Jump to content
Altostrata

Tips for tapering off stomach acid blockers or PPIs (esomeprazole, lansoprazole, omeprazole)

Recommended Posts

blackrabbit   
blackrabbit

blackrabbit, please read this topic from the beginning.

I did but my question was not answered so I wanted to see if anyone could give me advice.

Share this post


Link to post
Share on other sites
Petunia   
Petunia
Taperinq required to prevent rebound reflux

To prevent rebound reflux, taper off an acid blocker as soon as possible. As a medical non-professional, my guess of a good rate is 25% per week. If you get rebound reflux, lower the decrease and take longer to taper off.

Acid-suppressing drugs such as esomeprazole (Nexium), lansoprazole (Prevacid) and omeprazole (Prilosec) may trigger rebound hyperacidity and reflux if they are stopped abruptly.

 

Share this post


Link to post
Share on other sites
Prozac20   
Prozac20

I had been prescribed omeprazole 40mg prior to my experience with Prozac . Now , I'm don't know if taking it while going through withdrawal is better to deal with symptoms or not being that omeprazole has a few side effects on its own . Anyone taking acid reflux medication like omeprazole or Nexium ?

Share this post


Link to post
Share on other sites
Mort81   
Mort81

Ya this drug has been extremely difficult to kick for me during WD.  I have been on it for awhile.   So the rebound acid is bad. But  one of my toughest WD symptom has been stomach pain . So an change in my regiman affects my gut alot. I weened from 60mg-30mg . . than had 2 months of bad acid. until it leveled out.  Than I weened from 30mg-20mg. But at 20mg I started having lots of problems. So For me its a sign my system isnt strong enough to handle the rebound yet. So i am back at 30mg . I am on Dexilant. I have a really good diet so it bugs me that I know  I dont need the pills what so ever .  I only need it because im addicted to them. Id say if you can taper off it slowly and your system is okay , than Id stay off it. It wont help your recovery.  Its a bad drug ... but if the rebound acid is hurting too much and causing other symptms to be worse than maybe wait until you are strong enough to taper off it.   If you can be on the lowest possible dose that doesnt cause the rebound symptoms.

Share this post


Link to post
Share on other sites
Altostrata   
Altostrata

Mort, sometimes the indigestion is caused by a class of food, such as dairy or nightshades. Have you tried systematically excluding different kinds of foods.

Share this post


Link to post
Share on other sites
Mort81   
Mort81

Thanks for the response Alto, yes I have eliminated dairy and anything that could cause this. For the last few weeks ive only been to eat one meal a day .  Its always a plain healthy meal . For me my waves many of them have been an increase of distress in the gut no matter the diet.   ill ride it out , hopefully it passes  soon and I can resume my 2 meals a day.  My weight has dropped 10 in the last month. 

Share this post


Link to post
Share on other sites
btdt   
btdt

I had been prescribed omeprazole 40mg prior to my experience with Prozac . Now , I'm don't know if taking it while going through withdrawal is better to deal with symptoms or not being that omeprazole has a few side effects on its own . Anyone taking acid reflux medication like 

“PPIs,” whose Product information (PI) warns against their use in conjunction with drugs metabolized by CYP450 2C19

https://www.tga.gov.au/sites/default/files/review-tga-transparency-1101-submission-yolande-lucire2.pdf

 

There is a thread here called how to taper off ppi drugs... 

peace

Share this post


Link to post
Share on other sites
Frogie   
Frogie

Hi Lili,

One more time, I realigned how similar our med history on both PPI and AD, including timing!

Ironically, after taking 16 yrs proacid 15 mg, my doctor suggest me to switch to antacid. I did about 3 weeks ago and that was when I started seeing lights with my WD symptoms. It made me wondering if PPI is somehow part of the reason of the Wd.

I just read this topic today. Hope sudden stop of the PPI won't cause me any future problem. I'm good so far with the prescribed antacid.

I have been on omeprazole for about 15 years. I had rebound reflux on the 1st 25% cut. I've stayed there for 2 weeks now and am feeling better. How long did you have rebound acid and what did you do for it? As soon as I'm done with this I'm starting Zantac then back to my Lexapro. Thanks in advance for answering my question!

