In 2021, my initial problem was not digestive. I was mainly suffering from anxiety-related distress, with a sensation of a “hole in my chest.” I was then prescribed Seroplex drops (escitalopram), and later Laroxyl drops (amitriptyline) were added for severe headaches. Today, I no longer have headaches. When I was taking 1 mg of Seroplex and 1 mg of Laroxyl, I was doing very well. Then, between 2021 and 2024, I remained on a constant dose of Seroplex (escitalopram) + Laroxyl (amitriptyline).

 

Before these treatments, I did not have chronic constipation. My bowel movements were normal. Then, in September 2024, severe constipation appeared suddenly, overnight. For eight months, it was impossible for me to have a bowel movement without enemas. I had a very bloated abdomen, trapped gas, abdominal pain, sometimes small pellet-like stools, and the feeling that my intestines were no longer functioning normally.

 

I underwent many gastroenterology tests, and it is important to stress that they found nothing that could explain my condition. Scans, colonoscopy, and the digestive work-up did not show any organic disease or lesion that could explain my constipation. Other than the fact that I was clearly constipated, the tests found nothing. In other words, there is nothing on my medical exams that explains this situation.

 

After those eight months, a gastroenterologist prescribed Mestinon (pyridostigmine bromide), notably at 180 mg per day, and there was a significant partial improvement: I no longer needed enemas. However, my bowel function never returned to normal, and I was left with persistent digestive discomfort, including bloating and the feeling that my intestines were still not functioning normally.

 

I managed to stop Laroxyl (amitriptyline) in November 2025. Since this treatment had originally been introduced for headaches, and I no longer have headaches today, its original indication no longer exists. After that, the issue became centered again on Seroplex (escitalopram). I went through periods at 1 mg, 2 mg, then 3 mg. Whenever I tried to reduce or stop it, I experienced agitation, strange dreams, and a feeling of altered reality, with great difficulty getting off it. On 27/02/2026, I felt so bad that I went back up to 3 mg of Seroplex, with the impression that the constipation and bloating were worsening again.

 

Then there was a switch to sertraline, at 25 mg per day. During that switch, I experienced a substantial improvement for about two weeks, which gave me hope that changing medication would lead to a lasting improvement in my digestive condition. But for the past few days, it has become even worse than before: the constipation, bloating, and digestive suffering have all become severe again, and I have the feeling that sertraline is “stripping” or “burning” my gut. Because of this recent worsening, my psychiatrist switched me back to 1 mg of Seroplex (escitalopram) and 0.25 mg of Xanax.

 

I would like to know whether other people here have experienced something similar, especially severe constipation or a completely disrupted gut caused by antidepressants, despite normal gastroenterology tests. I am looking for testimonies from people who have gone through the same thing, whether with Seroplex (escitalopram), Laroxyl (amitriptyline), sertraline, or other antidepressants, to understand how it evolved for you and what helped you.

Hi @Satopsy

 

Welcome to the forum!

 

This is a volunteer-run, community forum aimed at helping those who are tapering and/or experiencing difficulties with psychiatric medications and withdrawl syndrome. We are not medical professionals and cannot offer medical advice. We simply offer support and opinions which you could use as talking points with a medical provider knowledgeable in withdrawing off psychiatric medications.

 

Please familiarise yourself with the forum rules and the disclaimer located here: Guidelines

 

Please make sure your signature is kept up to date with your drug history. This will allow members to see some basic information about your drug history and situation so that they may help you best. Information on how to do this is located in the FAQs section above, but here is a direct link: Update Signature

Once this is done, future posts made by you will have this signature turned on by default. For this reason please keep it clear but condensed as possible.

I'm so sorry to read about the tough time you've had recently you will find plenty of support here for sure.

 

When we come off these drugs we need to taper off them slowly. It is not a good idea to start or stop them abruptly nor switch doses around. Unfortunately many doctors don't realise this.

