I'm 28M and currently switching from Lexapro to Zoloft. I'm looking for experiences from people who had severe physical anxiety and stomach symptoms during an SSRI startup or switch, especially people who eventually recovered and got their normal appetite back.
The main problem I'm dealing with is a strange combination of:
Constant stomach tension
Nausea
Almost no appetite
Food aversion
Gagging/dry heaving
Difficulty getting food down even when I know I'm hungry
Increased physical anxiety
The mornings are by far the worst.
I wake up and almost immediately feel tension in my stomach. Food sounds disgusting, I feel nauseous, and sometimes I'll gag or dry heave even though I haven't taken my medication yet and my stomach is basically empty.
Then I start worrying about whether I'll be able to eat, and it feels like everything feeds itself:
anxiety -> stomach tightens -> nausea -> can't eat -> empty stomach -> worse nausea -> gagging/dry heaving -> more anxiety
The weirdest part is what happens later in the day.
As the day progresses, everything gradually settles down. By evening or nighttime my stomach can feel dramatically different. The tension decreases, my anxiety drops, food becomes normal again and sometimes I can eat a completely normal meal.
Then I sleep and wake up the next morning with the same symptoms again.
My medication transition has been pretty messy, which makes it difficult to know where the startup effects end and everything else begins.
I was on Lexapro 20mg for about a year. Starting Lexapro originally gave me basically zero side effects, and I lived completely normally on it. Eventually my panic attacks started returning, so my psychiatrist decided to switch me to Zoloft.
The first attempt was:
Lexapro 20mg -> 10mg + Zoloft 50mg
Within days I developed severe nausea, vomiting, dizziness, brain zaps and dramatically increased anxiety.
Around day 4 I contacted my psychiatrist because I could barely tolerate 50mg and was told to increase Zoloft to 100mg.
I didn't increase it.
By day 5 I ended up in the ER because of the vomiting, stopped Zoloft and changed psychiatrists.
After roughly two days without Zoloft, my new psychiatrist stopped Lexapro completely and restarted Zoloft much more slowly.
My current uninterrupted restart has been:
12.5mg for 7 days
25mg for 6 days
50mg, currently day 2
So right now I'm 14 days into the uninterrupted Zoloft restart, day 2 at 50mg, and day 14 completely off Lexapro.
My psychiatrist also started a short 10-day Xanax bridge two days ago while I adjust to 50mg. I'm taking 0.25mg with my Zoloft and another 0.25mg later in the day.
One thing that makes me suspect anxiety is perpetuating at least some of the stomach symptoms is that I've taken Seroquel 50mg nightly for years.
Once it kicks in and I relax, my stomach tension can almost completely disappear. I stop worrying about food and can sometimes eat normally after struggling to eat all day.
The same thing seems to happen when my daytime anxiety decreases.
So I'm wondering whether the SSRI transition/startup increased my physical anxiety enough to restart an old anxiety-stomach loop.
I did also have what seemed like a separate stomach bug during this period after eating questionable food, with diarrhea and vomiting for several days. Bloodwork was normal twice. However, the nausea, food aversion and difficulty eating had already started before the stomach illness, and they've continued after the worst of it passed.
I'm especially interested in hearing from anyone who experienced something similar while starting, stopping or switching SSRIs, not necessarily Zoloft specifically.
Did anxiety make your stomach feel physically locked up to the point where you couldn't eat?
Did you experience nausea, gagging or dry heaving, especially in the mornings?
Did you feel significantly better at night?
And most importantly, did your normal appetite and ability to eat eventually come back once your body adjusted to the medication? How long did it take?
I'm following my psychiatrist's treatment plan, so I'm not looking for advice on changing medications or doses.
I mainly want to know whether anyone else went through this horrible "my anxiety has taken control of my stomach and I can't fucking eat" phase during an SSRI transition and eventually came out the other side.