Share this post


Link to post
Share on other sites
Lois   
Lois

I am new here and hoping someone has some insights.

 

I have been on lexapro 10mg for 12 years and was bumped up to 15mg 2 years ago. In the mean time I was put on the ppi Protonix 2 years ago as well. I have been weaning off the Ppi over the past 3 weeks and I think it's having an effect on my absorption of lexapro. I haven't changed my dose of lexapro but I feel like I'm in WD!

 

I have read that ppis have an effect on the serum levels of SSRIS basically increasing the serum levels. And now that I'm weaning off the PPI I'm in effect lowering the serum levels of lexapro. Make any sense?

 

Help

Share this post


Link to post
Share on other sites
Frogie   
Frogie

I am new here and hoping someone has some insights.

I have been on lexapro 10mg for 12 years and was bumped up to 15mg 2 years ago. In the mean time I was put on the ppi Protonix 2 years ago as well. I have been weaning off the Ppi over the past 3 weeks and I think it's having an effect on my absorption of lexapro. I haven't changed my dose of lexapro but I feel like I'm in WD!

I have read that ppis have an effect on the serum levels of SSRIS basically increasing the serum levels. And now that I'm weaning off the PPI I'm in effect lowering the serum levels of lexapro. Make any sense?

Help

 

 

I did it backwards until I found this site. I was going off Lexapro 1st. I had already cut my Lexapro in 1/2. I am now on my 3rd week of weaning off the Prilosec and I definitely feel like I'm going through withdrawals from Lexapro. I'm sick to my stomach, and have a lot of intestinal issues going on. I know exactly how you feel. If you need to, slow down on your taper of protonix, and maybe that will help. That's what they told me on here. If I get rebound, to taper slower. I hope that helps. Let's keep in contact since we are going through the same thing. :)

Share this post


Link to post
Share on other sites
Frogie   
Frogie

Lois -- Welcome to Surviving Antidepressants (SA). Please start a topic in the Introductions forum so that we can get to know you and answer your questions.

Link to creating a new topic in Introductions

I hope I answered Lois as best as I could, with the information you helped me with. I'm on my last week of Prilosec and then we will see if I get rebound acid. I'm prepared with DGL and Maalox. Then on with the Lexapro!

Share this post


Link to post
Share on other sites
Cheri   
Cheri

It's amazing to discover so many side effects to antidepressants. Having GERD may be one of them. After recently reading about kidney issues (just discovered!), I'm determined to taper off my prescription. I'm wondering if I should do a concurrent taper of Pantoprazole 40 mg and Celexa 20 mg at same time.

 

Thoughts?

Share this post


Link to post
Share on other sites
Frogie   
Frogie

It's amazing to discover so many side effects to antidepressants. Having GERD may be one of them. After recently reading about kidney issues (just discovered!), I'm determined to taper off my prescription. I'm wondering if I should do a concurrent taper of Pantoprazole 40 mg and Celexa 20 mg at same time.

Thoughts?

I was told by Altostrata to taper off Prilosec, Zantac, Lexapro and then Xanax. One at a time. This is my last week for Prilosec, I'm already off Zantac, except as needed, then I can get off Lexapro. I think I'll hold a little while on the Xanax before getting off everything at once. I just went off 3 meds last year between September and December. I'm just soooooooo afraid of rebound acid, but I have DGL and Maalox standing by. The dr also gave me zofran, but that is something else you have to wean off of. I'm having liver problems, so I have good days and bad days, but I'm doing everything I can to get off the meds without too many problems. The moderators on here are really good. Keep me posted on how you are doing. :)

Share this post


Link to post
Share on other sites
Frogie   
Frogie

It's amazing to discover so many side effects to antidepressants. Having GERD may be one of them. After recently reading about kidney issues (just discovered!), I'm determined to taper off my prescription. I'm wondering if I should do a concurrent taper of Pantoprazole 40 mg and Celexa 20 mg at same time.

 

Thoughts?

How are you feeling?

Share this post


Link to post
Share on other sites
Altostrata   
Altostrata

Cherie, please do not change dosage of two drugs at the same time.