 

Tapering Information

 

I can't say whether the antidepressants you were taking were causing your gut issues. But we do know they effect the gut alot and this is not out of the question. On the basis you have had every other test done and ruled everything else out, I suspect they may be the culprit.

 

18 hours ago, Satopsy said:

Whenever I tried to reduce or stop it, I experienced agitation, strange dreams, and a feeling of altered reality, with great difficulty getting off it

This is common when we try to stop these drugs too quickly.

 

18 hours ago, Satopsy said:

Then there was a switch to sertraline, at 25 mg per day. During that switch, I experienced a substantial improvement for about two weeks, which gave me hope that changing medication would lead to a lasting improvement in my digestive condition. But for the past few days, it has become even worse than before: the constipation, bloating, and digestive suffering have all become severe again, and I have the feeling that sertraline is “stripping” or “burning” my gut. Because of this recent worsening, my psychiatrist switched me back to 1 mg of Seroplex (escitalopram) and 0.25 mg of Xanax.

Switching Ads is a common move from doctors. Its not a good idea. I don't understand why you felt intially better in the gut area tbh.

 

I think going back to 1mg of Seroplex is a good move. Hopefully it has reduced your WD symptoms and the lower dose hopefully will be the least disruptive to your gut problems. If it were me and you have not taken many pills of Xannax I would stop them before you gain dependance. The last thing your gut needs now is more Psych drugs.

 

From here, if it were me I would try to get as stable as you can then look to taper carefully off the Seroplex.

 

How are you taking 1mg? Do you guys have 1mg tablets?

 

In the mean time this is what I would do if I were you:

 

-Stay Hydrated 

 

-Eat a good clean whole food diet, avoiding processed foods and sugars.

 

-Stay away from caffeine, alcohol and antihistamines and any other psychoactive substances.

 

Supplements are to be avoided initially, as they often irritate our nervous systems. Try to get your nutrition through food.

 

Down the line, you may wish to introduce Fish Oil and Magnesium. Those who can tolerate them have found them calming to the nervous system. Be careful try one at a time and start low and see how you get on should you choose to try them.

 

A daily walk is very important as much as you can manage, if you can manage it. Gets you your fresh air and Vitamin D does wonders for your mind!

 

You are very welcome here and I hope you find the site supportive.

 

Chippy

Hello,

Thank you for your quick response and for the different suggestions for improvement.

I have carefully read all the information available on the former SA website, particularly regarding the 10% tapering rule.

 

Le 25/03/2026 à 09h33, Chippy a déclaré :

Je ne peux pas dire si les antidépresseurs que tu prenais causaient tes problèmes intestinaux. Mais nous savons qu’elles affectent beaucoup l’intestin et ce n’est pas exclu. Étant donné que vous avez fait tous les autres tests et que vous avez écarté tout le reste, je soupçonne qu’ils sont peut-être en cause.

I was on Laroxyl (amitriptyline) for about 3 years, and one of its very common side effects is constipation, due to its anticholinergic effect which can lead to intestinal atony.

However, despite stopping this medication 6 months ago, the constipation has not resolved. During this time, I continued escitalopram (Séroplex), initially at 1 mg, but due to the onset of hyperactivity after withdrawal, the dose was increased to 3 mg.

An important element is that only Mestinon (pyridostigmine bromide) helped restore my bowel movements. This drug is cholinergic (in contrast to the effect of amitriptyline) and acts on the nervous system. Its effectiveness suggests that my constipation is related to a neurogenic dysfunction of intestinal motility, likely induced by antidepressants, especially since Mestinon improved my condition by about 70%.

In addition:

* When I stopped Séroplex for 2 weeks, Mestinon  became more effective and I had more frequent bowel movements (although I remain open to the possibility of a psychological component)
* When I switched from Séroplex to sertraline, I experienced a major improvement in my digestive system, which was almost normal for about 2 weeks
* Finally, I never had any constipation issues before starting antidepressants

All these elements strongly suggest that my condition is caused by antidepressants, or at least that there is a high probability that they are the underlying cause.
 

