Do SSRIs worsen celiac symptoms?

[Anne G]

My 15 year old daughter with celiac just started an SSRI (fluoxetine) for anxiety 10 days ago. She got glutened 4 days ago and is still having debilitating fatigue (have to wake her up to give her water/food) and is missing her exams.  This is much more severe than her usual reaction (she ate a few bread crumbs by accident).

Has anyone else noticed worsening celiac symptoms after starting an SSRI??

Thank you.

[Anne G]

My 15 year old daughter with celiac just started an SSRI (fluoxetine) for anxiety 10 days ago. She got glutened 4 days ago and is still having debilitating fatigue (have to wake her up to give her water/food) and is missing her exams.  This is much more severe than her usual reaction (she ate a few bread crumbs by accident).

Has anyone else noticed worsening celiac symptoms after starting an SSRI??

Thank you.

[plumbago]

Anne, is the tablet itself gluten free? The rap on SSRIs is that they can often stimulate as opposed to depress one's nervous system. OTOH, maybe she's having some kind of paradoxical reaction. I can't write all that knowledgeably about it, other than to say, that when I take pseudoephedrine, I get very sleepy, whereas the rap on it, as a drug class, is that it is a stimulant. I often chuckle to myself and conclude that I must have ADHD.

[Anne G]

Yes, we found a gluten free (on label) that used corn starch as filler. She was fine 7 days on it but is having a dramatically worse fatigue than usual following gluten exposure.

[plumbago]

I wish I had something constructive to tell you. The only other thing I can think of is that once people are gluten-free, often when they next get glutened, the reaction can be even worse than when they were regularly eating it.

[Scott Adams]

It may be too late for this article, but it may be helpful:

 

 

[knitty kitty]

Welcome to the forum, @Anne G!

Sorry to hear your daughter is having such a rough time. 

I have had very bad reactions to SSRIs.  They are known to cause gastrointestinal side effects.  

Side-effect profile of fluoxetine in comparison with other SSRIs, tricyclic and newer antidepressants: a meta-analysis of clinical trial data

https://pubmed.ncbi.nlm.nih.gov/15744630/

 

How long has your daughter been diagnosed and on a gluten free diet?  Is she taking any other medications?  

Since Celiac Disease causes malabsorption of essential nutrients, has your daughter been checked for nutritional deficiencies?

Damage to the small intestine (villus atrophy) results in malabsorption of essential vitamins and minerals.  B vitamins cannot be made by the human body.  We must get sufficient B vitamins from our diet every day because B vitamins cannot be stored.  Unfortunately, the gluten free diet can be low in essential nutrients, especially if gluten containing products (which are required by U.S. law to be enriched and fortified with vitamins and minerals) are replaced with gluten free facsimile foods (not required to be enriched and fortified at all).  

Taking B Complex supplements boosts the availability and absorption of these essential vitamins.  

Discuss the benefits of supplementing with your Nutritionist or dietician, as well as your doctor.  Unfortunately, many doctors are not as well educated about the importance of vitamins as we would wish.  As a microbiologist, I understood how important these essential vitamins are to cellular function and health.  

 

Clinical trial: B vitamins improve health in patients with coeliac disease living on a gluten-free diet

https://pubmed.ncbi.nlm.nih.gov/19154566/

...Nutritional Imbalances in Adult Celiac Patients Following a Gluten-Free Diet

https://pubmed.ncbi.nlm.nih.gov/34445038/

And...Associations of dietary vitamin B1, vitamin B2, vitamin B6, and vitamin B12 with the risk of depression: a systematic review and meta-analysis

https://pubmed.ncbi.nlm.nih.gov/33912967/

... Dietary intake of B vitamins and their association with depression, anxiety, and stress symptoms: A cross-sectional, population-based survey

https://pubmed.ncbi.nlm.nih.gov/33848753/

 

Thiamine Vitamin B 1 has been shown to alleviate depression and promote intestinal healing.  

...Thiamine and benfotiamine: Focus on their therapeutic potential

https://pubmed.ncbi.nlm.nih.gov/38034619/

...Neurological, Psychiatric, and Biochemical Aspects of Thiamine Deficiency in Children and Adults

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459027/

And...Adjuvant thiamine improved standard treatment in patients with major depressive disorder: results from a randomized, double-blind, and placebo-controlled clinical trial

https://pubmed.ncbi.nlm.nih.gov/26984349/

And...Thiamine nutritional status and depressive symptoms are inversely associated among older Chinese adults

https://pubmed.ncbi.nlm.nih.gov/23173173/

Riboflavin Vitamin B 2 helps....

Dietary riboflavin intake in relation to psychological disorders in Iranian adults: an observational study

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10060244/

 

Pyridoxine Vitamin B 6 helps...

Vitamin B6: A new approach to lowering anxiety, and depression?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9577631/

 

And Folate Vitamin B 9....

Folate and Its Significance in Depressive Disorders and Suicidality: A Comprehensive Narrative Review

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10490031/

 

And Vitamin B 12 Cobalamine....

Vitamin B12 Supplementation: Preventing Onset and Improving Prognosis of Depression

https://pubmed.ncbi.nlm.nih.gov/33251075/

And Niacin Vitamin B 3....

Dietary niacin intake in relation to depression among adults: a population-based study

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10506255/

....Diagnostic value of niacin skin blunting response in adolescent patients with depression

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10634130/

....Comparative study of efficacy of l-5-hydroxytryptophan and fluoxetine in patients presenting with first depressive episode

https://pubmed.ncbi.nlm.nih.gov/23380314/

 

I found taking Tryptophan, a form of Niacin Vitamin B 3, more effective than any SSRI.  Tryptophan is used by our bodies to make more Serotonin. 

Serotonin is normally made in the intestines, but inflammation due to Celiac disease can reduce its production.  With less serotonin being made, depression results.  SSRIs prevent serotonin from being reabsorbed, so more serotonin is available. 

However, Tryptophan is used to easily make more Serotonin.  With more serotonin available, there's no need for a SSRI. 

Do NOT take Tryptophan while taking an SSRI, which can result in Serotonin Syndrome (too much serotonin that can result in physical and mental symptoms).  

Demystifying serotonin syndrome (or serotonin toxicity)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6184959/

My doctors had prescribed a plethora of pharmaceuticals which resulted in me developing Serotonin Syndrome.  Easily corrected by stopping the pharmaceuticals.  I just take Tryptophan since without problems.  

And Vitamin D helps, too...

Is Vitamin D Important in Anxiety or Depression? What Is the Truth?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9468237/

All of these vitamins help heal the digestive system and lower inflammation.  

I hope this helps!  

[Anne G]

Thanks so much for sending this informative response. I will have a lot of reading tonight!

She was diagnosed with celiac 9 months ago and her vitamin levels were improving except vitD and they didn't check vit B levels so will ask.

I hadn't read about tryptophan so will look into this!!

Thanks again.