 

Please post your question in your Introductions topic as the answer will take this topic off-topic.

Share this post


Link to post
Share on other sites
Frogie   
Frogie

Hi Lili,

One more time, I realigned how similar our med history on both PPI and AD, including timing!

Ironically, after taking 16 yrs proacid 15 mg, my doctor suggest me to switch to antacid. I did about 3 weeks ago and that was when I started seeing lights with my WD symptoms. It made me wondering if PPI is somehow part of the reason of the Wd.

I just read this topic today. Hope sudden stop of the PPI won't cause me any future problem. I'm good so far with the prescribed antacid.

When you stopped your PPI were you nauseous? If so, how long?

 

Thanks...

Share this post


Link to post
Share on other sites
LexAnger   
LexAnger

 

Hi Lili,

One more time, I realigned how similar our med history on both PPI and AD, including timing!

Ironically, after taking 16 yrs proacid 15 mg, my doctor suggest me to switch to antacid. I did about 3 weeks ago and that was when I started seeing lights with my WD symptoms. It made me wondering if PPI is somehow part of the reason of the Wd.

I just read this topic today. Hope sudden stop of the PPI won't cause me any future problem. I'm good so far with the prescribed antacid.

When you stopped your PPI were you nauseous? If so, how long?

Thanks...

Not nausea, but my typical WD symptoms, super dizzy, head pressure on the same day I stopped antacid. I was freaking out so updose lexapro from 2.7 to 3.7, feeling great for 1 week then all the symptoms back again, so updose again to 4.5 lex. All the hell broke since then experiencing severe drug reaction and WD. Been tapering since then getting worse each day.

Share this post


Link to post
Share on other sites
Frogie   
Frogie

 

 

Hi Lili,

One more time, I realigned how similar our med history on both PPI and AD, including timing!

Ironically, after taking 16 yrs proacid 15 mg, my doctor suggest me to switch to antacid. I did about 3 weeks ago and that was when I started seeing lights with my WD symptoms. It made me wondering if PPI is somehow part of the reason of the Wd.

I just read this topic today. Hope sudden stop of the PPI won't cause me any future problem. I'm good so far with the prescribed antacid.

When you stopped your PPI were you nauseous? If so, how long?

Thanks...

Not nausea, but my typical WD symptoms, super dizzy, head pressure on the same day I stopped antacid. I was freaking out so updose lexapro from 2.7 to 3.7, feeling great for 1 week then all the symptoms back again, so updose again to 4.5 lex. All the hell broke since then experiencing severe drug reaction and WD. Been tapering since then getting worse each day.

I have been really nauseous since I started tapering omeprazole. It's not GERD. It's like I have the stomach flu. I bought some apple cider vinegar today. I'm going to try that and see if it works. Otherwise I'm loaded up with Gaviscon, Maalox, antacids and DGL. I have some Zantac and took 1 today and it helped a lot. But I've already stopped taking it. Was really easy to taper off of that. I don't want to go back on it. I hope the apple cider vinegar works. I've got to get off the omeprazole before I can start my Lexapro taper. Thanks for answering me.

Good luck to you!

Share this post


Link to post
Share on other sites
Frogie   
Frogie

Has anyone tried the Apple Cider Vinegar to wean off Prilosec? Does it work? I've drank it twice, and it's nasty!

Share this post


Link to post
Share on other sites
Frogie   
Frogie

 

 

Hi Lili,

One more time, I realigned how similar our med history on both PPI and AD, including timing!

Ironically, after taking 16 yrs proacid 15 mg, my doctor suggest me to switch to antacid. I did about 3 weeks ago and that was when I started seeing lights with my WD symptoms. It made me wondering if PPI is somehow part of the reason of the Wd.

I just read this topic today. Hope sudden stop of the PPI won't cause me any future problem. I'm good so far with the prescribed antacid.

When you stopped your PPI were you nauseous? If so, how long?

Thanks...