Le 25/03/2026 à 09h33, Chippy a déclaré :

C’est courant lorsque nous essayons d’arrêter ces médicaments trop rapidement.

Yes, I experienced withdrawal effects when stopping Laroxyl (amitriptyline), and later when discontinuing Séroplex (escitalopram).

Overall, the symptoms were manageable (it is worth noting that I did not have any digestive issues at that time). The main symptoms I experienced were:

* Unusual/vivid dreams
* Insomnia
* Anxiety associated with a sense of hyperactivity (which I found difficult to distinguish from each other)

All of these symptoms were tolerable, except for the hyperactivity, which became particularly intense. After about two weeks, it became unbearable, which led me to restart Séroplex.
 

Le 25/03/2026 à 09h33, Chippy a déclaré :

Je pense que revenir à 1 mg de Seroplex est une bonne idée. J’espère que cela a réduit vos symptômes de WD et que la dose plus faible sera la moins perturbatrice pour vos problèmes intestinaux. Si c’était moi et que tu n’avais pas pris beaucoup de comprimés de Xannax, je les arrêterais avant de devenir dépendant. La dernière chose n’est pas ton intestin à besoin maintenant, ce sont plus de médicaments psychiatriques.

 

À partir de là, si c’était moi, j’essaierais de devenir aussi stable que possible puis je chercherais à réduire progressivement le Seroplex.

 

Comment prends-tu 1 mg ? Avez-vous des comprimés de 1 mg ?

I was taking 1 mg of Séroplex in liquid drops, not in tablet form. Looking back, I was genuinely stable last year on 1 mg of Séroplex and 1 mg of Laroxyl.

Today, several specialists have suggested different options:

**Option 1 – Psychiatrist:**
Return to a daily regimen of 1 mg of Séroplex and 0.25 mg of Xanax, with Xanax replacing Laroxyl.

 

**Option 2 – Neurologist:**
Stop all antidepressants and manage the withdrawal symptoms supportively. However, when anxiety and hypervigilance become unbearable, take 0.25 mg of Xanax as needed. I have only taken Xanax twice in my life. The neurologist strongly wanted me to stop Laroxyl, which I did 6 months ago, and to replace it with Xanax if necessary. I still do not fully understand why he found it so concerning that I was taking Laroxyl instead of Xanax.

 

**Option 3:**
If option 2 does not work, first return to 0.5 mg of Séroplex daily and take Xanax when needed.

 

Today, I decided to try the neurologist’s approach, meaning option 2.
 

 

 

 

Edited March 26Mar 26 by Satopsy

Welcome to the forum.

 

  

21 hours ago, Satopsy said:

The neurologist strongly wanted me to stop Laroxyl, which I did 6 months ago, and to replace it with Xanax if necessary. I still do not fully understand why he found it so concerning that I was taking Laroxyl instead of Xanax.

 

 

Is there any opportunity to follow up and clarify this?

22 hours ago, Satopsy said:

Return to a daily regimen of 1 mg of Séroplex and 0.25 mg of Xanax, with Xanax replacing Laroxyl.

 

Hey, thanks for your reply. Could I ask for your to 'quote' me in English please as my french isn't very good?

 

We wouldn't suggest moving your drugs/doses around so much. It causes nervous system dysregulation. Doctors love to stop, start and switch drugs. It is an exteremley dangerous practice.

 

22 hours ago, Satopsy said:

Stop all antidepressants and manage the withdrawal symptoms supportively. However, when anxiety and hypervigilance become unbearable, take 0.25 mg of Xanax as needed. I have only taken Xanax twice in my life. The neurologist strongly wanted me to stop Laroxyl, which I did 6 months ago, and to replace it with Xanax if necessary. I still do not fully understand why he found it so concerning that I was taking Laroxyl instead of Xanax.

