference.

Mine settled after about 4 weeks. Side effects weren't fun!

Try not to worry about keeping her on medication if its working for her. Sertraline has been amazing for me, it's helped so much. I don't love the idea of staying on it but I think it's worth it for the improvement in my mental health.

Huge thanks. Glad it worked for you!!

Can you break the tablet in half and titrate slowly?