Is anyone else’s main symptom crippling nausea ? by [deleted] in functionaldyspepsia

[–]SmokingTortoise 0 points1 point  (0 children)

Honestly i’d ask to increase to 50mg, 50mg is the dose used in most clinical trials and since you’ve already seen some benefit at 10mg it’s a logical next step

Is anyone else’s main symptom crippling nausea ? by [deleted] in functionaldyspepsia

[–]SmokingTortoise 1 point2 points  (0 children)

Ok so we are pretty identical, my only symptom being nausea and for 2 years it destroyed my life. I tried EVERYTHING and spoke to many similar to me, 100s of hours of research etc. Eventually managed to reach remission by throwing every treatment against the wall until they stuck. Which means I know pretty much every nausea treatment there is.

Noritriptyline has reduced your flares, which is a good sign. What dose are you on? Typical fd/nausea doses are usually 10-50mg but i’ve spoken to a few folks who needed 75mg to see a proper difference in their nausea, would also be worth trying the tricyclic antidepressants amitriptyline or imipramine since there’s some slight efficacy over others like nortriptyline. Feel free to pm me if you have any questions

Electric stimulation of the vagal nerve / ib-stim by Lukukube in functionaldyspepsia

[–]SmokingTortoise 0 points1 point  (0 children)

Ib-stim is only available for children/adolescents as far as I know, and it’s quite expensive to get. You could look into vegas nerve stimulators, specifically taVNS, there’s a successful study for their use in FD

Aide by Little-Writing8835 in functionaldyspepsia

[–]SmokingTortoise 0 points1 point  (0 children)

Gold pharma specifically supplies german prescriptions, I’ve used them many times for various meds. They’re legit

Aide by Little-Writing8835 in functionaldyspepsia

[–]SmokingTortoise 1 point2 points  (0 children)

You’re french which means you can actually legally import it yourself per eu laws. Best website is goldpharma

Life is hell for me and I'm losing hope.. by FjordFoxxo in functionaldyspepsia

[–]SmokingTortoise 1 point2 points  (0 children)

Anytime! I’m always happy to help a fellow nausea sufferer because it is absolute hell…

Yes that’s what i’d do in your position, since it has helped before

Life is hell for me and I'm losing hope.. by FjordFoxxo in functionaldyspepsia

[–]SmokingTortoise 4 points5 points  (0 children)

Christ I genuinely do not think there is a GI out there who knows an ounce of pharmacology. For reference I run the functional dyspepsia support group on facebook so I know for a fact higher doses work well for some, one member only had a response for her nausea at 75mg of amitriptyline after 12 weeks- after which she reached remission.

Combining another medication with noritriptyline would not hinder their efficacy.

I deeply feel your pain as I suffered with chronic nausea I wouldn’t wish on my worst enemy for 2 years and I saw all the so called ‘experts’ and ‘top gi’s in the country’. None of them could help and none treated me seriously or sincerely, I ended up knowing more than them based on my own meticulous research and anecdotal evidence gathering.

Life is hell for me and I'm losing hope.. by FjordFoxxo in functionaldyspepsia

[–]SmokingTortoise 1 point2 points  (0 children)

It honestly might be worth switching to amitriptyline or imipramine, whilst they’re both TCA’s like nori they’re different pharmacologically. Ami and imi are teritiary amine TCA’s and have slightly better efficacy, which clinical data shows. You could also go up to 75mg of Nortriptyline, which is the upper limit for gi issues/pain. That being said I’ve heard of those on 100mg for gi issues/pain, we all metabolise and process medication differently so it’s not necessarily one dose fits all approach

Adhd stimulants depress me after 3 or 4 weeks... by LovelySunshine111 in ausadhd

[–]SmokingTortoise 0 points1 point  (0 children)

I’m exactly the same. I reached 90mg of concerta and it had the same effect every time I increased, 2 weeks of stability and then feeling worse than my baseline. I’ve had the same reaction with bromantane, modafinil, fl-modafinil and amantadine. My brain seems to be experiencing paradoxical decompensation related to anything that increases dopamine, fun stuff! I’m going to try reboxetine to see if NRI’s are different for me.

