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The Effects of Bariatric Surgery on Pharmacokinetics of Antidepressants: A Systematic Review

Published online by Cambridge University Press:  23 March 2020

L. de Jonge ,
S. Petrykiv ,
J. Fennema  and
M. Arts
L. de Jonge
Affiliation:
Leonardo Scientific Research Institute, Geriatric Psychiatry, Bergen op ZoomThe Netherlands
S. Petrykiv
Affiliation:
University of Groningen, University Medical Center Groningen, Department of Clinical Pharmacy and Pharmacology, Groningen, The Netherlands
J. Fennema
Affiliation:
GGZ Friesland, Geriatric Psychiatry, Leeuwarden, The Netherlands
M. Arts
Affiliation:
University of Groningen, University Medical Center Groningen, Department of Old Age Psychiatry, Groningen, The Netherlands

Abstract

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Introduction

Morbid obesity (BMI ≥ 35) has been associated with mood and anxiety disorders. Regular use of antidepressants is common among patients who are candidate for bariatric surgery. The Roux-en-Y gastric bypass (RYGB) is one of the most common techniques used in bariatric surgery for reducing nutrient absorption. This type of surgery may however result in major changes in drug absorption.

Objectives and aims

To report and discuss the consequences of bariatric surgery on changes in antidepressant drug absorption.

Methods

We present all published in vitro and in vivo studies on antidepressant drug absorption after bariatric surgery.

Results

In vitro studies showed that only bupropion had a significantly increased dissolution in a post-RYGB environment; venlafaxine and citalopram showed no alteration of dissolution; fluoxetine, paroxetine, sertraline, and amitryptiline had an significantly decreased dissolution in a post RYGB environment. Some in-vivo studies reported that only citalopram and escitalopram had an increased dissolution.

Conclusion

After bariatric surgery, special caution is required in patients using antidepressant medication because of the expected changes in drug absorption, nutritional status, and electrolyte balance.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
e-poster walk: Consultation liaison psychiatry and psychosomatics–Part 1
Information
European Psychiatry , Volume 41 , Issue S1: Abstract of the 25th European Congress of Psychiatry , April 2017 , pp. S232 - S233
Copyright
Copyright © European Psychiatric Association 2017
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