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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10643
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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I am undergoing radiation for breast cancer, and to

Customer Question

I am undergoing radiation for breast cancer, and to alleviate appetite loss and depression, through psychiatrist I took yesterday and today escitalopram(lexapro)-I have bad stomach so for hours I was nauseaus.
I stopped, and after hours recovered. Outside of Remeron you recommended is there anything else currently available? Depression is bad, loss appetite is bad, but nausea is worse-equivalent to death for me.
Please please advise. I take clorazepam for sleep. Thanks HN
Submitted: 2 years ago.
Category: Mental Health
Expert:  Dr. Z replied 2 years ago.

*This website DOES NOT constitute treatment and only provides information and advice. For treatment (therapy and/or medications) you must go to a licensed professional in your area. Please note that anything said here is not private or confidential, as this is a public forum.

Hello, I believe I may be able to help you with your concern. I am very sorry that you experienced this nausea related to the Escitalopram, I can understand how distressing this can be for you. Unfortunately all of the newer antidepressants have the potential to cause nausea, especially within the first 1-2 weeks of use, but usually this initial adverse effect always goes away as your body gets used to the medication. In addition because you are currently undergoing radiation treatment that has the potential to increase the chance of nausea. So with that being said a good medication for you would be an older antidepressant called Amitriptyline that can lessen your depression and is an appetite stimulant as well. The incidence rate of nausea with this antidepressant is also very low, so it may be an effective choice for you.

In addition, the use of Seroquel may also be another choice for you as that medication can lessen depression and can stimulate appetite. The incidence rate of nausea with Seroquel is some moderate though unfortunately, but usually not as high as with the SSRI/SNRI antidepressants. This is also mitigated if the medication is started at a low dose and gradually increased so that your body becomes more well adjusted.

Lastly the use of Clonazepam, which you are taking, being used twice a day and Zofran, an anti-nausea medication, can help to lessen the overall nausea you feel with any antidepressant, or Seroquel. So while an antidepressant may cause nausea, it can be cancelled out with the Clonazepam, as this is sometimes used to help lessen nausea for patients receiving both chemotherapy and radiation treatment. And Zofran is the typical anti-nausea medication to help relieve this level of nausea you have received while taking the Lexapro. Also there is a report that the use of Ginger has been beneficial in lessening the nausea associated with psychotropic medications, so that may be an option as well for you. So far this has been only studied on a few occasions, but it may be an option for you. Here is a good link on the subject if you are interested.

I hope this answers your questions and gives you some guidance on this issue. I truly wish you all the best with your treatment and I hope your symptoms of depression lessen and that your appetite increases with the right medication.

My goal is to provide you with excellent service, so if you ever have any further questions or concerns please do not hesitate to contact me at anytime. If I answered your question satisfactorily I would very much appreciate if you could rate my performance in helping you so that I can get credit for this question. Thank you very much