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When people take certain drugs for anxiety, insomnia, heartburn or headache, they are trying to ease their discomfort. They surely don't intend to make things worse, yet sometimes that is what happens when they go off the medication.
It seems hard to imagine that stopping a medicine could trigger the same symptoms it was supposed to treat. Sometimes the reaction is actually more severe than the original problem.
Doctors occasionally have difficulty recognizing this rebound effect. That is because they may assume that the patients' difficulties are simply the return of the original symptoms.
During the 1970s, Valium and Librium were two of the most commonly prescribed drugs in America. These popular tranquilizers eased anxiety and helped people get to sleep.
When they were stopped abruptly, however, some people developed withdrawal symptoms that included severe anxiety, agitation, poor concentration, nightmares and insomnia. Many doctors just couldn't imagine that such symptoms might persist for weeks, since these drugs are gone from the body within several days. Nowadays the withdrawal syndrome from benzodiazepines like Ativan (lorazepam), Valium (diazepam) and Xanax (alprazolam) is well recognized.
Other drugs may also cause unexpected withdrawal problems. Quite a few people have trouble stopping certain heartburn drugs: "I have been taking Protonix for heartburn for about six months. After learning of potential ill effects from long-term use, I tried to stop taking it. After about a week, I had to start taking it again due to severe heartburn--the rebound effect, I suppose. I asked my provider how I should go about discontinuing its use, but she did not know."
Many physicians assumed that severe heartburn upon discontinuation was the reappearance of the underlying digestive problem. In the case of medications such as Aciphex, Nexium, Prevacid, Prilosec or Protonix, however, an innovative study demonstrated that perfectly healthy people suffer significant heartburn symptoms they'd never had before when they go off one of these drugs after two months of taking them (Gastroenterology, July, 2009).
In addition to benzodiazepines and heartburn medicines, other drugs can cause this type of rebound phenomenon. Decongestant nasal sprays are notorious for causing rebound congestion if used longer than three or four days. We have heard from people who got hooked and used them several times a day for years.
Another class of medications that can trigger withdrawal includes antidepressants such as Celexa, Effexor, Paxil or Pristiq. Many people who quit these drugs experience "brain zaps," dizziness or the sensation of having their "head in a blender," along with shivers, high blood pressure or rapid heart rate.
All these medications have two things in common: stopping suddenly triggers a rebound with symptoms similar to those of the original problem; and providers have very little information on how to ease their patients' withdrawal difficulties.
Patients deserve a warning before starting a drug that it may be difficult to stop. Providers should learn how to help patients stop a medication when they no longer need it.
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My problem has been with Prilosec. Each time I stop it--whamo, severe acid reflux. I complained to my doc, as I have read about the non-desirability of long term use (and I already have been on it a long time) and he said, basically, that it was harmless and just keep taking it. So really no answer. Will be anxious to read more about this issue.
Please add prednisone to the list of drugs which have been known to have rebound effects when stopped.
A question.
I am on synthyroid for life ( post thyroidectomy 30 yrs ago). Many years ago when I was an RN, there was a theory that a patient on this should take a 'medication holiday' for 3 weeks. The theory was that the effectivety was better after this drug holiday and the drug restarted.
Is this still true?
PEOPLE'S PHARMACY RESPONSE: THIS IS NO LONGER THE RECOMMENDATION.
How can we avoid the rebound effect if we want to discontinue these medications?
PEOPLE'S PHARMACY RESPONSE: GENERALLY, MEDICINES THAT CAUSE REBOUND NEED TO BE PHASED OFF SLOWLY. THE EXACT MANNER WILL VARY, SO ASK YOUR DOCTOR FOR HELP. (A NOSE SPRAY CAN BE DILUTED WITH PROGRESSIVELY GREATER AMOUNTS OF SALINE, FOR EXAMPLE, BUT THAT WON'T WORK FOR OTHER DRUGS.)
The problem with telling whether it's rebound or return of actual symptoms is that no one seems to know how long the withdrawal symptoms will last. No one, Patients or doctors seem to have any idea how long to wait it out before making a decision. This should be included in the drug info.
RN here, too--3 week holiday is news to me. I would check that out with my family doc.
So how long does the rebound effects last with each of these meds? Is it something to suffer through for awhile then its over, or does it last months/years?
PEOPLE'S PHARMACY RESPONSE: IT DEPENDS ON THE MEDICATION, AND PERHAPS ON THE PATIENT. WE KNOW THAT THE REBOUND FROM OMEPRAZOLE IN HEALTHY PEOPLE LASTED BETWEEN 1 AND 3 MONTHS.
You better believe it! My doctor tried to dismiss with a sneer that of course you'd get worse if you stopped Prilosec as that's why you were prescribed it. I read PP articles and insisted on stopping it as I didnt' think I NEEDED IT TO START WITH! After about 10 days I was okay. In the meantime, yes it was worse, but used strong antacids to help me out. After several months, haven't taken one since!!