 

You can't/shouldn't treat antidepressant withdrawal with more pysch medications. The only way to imporve AD WD is time or reinstatement of the drug that caused it. Reinstating an Antidepressant 

 

22 hours ago, Satopsy said:

If option 2 does not work, first return to 0.5 mg of Séroplex daily and take Xanax when needed.

Again, I think you need to stop seeing these drugs as something you can pick and choose from, start and stop when ever you like. It will cause you further problems.

 

22 hours ago, Satopsy said:

Today, I decided to try the neurologist’s approach, meaning option 2.

This your choice, although I would reccomend you think hard about what you have read on here and on Surviving Antidepressants. 

 

Hope all goes well for you and we are here for you should you need.

 

Chippy

Hello,

 

Thank you for your quick replies and for your support on this site.

1. I will of course ask the neurologist to clarify why he prefers Xanax over Laroxyl, but my next appointment is not for another three months.

2. Yes, I apologize for my previous mistake. I will be careful to write in English.

3. Regarding your comment about moving medications or doses around too much, I completely understand the point. That said, in my case, I only made one real switch in four years: from escitalopram to sertraline, solely to observe whether there might be any digestive benefit. That trial was not conclusive. Since Monday, I have stopped everything. I do recognize, however, that over the past month there have been several changes close together.

At the moment, I feel that I am at a crossroads between two main options.

 

Option A: return to my most stable state, which was November 2025
At that time, I was on 1 mg of Seroplex and 1 mg of Laroxyl. I did have constipation, but it remained controlled with Mestinon.

 

Option B: continue following the neurologist’s logic

• stop Laroxyl, which led me, because of withdrawal effects (anxiety, hyperactivity), to increase Seroplex from 1 mg to 3 mg;

• but at that dose, the constipated state was no longer controlled, even with Mestinon;

• then follow his current advice strictly: stop all antidepressants now and use Xanax occasionally when things become too difficult, in order to allow the serotonergic system to adapt to the absence of antidepressants while containing withdrawal symptoms.

Option B brings me to the following point.

I agree with the general idea that antidepressant withdrawal should not be treated by multiplying psychotropic medications, and that the two real ways out are often either time, or reinstating the medication that caused the withdrawal. I have personally experienced that reinstating Seroplex could improve withdrawal symptoms within a matter of hours.

However, in my case, two different problems seem to overlap.

 

1. Constipation: withdrawal effect or adverse effect?

 

By adverse effect, I mean a symptom caused or maintained by taking the medication itself, as long as the body remains exposed to it. In that logic, constipation would be a direct consequence of the medication’s action on my digestive system.

By withdrawal effect, I mean, on the contrary, a symptom that appears when the medication is reduced or stopped, not because the medication is still acting in a harmful way, but because the nervous system has to readapt to its absence. In that logic, constipation would be a temporary phenomenon related to discontinuation and the adaptation period that follows.

 

This is, in my view, one of the central questions in my case. My history points more toward the hypothesis of an adverse effect of antidepressants rather than a withdrawal effect, although I remain open to the possibility that I may be wrong.

If we assume the adverse-effect hypothesis is correct, then the logic would be that, in the long term, in order to make this constipation disappear, I would need to stop all the medications that may be maintaining it, including antidepressants and anxiolytics.

 

2. Anxiety, hypervigilance, and hyperactivity during discontinuation

By contrast, these symptoms clearly seem to be withdrawal symptoms in my case rather than adverse effects. And at times they are unbearable.

 

3. So if I summarize my dilemma:

 

• Constipation = adverse effect → long-term goal: stop the medications responsible;

• Anxiety / hypervigilance = withdrawal effect → major obstacle to stopping them.

In other words, my problem is not only that I want to stop antidepressants, but that I need to know how to tolerate stopping them without being overwhelmed by withdrawal.