Not nausea, but my typical WD symptoms, super dizzy, head pressure on the same day I stopped antacid. I was freaking out so updose lexapro from 2.7 to 3.7, feeling great for 1 week then all the symptoms back again, so updose again to 4.5 lex. All the hell broke since then experiencing severe drug reaction and WD. Been tapering since then getting worse each day.

How did you stop your Ppi?

Share this post


Link to post
Share on other sites
SMatthews   
SMatthews

I was not aware that acid blockers can have adverse neurological effects. I've had issues with GERD and esophageal spasms since I was a child. The spasms are triggered by reflux according to my gastroenterologist. I've taken acid blockers ever since I can remember and have been off and on PPIs for years. I've had depression issues ever since I can remember too. I'm now wondering if the acid blockers were/are a contributing factor.
 
I've previously read about the side effects of taking PPIs and weaned off them against my doctor's advice. I followed the steps in the article "How to Wean Off PPIs and Why" (http://howtotreatheartburn.com/how-to-wean-off-ppis-and-why). My acid rebounding was rough. I still have heartburn and esophageal spams but they not as frequent. I've changed my eating habits and plan on trying lacto-fermented foods to see if they help balance the bacteria in my digestive system and eliminate my reflux. Has anyone tried lacto-fermented foods to eliminate GERD? Thanks!

Share this post


Link to post
Share on other sites
scallywag   
scallywag

You can use a web search tool, such as Google, to search this site. Include site:survivingantidepressants.org as a search term with the topic of interest, "lacto-fermented food" in this instance.

Share this post


Link to post
Share on other sites
btdt   
btdt

I was not aware that acid blockers can have adverse neurological effects. I've had issues with GERD and esophageal spasms since I was a child. The spasms are triggered by reflux according to my gastroenterologist. I've taken acid blockers ever since I can remember and have been off and on PPIs for years. I've had depression issues ever since I can remember too. I'm now wondering if the acid blockers were/are a contributing factor.

 

I've previously read about the side effects of taking PPIs and weaned off them against my doctor's advice. I followed the steps in the article "How to Wean Off PPIs and Why" (http://howtotreatheartburn.com/how-to-wean-off-ppis-and-why). My acid rebounding was rough. I still have heartburn and esophageal spams but they not as frequent. I've changed my eating habits and plan on trying lacto-fermented foods to see if they help balance the bacteria in my digestive system and eliminate my reflux. Has anyone tried lacto-fermented foods to eliminate GERD? Thanks!

 

How PPI drugs affect depression and other drugs that are metabolized by P450 have both been covered in this thread on the previous posts. Please read back. 

 

Personally I had to cut pills and taper slowly and added other things like tums for break through acid baking soda and water Apple Cider vinegar and water both are helpful diet stress reduction thru meditation relaxation videos every bit helps... and sit up to sleep or raise your bed head for a time. 

 

I have used a lot of probiotics and colostrum new roots brand is what I use it really helped.... latest for me is candaclear four kills yeast and adds a probiotic... seems to be very helpful.  

 

Other things that helped when I was at my worst... apple sauce with three capsules of acidophilus mixed in the apple sauce is a prebiotic will give a growing medium (pectin) got this from a doc long ago... her other idea was florastor one pill and I had a big yeast problem ... could be I had it before but the florestore was not suppose to be a problem but it was... I have a full bottle still it is not cheap... none of this stuff is cheap.

 

 Really bad pain is helped by a cold pack sit upright chew slowly... sleep sitting up. No coffee... licorice did not help me but candied ginger did. I guess if a person lives long enough with these problems they will sort out what works for them. Chlorophyll helped me too...tho it is not pretty you will see if you try it...

 

Exercise helped me too... stretching neck rib shoulders back all help.

peace all 

Share this post


Link to post
Share on other sites
anonymous4317   
anonymous4317

I was prescribed Omeprazole 40 mg delayed-release capsules for 10 days for gastritis that showed up on an upper gastrointestinal endoscopy.

 

I have been taking it 7 days and need to get off. How long would you all recommend for tapering off? The OP says 25% each week, but would that be necessary seeing that I would be taking Omeprazole three more weeks?

 

Thanks!! The aspect of rebound acid scares me.

