Depression Treatment Medication Coping With Nausea While on Antidepressants Gastrointestinal Side Effects Common With SSRI Drugs By Nancy Schimelpfening Nancy Schimelpfening Nancy Schimelpfening, MS is the administrator for the non-profit depression support group Depression Sanctuary. Nancy has a lifetime of experience with depression, experiencing firsthand how devastating this illness can be. Learn about our editorial process Updated on February 18, 2021 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Table of Contents View All Table of Contents Causes Antidepressant Withdrawal Risk by Drug Type Minimizing Nausea Drug Tapering Strategies Nausea and vomiting are two of the more common side effects of antidepressants, and it may take some time to get over these symptoms when first starting treatment. In fact, nausea is often cited as the number one side effect of selective serotonin reuptake inhibitors (SSRIs) used to treat major depression and anxiety disorders. In some cases, nausea and vomiting can become so severe or persistent that a person has no other option but to stop treatment. Verywell / Brianna Gilmartin Causes Nausea and vomiting are common side effects of many drugs. These symptoms are more often due to the effect a drug has on the central nervous system (CNS) rather than any toxic effect it has on the stomach or gastrointestinal tract (GI tract). The situation is slightly different with SSRI antidepressants. This class of drug works by stimulating the effects of serotonin, a neurotransmitter associated with mood, cognition, and appetite. When serotonin levels increase under the influence of SSRIs, they stimulate serotonin receptors in the GI tract as well as the brain. The combined stimulatory effect—on both the GI tract and CNS—can trigger such side effects as: DiarrheaLoss of appetite (anorexia)NauseaVomiting Call your doctor if you experience persistent vomiting for more than 24 hours and have signs of moderate dehydration, or if vomiting and diarrhea are both present. Antidepressant Withdrawal Antidepressants can also cause nausea and vomiting when treatment is stopped too suddenly. Known as antidepressant discontinuation syndrome (or simply antidepressant withdrawal), the condition can cause an array of symptoms if the body is suddenly deprived of the drug. Gastrointestinal symptoms are among the most common and potentially severe. Antidepressant withdrawal symptoms can sometimes persist for several weeks and even lead to rebound depression (in which depressive symptoms return, sometimes worse than before). In addition to nausea and vomiting, antidepressant withdrawal can cause the following: Anxiety Confusion Diarrhea Dizziness Fever Hallucinations Headaches Panic attacks Profuse sweating Tremors Vivid dreams People who have taken antidepressants for longer than six weeks are more likely to experience withdrawal unless the daily dose is gradually tapered. How to Cope With Withdrawal Nausea Risk by Drug Type Nausea and vomiting doesn't only occur with SSRIs. The symptoms are also common with other classes of antidepressants, albeit less commonly or profoundly, including: Selective norepinephrine-dopamine reuptake inhibitors (SNDRIs) such as Wellbutrin (Buproprion) Serotonin-norepinephrine reuptake inhibitors (SNRIs) Tricyclic antidepressants (TCAs) Nausea and vomiting are less common with a class of antidepressants known as monoamine oxidase inhibitors (MAOIs). Minimizing Antidepressant Nausea In most cases, nausea and vomiting will develop soon after treatment is started and gradually resolve within one to two weeks once the body adapts to the medication. However, according to some research, as many as 32% of people taking an SSRI will continue to experience GI symptoms for up to three months. Fortunately, there are things you can do to minimize these symptoms: Take your medication with food, unless you are told otherwise.Take your antidepressant at bedtime to sleep through the worst of the symptoms.Eat smaller meals, more frequently.Suck on sugarless, hard candy whenever you are nauseous.Take an antacid like Pepcid (famotidine) or Tums.Sip ginger tea or slightly flattened ginger ale.Ask your doctor about a slow-release form of your antidepressant, or whether you need to