Does Pristiq-Induced Constipation Go Away? (+3 Factors)
By
Ivan Kahwa
Author bio
Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.
Mr Ivan Kahwa’s Highlights:
Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.
Professional Experience:
Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.
With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.
With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.
Education:
2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.
2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.
2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.
Publications:
▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7
▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60
▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.
https://ethnobotanyjournal.org/index.php/era/article/view/4683
▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.
https://doi.org/10.53388/TMRIM202307004
▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.
https://doi.org/10.1186/s43094-021-00296-2
▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.
https://doi.org/10.5799/jmid.951600
Published book Chapter
▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.
https://doi.org/10.1016/B978-0-323-91942-5.00012-4
Submitted manuscripts Under Review:
▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience
▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine
▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology
Submitted book chapters under review
1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.
2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press
You can view my works on the following professional sites:
Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa
Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en
ORCID: https://orcid.org/0000-0002-6440-3437
Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159
In this article, we will discuss whether constipation caused by Pristiq goes away. We will also discuss the mechanism through which Pristiq causes constipation and what factors increase the risk of constipation.
Does Pristiq-Induced Constipation Go Away?
Yes, Pristiq constipation goes away within a few weeks once your body adjusts to the medication. Pristiq is the brand name for desvenlafaxine which is an antidepressant and a serotonin-norepinephrine reuptake inhibitor (SNRI). Constipation is a commonly reported side effect of antidepressants.
If you are experiencing difficulty in passing stools, or have infrequent bowel movements which are less than normal it indicates constipation. Experiencing this while taking Pristiq is normal and it is called secondary constipation as it is caused by medications (1).
Constipation caused by Pristiq should go away within a few weeks of starting the medication. However, if you experience extreme pain or a burning sensation during or after defecation or other unusual symptoms, you must contact your healthcare provider.
How does Pristiq cause constipation?
Pristiq produces its therapeutic effects by increasing the levels of serotonin and norepinephrine (NE) in the brain. As NE increases, it inhibits the activity of acetylcholine (ACh) and thus produces anticholinergic activity resulting in constipation (2).
ACh acts on the gastrointestinal system and stimulates the vagus nerve. This action increases the stomach contractions and the secretory activity. When Pristiq inhibits ACh, the contractions or gastric motility is reduced which causes constipation (3).
What does research suggest?
According to the research, constipation is a frequently reported symptom of Pristiq. A systematic review of clinical trials was conducted to study the safety, efficacy, and tolerability of Pristiq in different doses. 3 clinical trials were included in this review (4).
This review mentions that constipation was reported as a side effect in all of the clinical trials. During these trials, patients were treated with different doses of Pristiq (50 mg, 60 mg, 100 mg) for 8 weeks and constipation was reported at every dose (4).
This review also demonstrated that the side effects of Pristiq depend on its dose. Higher doses are associated with intense side effects. The number of patients reporting constipation was more in high doses of Pristiq and the lowest with a 50 mg dose (4).
This review also suggested that patients are more likely to experience most of the side effects during the first week of treatment. The side effects gradually reduce in intensity in the following weeks (4).
Thus, the research indicates that you can experience constipation while taking Pristiq. It is likely to occur in the first week and resolve afterwards. If you are on a higher dose of Pristiq (more than 50 mg) you can experience the side effects of increased intensity.
Who is at higher risk of constipation while taking Pristiq?
Constipation is a commonly reported side effect of antidepressants like Pristiq, Wellbutrin, and mirtazapine. However, certain factors make an individual more susceptible to constipation while taking Pristiq.
High dose of Pristiq:
Individuals are more likely to experience constipation if they are taking Pristiq in a higher dose. The recommended initial dose of Prsitiq is 50 mg and the maximum dose is 400 mg. As the side effects of Pristiq are dose-dependent, a higher dose increases the risk of constipation (4).
Poor lifestyle:
Lifestyle compasses dietary consumption and physical activity levels. Individuals who have a poor fiber diet, have a sedentary lifestyle, and do not maintain adequate hydration are more likely to be constipated while taking Pristiq.
Medical conditions:
Individuals with certain conditions are diseases more likely to get constipation while taking Pristiq. Individuals with colon, rectal, or anal stricture, abnormally dilated colon, weakened rectal walls, and abnormally narrowed intestine or rectum are more susceptible to constipation (5).
Medical conditions that increase the risk of constipation include (5):
- irritable bowel syndrome (IBS)
- diverticulitis
- sigmoid or cecal volvulus
How to manage Pristiq-induced constipation?
Here are some useful tips to manage constipation caused by Pristiq (5)
- increase the consumption of fruits and vegetables. They are rich in fiber and fiber increases the bulk of the stool and helps with constipation.
- consume an adequate amount of water because dehydration is a common cause of constipation
- engage in physical activity or exercise as it stimulates bowel movement and eases constipation.
- taking OTC laxatives also helps with constipation. They are of different types and their long-term use should be under a healthcare provider’s guidance.
- if constipation persists, communicate it with your healthcare provider. They might consider dose adjustments or alternative treatment options.
From my perspective, the research I have done indicates that constipation is a frequently reported side effect of Pristiq which goes away within a few weeks of starting the treatment. Pristiq causes constipation due to its inhibitory effects on acetylcholine which results in decreased gut motility. Factors like dosage, poor lifestyle, and medical conditions increase the likelihood of constipation while taking Pristiq. Laxatives, improvement in lifestyle, and open communication with the healthcare provider are important to manage Pristiq-induced constipation.
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References
1.-
Diaz S, Bittar K, Hashmi MF, et al. Constipation. [Updated 2023 Nov 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513291/
2.-
Andrade C. Desvenlafaxine. Indian J Psychiatry. 2009 Oct-Dec;51(4):320-3. doi: 10.4103/0019-5545.58303. PMID: 20048462; PMCID: PMC2802384.
3.-
Sam C, Bordoni B. Physiology, Acetylcholine. [Updated 2023 Apr 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557825/
4.-
Liebowitz MR, Tourian KA. Efficacy, safety, and tolerability of Desvenlafaxine 50 mg/d for the treatment of major depressive disorder:a systematic review of clinical trials. Prim Care Companion J Clin Psychiatry. 2010;12(3):PCC.09r00845. doi: 10.4088/PCC.09r00845blu. PMID: 20944767; PMCID: PMC2947544.
5.-
Forootan M, Bagheri N, Darvishi M. Chronic constipation: A review of literature. Medicine (Baltimore). 2018 May;97(20):e10631. doi: 10.1097/MD.0000000000010631. PMID: 29768326; PMCID: PMC5976340.
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