Share this post


Link to post
Share on other sites
Altostrata   
Altostrata

Hello, anon. Just to be safe, I'd cut the dosage in half for 4 days, in half again for another 4 days, then go off.

Share this post


Link to post
Share on other sites
SMatthews   
SMatthews

Hello anonymous4317. It's not likely that your rebound would be as pronounced as those who have been on Omeprazole for longer time periods. You may be able to stop without tapering off and rely on an H2 blocker for any rebound in acid. In the past, I've taken numerous rounds of PPIs for 14 days and been ok with the use of an H2 blocker and antacids.

Share this post


Link to post
Share on other sites
mammaP   
mammaP

Tapering will hopefully mean that no other drug will be needed. Taking care of the gut is better than relying on drugs, a good pro-biotic helps keep the good bacteria balanced and helps eliminate acid reflux. 

Share this post


Link to post
Share on other sites
Marsha   
Marsha

Yes very important to take care of the gut.

Share this post


Link to post
Share on other sites
fightback72   
fightback72

Hello All,

I just started taking Nexium 40mg 2x a day to be taken like this for only two weeks and then to continue just 40mg 1x a day for the next 30 days. I have a suspected ulcer. I've had them in the past so it feels like that to me as well. First I started on 1 for 4 days until I saw my doctor and on the 5th day I began taking 2. Is this too soon to up the dose? I had shakiness and sensations in my head last night and this morning still some shakiness. No sleep at all. I know I have to taper when I'm done with the course of treatment. Do I have to wean off the second capsule before just only taking one capsule after the two weeks? How should the capsule be broken up? By 1/2?  

Thank you for any response. It really sucks to have to take this medicine after feeling like I was mostly stabilizing on my current dose that I'm on now for a month.

 

Share this post


Link to post
Share on other sites
Shep   
Shep

A study off PubMed about PPIs and SSRIs:

 

Effect of Proton Pump Inhibitors on the Serum Concentrations of the Selective Serotonin Reuptake Inhibitors Citalopram, Escitalopram, and Sertraline

 

Below is the Abstract from the study in which it was shown that various PPIs can increase the serum concentrations of SSRIs. In this study, Zoloft (sertraline), Lexapro (escitalopram), and Celxa (citalopram) were used, along with the PPIs Prilosec (omeprazole),  Nexium (esomeprazole), Prevacid (lansoprazole), and Protonix (pantoprazole). 

 

 

Abstract

Background:

The selective serotonin reuptake inhibitors (SSRIs) citalopram, escitalopram, and sertraline are all metabolized by the cytochrome P-450 isoenzyme CYP2C19, which is inhibited by the proton pump inhibitors (PPIs) omeprazole, esomeprazole, lansoprazole, and pantoprazole. The aim of the present study was to evaluate the effect of these PPIs on the serum concentrations of citalopram, escitalopram, and sertraline.

Methods:

Serum concentrations from patients treated with citalopram, escitalopram, or sertraline were obtained from a routine therapeutic drug monitoring database, and samples from subjects concomitantly using PPIs were identified. Dose-adjusted SSRI serum concentrations were calculated to compare data from those treated and those not treated with PPIs.

Results:

Citalopram concentrations were significantly higher in patients treated with omeprazole (+35.3%; P < 0.001), esomeprazole (+32.8%; P < 0.001), and lansoprazole (+14.7%; P = 0.043). Escitalopram concentrations were significantly higher in patients treated with omeprazole (+93.9%; P < 0.001), esomeprazole (+81.8%; P < 0.001), lansoprazole (+20.1%; P = 0.008), and pantoprazole (+21.6%; P = 0.002). Sertraline concentrations were significantly higher in patients treated with esomeprazole (+38.5%; P = 0.0014).

Conclusions:

The effect of comedication with PPIs on the serum concentration of SSRIs is more pronounced for omeprazole and esomeprazole than for lansoprazole and pantoprazole, and escitalopram is affected to a greater extent than are citalopram and sertraline. When omeprazole or esomeprazole are used in combination with escitalopram, a 50% dose reduction of the latter should be considered.

 

Edited by Shep
added highlighting

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

×

Important Information

By using this site, you agree to our Terms of Use.