It is in this context that the SA article about stopping several psychiatric medications speaks to me a great deal:

 

Taking multiple psych drugs? Which drug to taper first? - Tapering - Surviving Antidepressants

 

If I understand their logic correctly:

• the antidepressant acts as an “accelerator”;

• the benzodiazepine acts as a “brake”, by reducing the activation of the nervous system related to withdrawal.

The article explains that the most common and most significant antidepressant withdrawal symptoms are precisely symptoms of nervous system activation: hyperarousal, insomnia, abnormal anxiety, agitation. It also explains that if a sedating medication is present, it can soften this activation during the taper, and the sedative can then be tapered later.

That is the logic that interests me.

My question, then, is this: why recommend stopping the antidepressant first and temporarily keeping the benzodiazepine, when benzodiazepines are themselves known for their addictive potential?

The only answer I can see, in my personal case, is the following: the most acute and disabling problem at the time of discontinuation seems to be antidepressant withdrawal. If an occasional benzodiazepine can soften that phase and allow the nervous system to gradually adapt to the absence of the antidepressant, then this partly aligns with the neurologist’s proposal.

In other words, my reasoning would be:

• stop antidepressants in order, eventually, to eliminate the constipation that I consider to be an adverse effect;

• use Xanax very sparingly, only when withdrawal symptoms become too intense, while giving the nervous system time during that phase to adapt over several months.

I am aware that there may be flaws in this reasoning, and that is precisely why I am writing to you.

My questions are therefore the following:

1. Do you think this reasoning is defensible in light of the sources I cited?

2. Do you see any major flaws in this logic?

3. In your experience, does this seem like a coherent strategy?

Finally, I also wanted to share an important observation regarding how I felt when stopping escitalopram compared with stopping sertraline.

 

Stopping Seroplex

• within 48 hours: insomnia and strange dreams, which disappeared within one week;

• after two weeks: very intense anxiety and hypervigilance;

• improvement in constipation.

Stopping sertraline since Monday, March 23, 2026

• no neurological withdrawal effects so far (as of Friday, March 27): no insomnia, no strange dreams, no anxiety, no hypervigilance;

• constipation is still present, but there has been neither improvement nor worsening since stopping it.

This difference between the two discontinuations raises many questions for me.

 

Thank you again for the time you are giving me and for your help.

Edited March 27Mar 27 by Satopsy

Can you update your signature regarding every single latest move with the drugs ? it's currently a bit confusing. are you currently off all drugs ?

6 hours ago, Satopsy said:

My question, then, is this: why recommend stopping the antidepressant first and temporarily keeping the benzodiazepine, when benzodiazepines are themselves known for their addictive potential?

benzodiapines can be addicting to people, but here the problem is not addiction, all these drugs cause dependency, the thing is anti depressants are stimulating and benzos are sedating, so in theory tapering the antidepressants first could be easier since you have the sedating benzo that makes the whole system more sedated while tapering the antidepressants, instead of the taking off the sedating benzo, which then you have the antidepressants that stimulate the system.

have you developed withdrawals after stopping amptryline ? Regardless it's been a long time, I wouldn't recommend you to go back to a drug you already stopped.

6 hours ago, Satopsy said:

I will of course ask the neurologist to clarify why he prefers Xanax over Laroxyl, but my next appointment is not for another three months.

I think it might relate to something with the constipation issues, but I'm not sure as I haven't dealt with those kind of problems personally.

 

I'm trying my best but your posts were a little bit confusing to me and your signature hasn't been fully updated to latest developments.

 

overall it's better to avoid doing drastic changes with those drugs (except the drugs are causing an effect that threatens your health significantly like potentially losing an organ), even going off from 1mg of escitalopram to 0mg could be too much as those drugs work hyperbolically.

 

taking the xanax could cause you to develop a new dependency which will cause more problems as you will need to taper that drug.

