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my question is about what happens when the large intestine is removed, and the amount of serotonin that intestines can create is reduced.  I’m having severe antidepressant withdrawal effects that are abnormal  and I suspect it’s the jpouch.

I had been on the paroxetine SSRI antidepressant for over 10 years.  I went on it when I got my jpouch. And starting 2 years ago I slowly tapered down to get off of it.   My taper is exceptionally slow.
Because if I go any faster, I get all sorts of symptoms of low serotonin .  So under the care of my GP,  I go to a compounding pharmacy and we titrate at the glacial pace of 2.5% every six months. Simply lowering the dose by even that amount is enough to knock me off my feet for days. And I don’t really bounce back all that well in general, it almost seems like my system does not want to generate serotonin.  
I had thought that this is all a chemical issue in the brain, but just realized that perhaps some of the serotonin was being created in my small intestine.  Which no longer exists.  
Have you heard of this sort of case before or someone with a pouch has extreme SSRI withdrawal symptoms?   At this point we may have to look at raising the paxil again because it seems my body is just not bouncing back like anybody else’s and it’s somewhat debilitating at the low dose I have been on now for 6 months (5.85mg). I had originally been on 20 mg, which was a standard/regular dose for adults.
Has anyone hear heard of a situation like this before?
Thank you
Last edited by superfannypack
Original Post

I wish there was more information out there regarding this sort of topic.  I had my JPouch surgery almost 20 years ago, and have struggled with depression ever since.  I am sure there is some sort of genetic pre-disposition, but I would have to believe that removing the organ that produces 90% of the body's serotonin would be problematic in this regard. I wish someone would have mentioned that all those years ago.

To this day, I rarely, if ever, find information/articles that focus on this.

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