Antidepressant/anti anxiety medication least likely to have nausea as a side effect

[JustForTheTasteOfItDC]

I'm finally going to the GP to discuss starting some medication for my mental health. I've had OCD/emetophobia for years with anxiety at times, and at the moment I feel completely flat. I recently had a breast lump that I needed to get checked out and my thinking around it was not worrying that I was going to die and leave my children without a mum, it was more a sense of relief that my life would be over. I am not suicidal, and I wouldn't even say I'm depressed, but I can't keep living like this.

I am really anxious about starting any kind of medication because so many of them have nausea/vomiting as a side effect, and as an emetophobe, I genuinely don't think I can cope with that. I know some other types of medication are less likely to have nausea as a side effect but are more likely to cause weight gain, and as someone who has been anorexic in the past, that's a pretty difficult side effect for me to manage too.

I know that no medication is side effect free, but wondered if people have got experiences of these types of medications and not experienced nausea with them?

I used to take mine before bed and never had any side effects or if I did I slept through them!

Thanks @BeMintBee . Which one did you take?

Venlafaxine gave me no side effects (started beginning of this year).

I took citalopram. I don’t remember any side effects other than being a bit drowsy for the first couple of weeks.

Did you notice any weight gain with this one?

I have emetophobia and have been on a huge variety of anti depressants and anti anxiety meds over the past 24 years. None of them have ever made me feel sick or vomit.
From memory I have taken fluoxetine, mirtazaline, olanzipine, venlafaxine, escitalopram, lorazepam, aripiprazole, lamotrigine, diazepam, propanalol, sertraline
There will be others but these are all I can remember at the moment.

@JustForTheTasteOfItDC no weight gain

Thanks @Mittens67

Which did you find most helpful?

I'm a therapist op and I've never heard a patient say a new anti depressant has made them vomit, feel sick yea but not vomit. I think as long as you start on a small dose and work up slowly you'll be totally fine. About of drs like to start on either sertraline, fluoxetine or citalopram. Citalopram seems to be a good introduction one from what patients say

Escitalopram and lorazepam probably most helpful.
Mirtazapine and olanzapine made me gain stones of weight. The others were much of a muchness.

Venlafaxine made me very nauseous for the first week and if I didn't take it at exactly the same time every day, it has a very short half-life. It is however an extremely effective drug and if your anxiety is crippling, I would recommend it. I went from not being able to leave the house, to functioning fairly normally. It literally wipes out any emotional response.

Of all the meds that I took over some twenty or so years, it is the one that worked best.

Thanks @WhatMe123 I struggle with nausea too - it’s like I completely shut down and can’t function at all. Part of me thinks maybe having nausea that I know doesn’t have an infective cause might help me to get over it, or at least learn to be less afraid of it, but the other part of me is completely horrified by even entertaining that thought.

Ask for some cyclizine or similar to be prescribed at the same time? You don't have to take it, but it might help you to have it there. They were happy to do that for me when I was in a similar position to you (anxiety and severe emetophobia).

Yes that’s a good idea. What medication were you prescribed (not the cyclizine - the other one)? Did it help?

Thank you. Are you still taking it or have you stopped now? If you’ve stopped, did you have any problems coming off it?

I've taken fluoxetine before with no side-effects.

@JustForTheTasteOfItDC I no longer take any meds. Turns out all I needed was a divorce.

Coming off needs management. It takes time but is fairly easy if you are consistent. The capsules contain tiny pills, so you can just twist them open and remove one tiny pill every few weeks and drop the dose really slowly. (Dr told me to do this).

I timed stopping entirely for when I was on holiday so that I could just do nothing if need be. It was fine in the end. Probably took me about a year and a half, but I was on the max dose of 375 mg.

Sertraline given, and agreed to give an anti emetic too - metoclopramide.

I'll start after the weekend as I've got a 4 day conference that I'd rather not feel crappy for!