Anti-depressant causes depressing constipation

Dear Alice,

Ever since I've started taking Effexor XR, life has been splendid: Instead of waking up in the morning under a black cloud, I wake up feeling fairly normal and am able to function throughout the day.

Despite the wonders of feeling good emotionally, I've become constipated. I've tried everything. I eat right. I drink TONS of water (not just for this, but in general). Tried flushing my system with hot tea. I eat high fiber vegetables daily. I've even tried stool softeners. I've talked to doctors (who suggested that I must be exaggerating about how well I eat/exercise). Still, I only go every few days, and when it does happen it's often dry, difficult, and sometimes painful.

The only thing I haven't done is stimulant laxatives... And I really don't want to go that route.

What should I do?

In Search of Movement

Dear In Search of Movement, 

When times are gloomy, anti-depressant medications may help you get back in the groove mentally and emotionally. Unfortunately, antidepressants can put the brakes on other bodily functions like libido and digestion. Take heart if you've started your medication recently, constipation often subsides as you adjust to the medicine. In the meantime, continuing to eat a diet filled with fluids and fiber along with regular physical activity may help move things along. 

Antidepressants can impact the way your digestive tract functions, disrupting its normal routine. Other medicines that are likely to cause constipation can include iron, aluminum antacids, calcium supplements, antipsychotics, antiepileptics, narcotics or pain meds, and even diuretics. 

It's possible that your anti-depressant medication isn't the only thing slowing you down. There are plenty of other factors that could be contributing to constipation including: 

  • Dairy 
  • Irritable bowel syndrome 
  • Changes in life or routine such as pregnancy, aging, and travel 
  • Ignoring the urge to have a bowel movement 
  • Specific diseases or conditions, such as stroke 
  • Anxiety and depression

List adapted from the National Health Service 

You might find it helpful to use a journal or logbook to keep track of your eating and activity patterns. Drinking plenty of water, eating veggies rich in fiber, and daily physical activity foster regular movements. After each meal or snack, try to write down exactly what you ate, along with any physical activity you do that day, consider recording your fiber intake as well. Doing this may help you identify "hidden" causes of constipation. For example, alcohol and caffeinated drinks like soda, coffee, and tea can contribute to constipation, and it's easy to lose count of how many beverages you drink during the day. 

You're right to be wary of laxatives; with over-use, laxatives can damage the intestines, cause dependence, and actually worsen constipation. That said, consider speaking with a health care provider if you're curious about using them. A milder form of laxatives are fiber supplements such as those that contain methylcellulose, psyllium, and calcium polycarbophil, which may be used in moderation. 

If lifestyle changes don't do the trick, a health care professional or dietitian might recommend other treatment options for your constipation after doing a more thorough exam. 

Hope you find a way to loosen up soon! 

Last updated Jun 09, 2023
Originally published Mar 20, 2009

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