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Gastric Issues
Hello Doctor,
I have been taking Paroxetine CR 12.5 mg at night for the past 3 months for anxiety and mild depression. Mentally, I am feeling much better.
However, I am facing some issues:
* Irregular bowel movements: frequent loose or semi-loose stools, sometimes normal. Urge to pass stool after eating.
* Anal itching/discomfort: constant itching and irritation in the anal area.
* Daytime drowsiness: difficulty waking up before 10–11 AM even after adequate sleep.
* Weight gain over the past few weeks.
I have attached a stool image for reference.
My questions:
1. Are these side effects of Paroxetine?
2. Should I change dose/timing or switch medicine?
3. Can I take probiotics for gut health?
4. Do I need any tests?
5. How to manage drowsiness and weight gain?
Please suggest treatment or lifestyle changes.
Thank you.
Answers (18)
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roxetine can cause side effects such as loose motions, drowsiness, sedation, and weight gain. It may also contribute to IBS-like symptoms. Other factors like poor diet, physical inactivity, and sleep cycle disturbances can further worsen these issues.
You should visit our clinic so that we can evaluate you properly and guide you regarding medication, diet, and exercise
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These are the side effects of paroxetine.
Need to change your medication.
Symptomatic management is required for iprovement in your current status.
Next Steps
do consult
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Need some basic tests to rule out certain conditions. Looks primarily like a gut infection.
Next Steps
Consult a internal medicine expert
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All your symptoms are associated with depression. Please consult a Gastroenterologist in your area for a physical examination. You should also divulge the information regarding your treatment with antidepressants.
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Yes, some of your symptoms like loose stools, drowsiness, and weight gain can be side effects of paroxetine.
You can try taking it earlier in the evening and Probiotics for gut symptoms, Diet regulation.
Do not stop or change the dose on your own if symptoms dont improve dose adjustment or switching may be needed.
Basic tests like Hb, B12, and thyroid can be considered if issues continue.
You can consult for a detailed plan and medication adjustment.
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While it is encouraging that you are feeling mentally better on Paroxetine, the symptoms you are experiencing—irregular bowel movements, urge to pass stool after eating (increased gastrocolic reflex), and drowsiness—are documented side effects of SSRIs. Serotonin plays a major role in gut motility; therefore, medication that alters serotonin can frequently lead to loose stools or 'SSRIs-induced diarrhea.' Additionally, Paroxetine is known to be one of the more sedating and weight-gain-prone medications in its class due to its mild anticholinergic effects and impact on metabolism."
Next Steps
"1. Side Effects: Yes, frequent loose stools, daytime drowsiness, and weight gain are classic side effects of Paroxetine. The anal itching could be secondary to the frequent loose stools (perianal irritation) or a separate localized issue.
2. Medication Change: You should not change the dose or switch medicine on your own. Sudden stoppage can cause 'Discontinuation Syndrome.' This must be discussed with your psychiatrist, who may suggest a morning dose to tackle drowsiness or a switch to a more weight-neutral SSRI like Escitalopram or Sertraline.
3. Probiotics: Yes, you can safely take probiotics (like those containing Lactobacillus or Saccharomyces boulardii) to help stabilize your gut flora and improve stool consistency.
4. Tests: A baseline Stool Routine/Microscopy is recommended to rule out infections or parasites (especially for the itching). A Thyroid Profile (TSH) and Blood Sugar check are also advisable given the weight gain and drowsiness."
Health Tips
"1. Consult Your Psychiatrist: Share this list of side effects with them. They may adjust the timing to 'Morning' to reduce daytime sleepiness or cross-taper you to a different medication.
2. Anal Hygiene: For the itching, maintain strict perianal hygiene. Use a soothing barrier cream (like Zinc Oxide) after bowel movements.
3. Lifestyle: To manage weight gain, focus on a high-protein, low-glycemic index diet and aim for 30 minutes of physical activity, which also helps combat lethargy.
4. Hydration: Since you have loose stools, ensure you are drinking adequate water and electrolytes to prevent dehydration."
Do not ignore these side effects, as long-term drowsiness and weight gain can impact your quality of life. For a detailed clinical evaluation, personalized medicine prescription, and direct follow-up, you can consult me directly through my profile."
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Aapke symptoms ko 2 parts me samajhna hoga — medicine related + gut issue.
1. Kya ye Paroxetine ke side effects ho sakte hain?
Haan, kaafi cheezein match karti hain:
• Loose stools / bowel changes → common SSRI side effect
• Daytime drowsiness → especially agar raat me le rahe ho
• Weight gain → long term me hota hai
Lekin anal itching aur stool ke baad urge → ye zyada gut related lag raha hai (IBS-type ya local irritation).
2. Dose/timing change karna chahiye?
• Try karo raat ki jagah subah lena (many patients me drowsiness kam hoti hai)
• Dose change ya switch (jaise escitalopram) sirf doctor se discuss karke hi karo
3. Probiotics le sakte ho?
Haan, bilkul le sakte ho 2–3 weeks
• Saath me curd/dahi bhi include karo
• Ye bowel irregularity me help karega
4. Tests ki zarurat hai?
Agar symptoms persist kare to basic tests:
• Stool routine/microscopy (worms, infection rule out)
• Sometimes IBS consider kiya jata hai agar sab normal ho
5. Drowsiness aur weight gain kaise manage karein?
• Morning dosing try karo
• Daily 30–40 min walk
• Sugar, junk, late night eating avoid
• Proper sleep routine maintain karo
Anal itching ke liye:
• Hygiene maintain karo, area dry rakho
• Warm water se wash
• Agar zyada itching hai to mild antifungal/anti-itch cream short term use (doctor advice se)
Important:
• Stool image me koi alarming cheez (blood etc.) clear nahi dikh rahi
• Zyada tar ye functional bowel issue + drug side effect lag raha hai, serious disease nahi
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Dr. Vetsa Sri Krishna Chaitanya
General Physician
7 yrs exp
Rajahmundry
Need a few more details please consult for further evaluation and treatment
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Dr. Nazia Begum M.G
General Physician
15 yrs exp
Belgaum
Consult online
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Dr. Rajiv Kumar
General Physician
24 yrs exp
Pune
Regular follow up and it is manageble .
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Dr. Suraj Sharma
General Practitioner
4 yrs exp
Jaipur
Do consult
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Dr. Gaurav Jaiswal
General Physician
7 yrs exp
Jhansi
Kindly do connect and consult
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Dr. Ravi Kumar Nadella
General Physician
18 yrs exp
Hyderabad
Immediately do colonoscopy
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Dr. Anuj Mothsra
General Practitioner
7 yrs exp
Jhunjhunu
Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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Dr. Rachna Pande
Internal Medicine
42 yrs exp
Bhopal
You have side effects of antidepressants. Please consult your prescribing Dr.
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Dr. Sowmya
General Practitioner
13 yrs exp
Udupi
I would suggest you to go for follow up.
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