high-dose ppi treatment

Hi,

At the outset, I would like to apologize for my English, but I am from Poland and I don't speak English on daily basis.

A few months ago I had very bothersome symptoms of gastroesophageal reflux (the pain in my esophagus was almost unbearable). I went to a very famous gastroenterologist who prescribed me high doses of drugs that I was supposed to take over a period of several months. The recommendations were:

dexilant (dexlansoprazole) 60 mg twice a day

sulpiride 50 mg twice a day (I know this is a neuroleptic, but as I found out later, gastrologists also use it within their therapy - I have never taken any medications for mental disorders before btw)

prokit (itopride) 50 mg three times a day

famogast (famotidine) 50 mg at bedtime

probiotics

I was a bit surprised by this drugs combination and such high doses, but the symptoms were unbearable, so I followed the treatment regimen. After two weeks, my reflux symptoms subsided, but the doctor told me to continue the treatment for another two months. During the second month of the therapy, I've developed some neurological symptoms (brain fog, tinnitus, photophobia, headaches - btw I've never been diagnosed with covid). After consulting with my doctor, I've gradually stopped taking the medications (unfortunately after discontinuing sulpiride I developed brief depression with insomnia). With time, all the withdrawal symptoms resolved (acid rebound, depression and intestinal pain), the brain fog has passed, and the symptoms of gastroesophageal reflux ceased to bother me.

I would like to end my story here, but unfortunately, about 2 months after discontinuing the medications, I've started to develop some new neurological symptoms (fasciculations, pins and needles, muscle twiching, hypersalivation, middle ear myoclonus at bedtime). I've consulted two neurologists but they were unable to tell me anything (no changes in the brain MRI, no abnormalities in EMG, negative tetany test, the only thing that was found was thinning of the retina).

At the moment, perhaps the most logical assumption is that this may be anxiety disorder - one of the neurologists opinion (especially in connection with the sulpiride treatment). On the other hand, I am a bit afraid that such high PPI doses could affect the gut microbiota and in some way trigger some autoimmune disease, would you consider that even possible? Despite the fact that the doses were high, the treatment lasted only 2 months.

Another thing, I'm wondering if this drug combination and doses have any logical explanation. Dexilant at a dose of 60 mg should work around the clock, so why take it twice a day? Anyone tried dexlansoprazole twice a day? Does it make any difference? Also, could famotidine have any benefit since I was taking PPIs anyway? Have any of you ever had any similar experience? Anyway, I should probably ask this before starting my therapy 😃

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