Table of ContentsView AllTable of ContentsCausesAntidepressant WithdrawalAntidepressants That Cause NauseaMinimizing NauseaDrug Tapering Strategies
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Table of Contents
Causes
Antidepressant Withdrawal
Antidepressants That Cause Nausea
Minimizing Nausea
Drug Tapering Strategies
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Antidepressants can provide relief from depression, anxiety, and other mental health conditions, but they can also cause side effects—which can include feeling sick to your stomach. Nausea and vomiting are two of the more common side effects of antidepressants, and it may take some time to get over these symptoms when first starting treatment.
In fact, nausea is often cited as the number one side effect ofselective serotonin reuptake inhibitors (SSRIs)used to treat major depression andanxiety disorders.In some cases, nausea and vomiting can become so severe or persistent that a person has no other option but to stop treatment.
Do not stop taking your antidepressant without talking to your doctor first. Suddenly stopping your medication can lead to withdrawal symptoms or a relapse of your condition. Instead, discuss your options with your provider, which may include tapering your dose or switching to a different medication.
Verywell / Brianna Gilmartin
Why Antidepressants Can Cause Nausea?
Nausea and vomiting are common side effects of many drugs. These symptoms are more often due to the effect a drug has on thecentral nervous system (CNS)rather than any toxic effect it has on the stomach or gastrointestinal tract (GI tract).
When serotonin levels increase under the influence of SSRIs, they stimulate serotonin receptors in the GI tract as well as the brain. The combined stimulatory effect—on both the GI tract and CNS—can trigger such side effects as:
When to Call Your DoctorCall your doctor if you experience persistent vomiting for more than 24 hours and have signs of moderate dehydration, or if vomiting and diarrhea are both present.
When to Call Your Doctor
Call your doctor if you experience persistent vomiting for more than 24 hours and have signs of moderate dehydration, or if vomiting and diarrhea are both present.
Nausea During Antidepressant Withdrawal
Antidepressants can also cause nausea and vomiting when treatment is stopped too suddenly. Known asantidepressant discontinuation syndrome(or simply antidepressant withdrawal), the condition can cause an array of symptoms if the body is suddenly deprived of the drug. Gastrointestinal symptoms are among the most common and potentially severe.
Antidepressant withdrawal symptoms can sometimes persist for several weeks and even lead to rebound depression (in which depressive symptoms return, sometimes worse than before).
In addition to nausea and vomiting, antidepressant withdrawal can cause the following:
People who have taken antidepressants for longer than six weeks are more likely to experience withdrawal unless the daily dose is gradually tapered.
How to Cope With Withdrawal Nausea
Types of Antidepressants That Can Cause Nausea
Nausea and vomiting doesn’t only occur with SSRIs. The symptoms are also common with other classes of antidepressants, albeit less commonly or profoundly, including:
Nausea and vomiting are less common with a class of antidepressants known asmonoamine oxidase inhibitors (MAOIs).
Minimizing Antidepressant Nausea
In most cases, nausea and vomiting will develop soon after treatment is started and gradually resolve within one to two weeks once the body adapts to the medication. However, according to some research, as many as 32% of people taking an SSRI will continue to experience GI symptoms for up to three months.
Fortunately, there are things you can do to minimize these symptoms:
While proton pump inhibitors like Prilosec (omeprazole) may help, they can sometimes increase the concentration of certain antidepressants in your blood. They may require a dose adjustment to avoid new or worsening side effects. Talk to your doctor before taking this or any other medication if you are taking an antidepressant.
If your nausea or vomiting becomes intolerable, your doctor may have no other choice but to change treatment to another antidepressant with a lower nausea risk.
To reduce the risk of withdrawal symptoms when stopping an antidepressant, speak with your doctor about the appropriatetapering strategy. Going “cold turkey” is never advised and may end up triggering the very symptoms you were being treated for.
As a general rule, the longer you’ve been on antidepressants, the longer and slower the tapering period will be. Some people can be tapered off in a matter of weeks; others may take months.