I'm stuck on Soma. Took it for a neck injury, am cutting down, but Doc can't believe I'm having withdrawal. Nausea, headaches, chills, insomia, etc. that I didn't have before. How long does this take to settle out?
I was on prilosec and every time the doctor tried to take me off, I was miserable. I wanted to stop it so he referred me to a naturopath. Plus, I did studying on my own. I was in peri-menopause and found that cider vinegar before a meal helped, as the problem with us older folk is not enough acid. Then the system whammies us with more because the food isn't digested. The naturopath had me take 1/2 cup of aloe vera juice (or 3 tablespoons AV gel) after each meal.
I also use papya tablets after a meal. I use acid blockers a few times a month like if I eat pizza. But am usually quite heart burn free. Oh, and at the time I was out on prilosec WATER gave me heartburn. Nothing left me heartburn free.
has anyone experienced rebound from asthma drug inhalers? Has anyone ever had original symptoms get worse over time when using these types of inhalers?
I want to stop Wellbutrin as it may be a contributing factor in my heart palpitations. From what I've read in Elizabeth Lee Vliet's book SCREAMING TO BE HEARD increased norepinephrin may trigger palpitations, and Wellbutrin has an effect on that particular chemical. Anyone else had that experience? Or have any knowledge related to the subject?
Thanks.
I was on omeprazole for 14 months beg. Nov. 2010. The first dosage was for 40 mg. a day of omeprazole. Two months later, Jan. 2011, the dosage was doubled to 40 mg. a day 2x a day.
I was on that for a full year, til January 20th, 2012 when all of a sudden the medication just stopped working.
I would take the dosage 1/2 hr to 1 hour before meals and within a couple of hours the heartburn would start in again. I had vision problems, numbness and stiffness in my feet and toes and ankles, when I passed urine, it was never yellow but always clear. That shouldn't happen especially when you first get up in the morning. It should be a bright yellow. I got concerned about my kidneys. I read where long term dosages such as what I had, can ultimately affect your kidneys, liver, pancreas, etc.
In the morning I would wake up sick to my stomach to the point of throwing up, clear mucus in my throat, difficulty swallowing. One Saturday, I woke up, nervous as to how I was going to feel - every morning I dreaded getting up because I knew how I was going to feel. I had pillows and comforters stacked high so I could keep my head up. One Saturday morning I woke up and had a very severe wave of a burning sensation creep up my body, from my lower intestinal area to my shoulders. It felt like someone poured gasoline down my throat and lit a match. I thought I was literally going to die! I panicked. WTH was going on?
I took my omeprazole as recommended the day before as always, one 1/2 hr to 1 hour before breakfast and the same thing, before dinner. However, shortly after dinner I was having the burning sensations. I was going to bed with heartburn. I tried some mylanta, but it didn't help. I called the doctor's office, of course, office closed. Later the doctor called me back and suggested I take a 3rd capsule until I could get an appointment to see my doc the following week.
I got in on Tuesday. That was no help. I don't know what he was thinking. I have had severe lethargy and exhaustion. I don't know if my digestive problems have caused my stomach to not process my food adequately and my body is not absorbing correctly the nutrients from the foods I have eaten. I am going to have to beef up my intake of magnesium and the B vitamins and see what happens.
I am a woman in her early 60's. What I suspect is that the omeprazole had become too much for my stomach. Like I said I was on a high dosage for 12 months straight until it stopped working and caused me to have severe side affects. I suspect as time went on taking this drug, I did make enough stomach acid to process my meals and this is how that drug affected me.
I saw the doctor, he changed the prescription to Pantoprazole. I haven't taken it yet. That was a month ago. I'm to afraid of having those symptoms return again. I'm having another endoscopy in a couple of weeks. A year ago, I was diagnosed with Barrett's esophagus, which is not a reversible condition. Followup endoscopies are necessary on a regular basis to monitor the condition of the esophagus. My problem is with the lower end of the esophagus just above the stomach. It can turn to cancer eventually but that's a small percentage. I just hope I don't fall in that 1% category or whatever the real percentage is.
I went cold turkey off of the omeprazole, and refused to take the new drug which would have produced the same results.
I read somewhere you shouldn't go off this medication cold turkey without telling the doctor. Well, I did. I don't feel so bad. I take a zantac now and then if I feel I need it.
But after reading all these testimonials about ACV I am going to the GNC store to buy myself a big jug of the Bragg's Organic Apple Cider Vinegar and give it a try. What have I got to lose? I am also going to take that baking soda test that will give me an indication if I have high or low stomach acid. I suspect I have low stomach acid, which is what happens naturally anyway as we get older anyway. I think the omeprazole got to be too much for me and was working against me and making me very sick. It just stopped working, just like that.