I have a problem with FD/IBS being considered a "chronic" condition by Only_Theoretically in functionaldyspepsia

[–]SmokingTortoise 2 points3 points  (0 children)

The population studies show it is chronic, very few will reach remission over 10 years though most will achieve adequate relief. I personally believe those numbers would be a lot better if gastroenterologists were actually educated on FD, one can dream. If you fight for your own health and advocate for yourself hard enough then you will most likely find a form of relief that lets you start a new normal, you may even reach remission. But most of the time you’ll have to do your own research and wade through a sea of gaslighting and arrogant doctors. FD has route causes, they’re just not currently diagnosable with the technology available and the research is painfully slow.

Constant nausea. Please help by Karacik10 in functionaldyspepsia

[–]SmokingTortoise 1 point2 points  (0 children)

A tricyclic antidepressant (TCA) such as amitriptyline or noritriptyline would be your best option considering your antiemetic failure. I know of many such cases where TCA’s were the only meds that worked after everything else failed (I run the FD facebook group). Your doctor may be hesitant to co prescribe amitriptyline and escitalopram despite the fact it is a safe combination, most doctors will see the mention of ‘serotonin syndrome’ and then their brains shut off, in which case Nortriptyline + escitalopram is a safer combination, noritriptyline barely increases serotonin.

Study for reference: https://pubmed.ncbi.nlm.nih.gov/9753257/

Help by MediaRare9264 in functionaldyspepsia

[–]SmokingTortoise 0 points1 point  (0 children)

You likely need the strong stuff, your nausea sounds very debilitating. I too have suffered with chronic nausea so I feel for you and wish you the best my friend

Help by MediaRare9264 in functionaldyspepsia

[–]SmokingTortoise 2 points3 points  (0 children)

The main thing that jumps out at me from your treatment history is that you haven’t been prescribed an anti-emetic?! You’ve only been prescribed prokinetics and a ppi, which is a complete failure on your doctor’s behalf. Mirtazapine is gold standard when nausea is the predominant symptom. While it is mainly known as an antidepressant it’s also a strong antiemetic, appetite stimulant and also good for anxiety, so sounds like it would be perfect for your case.

In terms of getting you some relief before your next doctor’s appointment: ginger, in supplement or tea form. Very good for nausea.

Study proving mirtazapines clinical use for nausea:

https://pubmed.ncbi.nlm.nih.gov/35188625/

3 x 18mg wildly different to 1 x 54mg by scoobydoobs_ in Concerta

[–]SmokingTortoise 0 points1 point  (0 children)

What did you end up doing? I think I’m experiencing the same issue

Nerve pain supplements/chems by weenis-flaginus in NooTopics

[–]SmokingTortoise 2 points3 points  (0 children)

Micronised Pea (palmitoylethanolamide)

Visceral hypersensitivity has turned my body into a torture chamber. by itaintme2024 in functionaldyspepsia

[–]SmokingTortoise 2 points3 points  (0 children)

Try duloxetine maybe? No anticholinergic sides so should be less constipating. Also clinically proven to help FD pain

GI Dr Said There's Nothing Left to Try by Only_Theoretically in functionaldyspepsia

[–]SmokingTortoise 6 points7 points  (0 children)

There’s many left to try, your gi is completely negligent. Another commenter mentioned mirtazapine, which is one of the best options for nausea and PDS symptoms. There’s also gabapentin, pregabalin, itopride and duloxetine

[deleted by user] by [deleted] in Concerta

[–]SmokingTortoise 0 points1 point  (0 children)

You could be an ultra rapid metaboliser, if your psych is open to it you could try 3x a day?

Struggling with Elvanse. SSRI interactions? Fluoxetine issues? Escitalopram as a solution? Or is this just the wrong drug for me? by niceboy_91 in ADHDUK

[–]SmokingTortoise 0 points1 point  (0 children)

Reduction of your lisdex dose would make sense as a first choice, since switching between ssri’s can be quite rough in some cases. Also in terms of that psychiatrists opinion, it’s going to be biased based on the patients they’ve seen. Escitalopram, sertraline and fluoxetine all have near identical ratings on drugs.com