Paxil (Paroxetine)
Celexa (Citalopram)
Lexapro (Escitalopram)
Prozac (Fluoxetine)
Zoloft (Sertraline)
Tapering should always be done under the supervision of a doctor. In some cases, tapering may require altering doses if an interim dose is not available. (For example, you may need to take 40mg one day and 20mg the next if a 30mg pill is not available.)
Unless otherwise directed, never cut an antidepressant in half as this may affect the speed in which it is absorbed and may trigger side effects. Call your doctor immediately if you experience any signs of withdrawal.
Takeaways
If your nausea is severe, talk to your doctor. In some cases, you may need to adjust your dose or switch to a different medication. However, you should only change your dose or stop taking your antidepressant under the supervision of your doctor.
Tips for Antidepressant Withdrawal Relief
6 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Carvalho A, Sharma M, Brunoni A, Vieta E, Fava G.The safety, tolerability and risks associated with the use of newer generation antidepressant drugs: A critical review of the literature.Psychother Psychosom. 2016;85:270-288. doi:10.1159/000447034Singh P, Yoon SS, Kuo B.Nausea: A review of pathophysiology and therapeutics.Therap Adv Gastroenterol. 2016;9(1):98-112. doi:10.1177/1756283X15618131Berwian IM, Walter H, Seifritz E, Huys QJ.Predicting relapse after antidepressant withdrawal - a systematic review.Psychol Med. 2017;47(3):426-437. doi:10.1017/S0033291716002580Kelly K, Posternak M, Alpert JE.Toward achieving optimal response: Understanding and managing antidepressant side effects.Dialogues Clin Neurosci. 2008;10(4):409-18.Canziani BC, Uestuener P, Fossali EF, et al.Clinical practice: Nausea and vomiting in acute gastroenteritis: physiopathology and management.Eur J Pediatr. 2018;177(1):1-5. doi:10.1007/s00431-017-3006-9Keks N, Hope J, Keogh S.Switching and stopping antidepressants.Aust Prescr. 2016;39(3):76-83. doi:10.18773/austprescr.2016.039Additional ReadingGjestad C, Westin AA, Skogvoll E, Spigset O.Effect of proton pump inhibitors on the serum concentrations of the selective serotonin reuptake inhibitors citalopram, escitalopram, and sertraline.Ther Drug Monit. 2015;37(1):90-7. doi:10.1097/FTD.0000000000000101Renoir T.Selective serotonin reuptake inhibitor antidepressant treatment discontinuation syndrome: A review of the clinical evidence and the possible mechanisms involved.Front Pharmacol. 2013;4:45. doi:10.3389/fphar.2013.00045
6 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Carvalho A, Sharma M, Brunoni A, Vieta E, Fava G.The safety, tolerability and risks associated with the use of newer generation antidepressant drugs: A critical review of the literature.Psychother Psychosom. 2016;85:270-288. doi:10.1159/000447034Singh P, Yoon SS, Kuo B.Nausea: A review of pathophysiology and therapeutics.Therap Adv Gastroenterol. 2016;9(1):98-112. doi:10.1177/1756283X15618131Berwian IM, Walter H, Seifritz E, Huys QJ.Predicting relapse after antidepressant withdrawal - a systematic review.Psychol Med. 2017;47(3):426-437. doi:10.1017/S0033291716002580Kelly K, Posternak M, Alpert JE.Toward achieving optimal response: Understanding and managing antidepressant side effects.Dialogues Clin Neurosci. 2008;10(4):409-18.Canziani BC, Uestuener P, Fossali EF, et al.Clinical practice: Nausea and vomiting in acute gastroenteritis: physiopathology and management.Eur J Pediatr. 2018;177(1):1-5. doi:10.1007/s00431-017-3006-9Keks N, Hope J, Keogh S.Switching and stopping antidepressants.Aust Prescr. 2016;39(3):76-83. doi:10.18773/austprescr.2016.039Additional ReadingGjestad C, Westin AA, Skogvoll E, Spigset O.Effect of proton pump inhibitors on the serum concentrations of the selective serotonin reuptake inhibitors citalopram, escitalopram, and sertraline.Ther Drug Monit. 2015;37(1):90-7. doi:10.1097/FTD.0000000000000101Renoir T.Selective serotonin reuptake inhibitor antidepressant treatment discontinuation syndrome: A review of the clinical evidence and the possible mechanisms involved.Front Pharmacol. 2013;4:45. doi:10.3389/fphar.2013.00045
