heartburn and trouble sleeping
 

One theory:

Heart burn related issues supposedly led to other symptoms such as throat spasms and eventually even migrated up to my temples causing spasms there. so the doctor(ENT), who is a great doctor put me on prilosec. it has def tempered down these spasms. but in other ways it may have caused other issues.

These spasms all began when I recall a year ago, i had the same type of issue with heartburn, but more importantly prototypical heartburn sympoms. so i begin to take nexium. and the heartburn leaves, but at the time I am really into alternative health stuff. and nexium supposedly causes your body to deplete itself in electrolytes like calcium, or magnesium. so i tell my doc, I'm going to discontinue Nexium and take something else. I was thinking of taking digestive enzymes, which are known to help gastro issues, and also take betaine HCL. But anyways back to the story soon after I discontinued nexium, these spasms which i never had before came up.

and since at the same time I discontinued nexium I discontinued gabapentin. to see if i could go without it. These spasms increased. so i decided to go back to taking the gabapentin to see if it would go away, it did initially but after awhile it didn't matter. I was convinced that it was actually the stopping of the gabapentin(not the nexium) that made it worse.

so even though these enzymes, PPIs, and betaine HCL could decrease my heartburn gastro issues. they def may have been causing other issues like trouble sleeping etc. I feel like maybe with no acid production in my stomach there is no acid to metabolize the medications. anyone experience this?

2. then there is one another theory i had....when i went off lexapro for a sustained amount of time 1 1/2 or 2 weeks. i def had some trouble sleeping during that phase, although during the day i could function quite well, my anxiety was there at times, but overall i could function. Music sounded better, tv shows started to actually be interesting. but it was so hard just not sleeping at all for like 2 nights in a row. it was actually so shocking that i had to go back on them. so, this theory could be true, that since i went off lexapro for such a duration as to make it not work as effectively when i came back on it. this is my main theory.

You poor thing. It sounds like you have more a case of gastric reflux going on. I deal with that from time to time and I've noticed that it comes back when I've taken some kind of new medication. Fortunately for me Nexium usually does the trick after just a few doses.

I sure hope you find the answer and get some decent rest. Heartburn is just so awful. :hug:

right, but if u read a little more carefully you'd understand that the heartburn medication itself may be causing more insomnia. because it's cutting off the acid used to absorb the other psych meds i take.

altho yes, heartburn for awhile was a big issue for me.

I don't believe that stomach acid enhances absorption of medications.

But stomach acid CAN affect negatively some compounds. This is why peptides are not given orally, since stomach acid breaks them up/digests them. Some drugs are enteric coated for this reason. Peptides are small proteins, and the bonds between the amino acids are broken by acid.
Also many people don't know this, but Prilosec has to have a basic non acid vehicle to be used orally. So does Prevacid. They are inactivated by stomach acid. We add bicarb to them when making them into liquids. The Prilosec beads(caps) and tablets are enteric coated.
This wiki explains it:
http://en.wikipedia.org/wiki/Omeprazole

You may notice motility changes when going off or on SSRI drugs like Lexapro. Since this drug increases serotonin in the synapse, it affects gastric functioning for some people. Some people have nausea/vomiting on it or diarrhea. Serotonin is the main neurotransmitter in the GI tract.

Here is an article explaining drug absorption, where most is accomplished in the small intestine. By the time drugs reach the intestine, the acids in the stomach have been neutralized by the pancreatic bicarb that is provided by the pancreas.
http://www.merck.com/mmpe/sec20/ch303/ch303b.html
Solubility in water, is the most critical factor for absorption, but even then, some insoluble things do get thru. Giving highly lipophilic drugs with a fatty meal, can help absorption of this type.

I have not been aware of drugs needing acid to be absorbed...I wonder who told you that.

In fact long term use of PPI drugs leads to gas and more reflux.
This is because the protein you eat is not digested properly and is fermented by bacteria in the intestine instead forming gas.
The gas then come back up or down depending along with diarrhea for some people. This is why those side effects are listed for those drugs. Gas coming back up as a belch, will also reflux food if it is present.

well it wasnt a firmly held belief
 

well it wasnt a firmly held belief about stomach acid, it was just a theory that it was causing medications to become less effective. i was just having trouble sleeping, and looking for a reason for this.

There is an antacid that coats the esophagus and is useful for resistant heartburn. It is called Gaviscon. If you don't have warnings on your pill bottles, about calcium etc, you can try this before bedtime. It usually does the trick for many people.

Insomnia is listed for all the PPI meds in that family as a side effect. I tried looking for the mechanism and could not find it.

Just having an upset stomach can cause sleep disturbances. I have a birth defect of the GI tract that when it starts, begins with insomnia, before I feel the cramping which comes later.

yah i mean i much rather not take gaviscon every night, instead of a PPI. because the PPI seems to be able to take away the spasms ive been having, and im trying to live with the insomnia. i mean before i even started taking the PPI i had insomnia. so like i said it was just a "theory" that it would be causing insomnia. i actually didn't see insomnia listed as a common side effect for PPI meds.

PPIs do nothing for spasms. They only reduce the secretion of acid.

What happens sometimes is that chronic irritation of the esophagus leads to a spasm there. By using an antacid for a week or so,this may heal up and stop. You may not need the Gaviscon every day after that.

Some drugs are irritating too. If you take your medications at night, you might consult your doctor and ask if you can take them in the daytime instead. Or take at least one hour before you lie down, and make sure you drink enough water with them.
The stomach has a mucus coat to protect it, but the esophagus does not. So some drugs may actually be irritating you.

hmm, not completely sold on using an antacid for a week, and then not using it. cause with me calcium carbonate doesn't seem to really help out my heartburn. I read somewhere that antacids aren't effective for heartburn, as you may need more and more of them, and they are just a temporary solution. and they cause heartburn to come back more and more worse when they do come back. not that PPIs don't do that. but my ENT doctor, who looked down the back of my throat said that my heartburn, or my stomach acid, is causing the spasms.

maybe i just need to cut back on the dosage of the PPI, cause I am taking 40 mg which was prescribed. but, they do have a 20 mg dosage. I didnt find anything that said PPIs can cause insomnia.

Gaviscon is not like other antacids. It sticks to and coats the esophagus.
This is how it works:
http://www.netdoctor.co.uk/medicines/100001145.html

It is a unique product and very effective.