 

7 hours ago, Satopsy said:

Option A: return to my most stable state, which was November 2025
At that time, I was on 1 mg of Seroplex and 1 mg of Laroxyl. I did have constipation, but it remained controlled with Mestinon

you are assuming your withdrawal would end, but the nervous system isn't that simple, even if you react well to the drugs again, there is a good chance it won't solve all your symptoms as your nervous system has already taken a blow from all the harsh changes you have made with your drugs.

 

there is a chance you have confused your nervous system further by taking a new antidepressant (sertraline) after quitting seroplex (lexapro).

 

you could try reinstating 0.5mg of seroplex , which is a more small amount, to see if you react well to it and if it improves your withdrawals symptoms.

16 hours ago, Satopsy said:

Option A: return to my most stable state, which was November 2025
At that time, I was on 1 mg of Seroplex and 1 mg of Laroxyl. I did have constipation, but it remained controlled with Mestinon.

 

Hey @Satopsy I want to point out that is isnt likley you can simply return to this state by putting these drugs back at these doses. It is alot more complicated then this. Each time we stop or start a drug it causes further nervous system dysfunction. You can't simply reload that period in time. Hypersensitivity and kindling

 

16 hours ago, Satopsy said:

• stop Laroxyl, which led me, because of withdrawal effects (anxiety, hyperactivity), to increase Seroplex from 1 mg to 3 mg;

• but at that dose, the constipated state was no longer controlled, even with Mestinon;

Coming off these meds whilst surffering adverse effects such as constipation is a juggling act. It is true that they can cause issues being on them and coming off them resolves this. However that fact does not make you immune to the WD effects of coming off the drug. Most have to carefully taper as quickly as they can manage to reduce the adverse effects but trying to balance the WD effects. It is a difficult situation to find yourself in. It is found at lower doses adverse effects lessen. So the hope it as you taper these effects lessen.

 

16 hours ago, Satopsy said:

If I understand their logic correctly:

• the antidepressant acts as an “accelerator”;

• the benzodiazepine acts as a “brake”, by reducing the activation of the nervous system related to withdrawal.

You are correct, antidepressants and the WD symptoms you get from them are 'activating'. Benzo can reduce this as they act as brakes. 

This entire topic you linked is to help SA members understand which drug to taper first. I wrote a similar one here for you to read:  Polydrugged? Which to taper off first?

 

They are not suggesting, and from memory say specifically not to, add in benzos to treat AD WD. It is only advice for those unfortunate enough to find themselves on both types of drugs.

 

Bottom line is:

 

1. Adding back in one or even both of your old antidepressants may relieve WD symptoms but not fix them. It is likley you will still have some effects to deal with from the nervous system dysregulation that has been caused by stopping them and adding in more drugs on top. We dont suggest RI two drugs I would choose the main culprit which from what I am reading is Seroplex, but this is your choice. You would also have to conisder a RI dose which we could help you with if you decided to RI. Reinstating an Antidepressant

2. You could stay off the old ADs and wait to recover from AD WD. This can take a long time and happens in a non linear fashion in waves and windows.

3. I am not 100% sure what you're taking at the moment but I would not add in any more drugs to complicate your situation further. If have stopped Sertraline already I would stay off, as you only taken it breifly, however that doesn't mean you didnt gain at least some dependance to it, and now suffer a little WDs from stopping. If you are still taking it, you risk WD from stopping so you could do a fast taper to get off quickly, say 25% linear taper every two weeks. To be honest, as much as I don't advocate stopping these drugs suddenly, if you only have taken it two weeks, you might consider just stopping it. Means you don't gain any more dependance and can consider your RI sooner.

 

Do you see what I mean? These drugs are potent and complex. The more we add in the difficult our situation becomes and the more angry our nervous systems get!

 

There isn't a perfect solution here. Unfortunately you won't find a magic drug or dose or combination that makes all this right. All you can do is minimise the damage by not adding in further drugs to the situation and consider RI some of your old drugs to reduce WD symptoms.

 

Chippy