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Carvalho A, Sharma M, Brunoni A, Vieta E, Fava G.The safety, tolerability and risks associated with the use of newer generation antidepressant drugs: A critical review of the literature.Psychother Psychosom. 2016;85:270-288. doi:10.1159/000447034Singh P, Yoon SS, Kuo B.Nausea: A review of pathophysiology and therapeutics.Therap Adv Gastroenterol. 2016;9(1):98-112. doi:10.1177/1756283X15618131Berwian IM, Walter H, Seifritz E, Huys QJ.Predicting relapse after antidepressant withdrawal - a systematic review.Psychol Med. 2017;47(3):426-437. doi:10.1017/S0033291716002580Kelly K, Posternak M, Alpert JE.Toward achieving optimal response: Understanding and managing antidepressant side effects.Dialogues Clin Neurosci. 2008;10(4):409-18.Canziani BC, Uestuener P, Fossali EF, et al.Clinical practice: Nausea and vomiting in acute gastroenteritis: physiopathology and management.Eur J Pediatr. 2018;177(1):1-5. doi:10.1007/s00431-017-3006-9Keks N, Hope J, Keogh S.Switching and stopping antidepressants.Aust Prescr. 2016;39(3):76-83. doi:10.18773/austprescr.2016.039
Carvalho A, Sharma M, Brunoni A, Vieta E, Fava G.The safety, tolerability and risks associated with the use of newer generation antidepressant drugs: A critical review of the literature.Psychother Psychosom. 2016;85:270-288. doi:10.1159/000447034
Singh P, Yoon SS, Kuo B.Nausea: A review of pathophysiology and therapeutics.Therap Adv Gastroenterol. 2016;9(1):98-112. doi:10.1177/1756283X15618131
Berwian IM, Walter H, Seifritz E, Huys QJ.Predicting relapse after antidepressant withdrawal - a systematic review.Psychol Med. 2017;47(3):426-437. doi:10.1017/S0033291716002580
Kelly K, Posternak M, Alpert JE.Toward achieving optimal response: Understanding and managing antidepressant side effects.Dialogues Clin Neurosci. 2008;10(4):409-18.
Canziani BC, Uestuener P, Fossali EF, et al.Clinical practice: Nausea and vomiting in acute gastroenteritis: physiopathology and management.Eur J Pediatr. 2018;177(1):1-5. doi:10.1007/s00431-017-3006-9
Keks N, Hope J, Keogh S.Switching and stopping antidepressants.Aust Prescr. 2016;39(3):76-83. doi:10.18773/austprescr.2016.039
Gjestad C, Westin AA, Skogvoll E, Spigset O.Effect of proton pump inhibitors on the serum concentrations of the selective serotonin reuptake inhibitors citalopram, escitalopram, and sertraline.Ther Drug Monit. 2015;37(1):90-7. doi:10.1097/FTD.0000000000000101Renoir T.Selective serotonin reuptake inhibitor antidepressant treatment discontinuation syndrome: A review of the clinical evidence and the possible mechanisms involved.Front Pharmacol. 2013;4:45. doi:10.3389/fphar.2013.00045
Gjestad C, Westin AA, Skogvoll E, Spigset O.Effect of proton pump inhibitors on the serum concentrations of the selective serotonin reuptake inhibitors citalopram, escitalopram, and sertraline.Ther Drug Monit. 2015;37(1):90-7. doi:10.1097/FTD.0000000000000101
Renoir T.Selective serotonin reuptake inhibitor antidepressant treatment discontinuation syndrome: A review of the clinical evidence and the possible mechanisms involved.Front Pharmacol. 2013;4:45. doi:10.3389/fphar.2013.00045
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