temporarily lower your dosage.Talk to your doctor about anti-nausea medication, such as Zofran (ondansetron). While proton pump inhibitors like Prilosec (omeprazole) may help, they can sometimes increase the concentration of certain antidepressants in your blood and may require a dose adjustment to avoid new or worsening side effects. If your nausea or vomiting becomes intolerable, your doctor may have no other choice but to change treatment to another antidepressant with a lower nausea risk. Drug Tapering Strategies To reduce the risk of withdrawal symptoms when stopping an antidepressant, speak with your doctor about the appropriate tapering strategy. Going "cold turkey" is never advised and may end up triggering the very symptoms you were being treated for. As a general rule, the longer you've been on antidepressants, the longer and slower the tapering period will be. Some people can be tapered off in a matter of weeks; others may take months. Most doctors will reduce the daily dosage in three to four stages, maybe more if you've been on a drug for a long time. The following are some examples of tapering schedules by medication. Paxil Starting dose: 60 milligrams (mg)1st dose reduction: 40mg2nd dose reduction: 30mg3rd dose reduction: 20mg4th dose reduction: 10mg Celexa Starting dose: 40mg1st dose reduction: 30mg2nd dose reduction: 20mg3rd dose reduction: 10mg Lexapro Starting dose: 20mg1st dose reduction: 15mg2nd dose reduction: 10mg3rd dose reduction: 5mg Prozac Starting dose: 60 mg1st dose reduction: 40 mg2nd dose reduction: 30 mg3rd dose reduction: 20 mg4th dose reduction: 10 mg Zoloft Starting dose: 200mg1st dose reduction: 150mg2nd dose reduction: 100 mg3rd dose reduction: 75mg4th dose reduction: 50mg Tapering should always be done under the supervision of a doctor. In some cases, tapering may require altering doses if an interim dose is not available. (For example, you may need to take 40mg one day and 20mg the next if a 30mg pill is not available.) Unless otherwise directed, never cut an antidepressant in half as this may affect the speed in which it is absorbed and may trigger side effects. Call your doctor immediately if you experience any signs of withdrawal. How to Taper Off Your Antidepressant Medication 6 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Carvalho A, Sharma M, Brunoni A, Vieta E, Fava G. The safety, tolerability and risks associated with the use of newer generation antidepressant drugs: A critical review of the literature. Psychother Psychosom. 2016;85:270-288. doi:10.1159/000447034 Singh P, Yoon SS, Kuo B. Nausea: A review of pathophysiology and therapeutics. Therap Adv Gastroenterol. 2016;9(1):98-112. doi:10.1177/1756283X15618131 Berwian IM, Walter H, Seifritz E, Huys QJ. Predicting relapse after antidepressant withdrawal - a systematic review. Psychol Med. 2017;47(3):426-437. doi:10.1017/S0033291716002580 Kelly K, Posternak M, Alpert JE. Toward achieving optimal response: Understanding and managing antidepressant side effects. Dialogues Clin Neurosci. 2008;10(4):409-18. Canziani BC, Uestuener P, Fossali EF, et al. Clinical practice: Nausea and vomiting in acute gastroenteritis: physiopathology and management. Eur J Pediatr. 2018;177(1):1-5. doi:10.1007/s00431-017-3006-9 Keks N, Hope J, Keogh S. Switching and stopping antidepressants. Aust Prescr. 2016;39(3):76-83. doi:10.18773/austprescr.2016.039 Additional Reading Gjestad C, Westin AA, Skogvoll E, Spigset O. Effect of proton pump inhibitors on the serum concentrations of the selective serotonin reuptake inhibitors citalopram, escitalopram, and sertraline. Ther Drug Monit. 2015;37(1):90-7. doi:10.1097/FTD.0000000000000101 Renoir T. Selective serotonin reuptake inhibitor antidepressant treatment discontinuation syndrome: A review of the clinical evidence and the possible mechanisms involved. Front Pharmacol. 2013;4:45. doi:10.3389/fphar.2013.00045 By Nancy Schimelpfening Nancy Schimelpfening, MS is the administrator for the non-profit depression support group Depression Sanctuary. Nancy has a lifetime of experience with depression, experiencing firsthand how devastating this illness can be. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for Depression Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.