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What Could Cause Persistent, Painful Hunger Pangs After Eating Despite Adequate Water And Fiber, Given My Controlled HIV?
Posted on
Tue, 12 May 2020
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Tue, 12 May 2020
Answered on
Fri, 21 Nov 2025
Last reviewed on
Question : I have been getting hunger pangs AFTER I eat, especially at dinner, and they last until I fall asleep. There is an intense urge to keep eating in a somewhat painful way. I've tried drinking more water and eating more fiber but it doesn't seem to help.
I am taking Lamictal 100mgs, celexa 5mgs, klonopin .25 mgs at bedtime, and propranolol 5mg bid.
I take antiretrovirals for HIV infection (controlled)
10mg famotidine for GIRD
2.5-5mg ritalin OR 50-100mgs modafinil PRN
I am taking Lamictal 100mgs, celexa 5mgs, klonopin .25 mgs at bedtime, and propranolol 5mg bid.
I take antiretrovirals for HIV infection (controlled)
10mg famotidine for GIRD
2.5-5mg ritalin OR 50-100mgs modafinil PRN
Brief Answer:
Vague problem....Trial and hit method to be used.
Detailed Answer:
Hello,
Thank you for choosing "Ask a Doctor" service for your query. Have seen your details and I appreciate your concerns.
One very likely cause of your problem could be that
HIV infection increases the body’s need for energy and protein, which is thought to be due to increases in the production of cytokines—hormone-like proteins that regulate the inflammatory immune response. People with HIV therefore have higher dietary needs in terms of more protein and nutrients and may feel hunger pangs but they are not painful.
Second possible explanation is that in some patients Citalopram could cause abdominal pain. As the problem is seen at night time only I would suggest you to take night medications in evening for few days(I mean alter their timings don't take all three together) this would help you to rule out direct involvement of any medicine in it.
Try it and report me back after 4-5 days.
Take care. Hope I have answered your question. Let me know if I can assist you further. Thanks.
Regards
Vague problem....Trial and hit method to be used.
Detailed Answer:
Hello,
Thank you for choosing "Ask a Doctor" service for your query. Have seen your details and I appreciate your concerns.
One very likely cause of your problem could be that
HIV infection increases the body’s need for energy and protein, which is thought to be due to increases in the production of cytokines—hormone-like proteins that regulate the inflammatory immune response. People with HIV therefore have higher dietary needs in terms of more protein and nutrients and may feel hunger pangs but they are not painful.
Second possible explanation is that in some patients Citalopram could cause abdominal pain. As the problem is seen at night time only I would suggest you to take night medications in evening for few days(I mean alter their timings don't take all three together) this would help you to rule out direct involvement of any medicine in it.
Try it and report me back after 4-5 days.
Take care. Hope I have answered your question. Let me know if I can assist you further. Thanks.
Regards
Above answer was peer-reviewed by :
Dr. Raju A.T
thank you for getting back to me.
I currently take my Celexa (only five mgs) at night along with my Descovy and Isentriss (HIV), and klonopin.
During the day/morning is when I take the Lamictal and stimulants. I don't do well taking the celexa and lamictal at the same time.
I definitely get more than enough nutrients, including protein!
I have found that Lamictal, especially the brand name, results in a lot of involuntary muscle tightness (hips and neck muscles) as well as smooth muscles like esophageal spasms. Could this be affecting the stomach, causing contractions?
I currently take my Celexa (only five mgs) at night along with my Descovy and Isentriss (HIV), and klonopin.
During the day/morning is when I take the Lamictal and stimulants. I don't do well taking the celexa and lamictal at the same time.
I definitely get more than enough nutrients, including protein!
I have found that Lamictal, especially the brand name, results in a lot of involuntary muscle tightness (hips and neck muscles) as well as smooth muscles like esophageal spasms. Could this be affecting the stomach, causing contractions?
Brief Answer:
May be or may not be. These are not common side effects.
Detailed Answer:
Hello again my dear patient,
I can very well understand your problem but as said by me all of the drugs you are having are strong one schedule R and X drugs.
So the easiest way to find out which drug is causing the problem is to hold the medicine for few hours.
For Example: Today don't take Lamictal with other medicines rather take it 2-3 hours after taking your meds. If the pain occurs even without taking it the culprit is some other drug however, if after taking Lamcital pain returns back culprit it Lamcital.
Try and hit will take 2-3 days and would make things clear.
Take care. Hope I have answered your question. Let me know if I can assist you further. Thanks!
Regards
May be or may not be. These are not common side effects.
Detailed Answer:
Hello again my dear patient,
I can very well understand your problem but as said by me all of the drugs you are having are strong one schedule R and X drugs.
So the easiest way to find out which drug is causing the problem is to hold the medicine for few hours.
For Example: Today don't take Lamictal with other medicines rather take it 2-3 hours after taking your meds. If the pain occurs even without taking it the culprit is some other drug however, if after taking Lamcital pain returns back culprit it Lamcital.
Try and hit will take 2-3 days and would make things clear.
Take care. Hope I have answered your question. Let me know if I can assist you further. Thanks!
Regards
Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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