Do any of you know of an anti-depressant medication that works with the absorption related to gastric bypass surgery?  I have taken Cymbalta since 2004.  Had my RNY done on 10/24/08.  Recently the Cymbalta has not been cutting it.   My local Doctor gave me a 3 week sample of Pristiq and said I shouldn't need a build up since I've been on the Cymbalta.    Although it's only been a week on the Pristiq, I seem to be going down hill fast!    I'm wondering if it has to do with the fact that the Pristiq is a tablet and the Cymbalta was a capsule.  The capsule probably dissolved faster.   With the absorption issues related to gastric bypass surgery I was wondering if there was something better to take for general depression/anxiety.

I had lost 110 pounds, but have recently gained back 21 pounds.   The weight seems to be coming on fast.    My depression/anxiety is keeping me a prisoner of my house, sleeping a lot and spending most of my waking time on my recliner with my laptop.

Sorry to rattle on, but I wanted to be sure to get all the details out!

Thank you for your time!

Antidepressants by themselves may not solve your issue. I hear plenty of post ops at support groups speak about their depression. Many of them find counseling very beneficial.  Antidepressant medications seem to work fine and are not malabosbed. I saw a medical chart a couple of years ago, and of the 4 types of psych med classifications (including antidepressants, sleeping meds, anti-psychotic drugs), it appeared that only the antipsychotic drugs had the significant issue of partical malabsorption.  Meds vary with your personal physical needs. Sometimes it takes several tries at antidepressants, combinations of meds, or dosages.  I have to attend med review groups sessions every 6 months because I take antidepressant and anxiety meds.  I hear the psych doctor discuss meds and how they are working with many patients during these sessions.  It also takes several weeks for this type of medication to being working effectively.  A 3 week sample may not be enough time to detect whether it is working well for you or not.  If your depression and anxiety is keeping your from leaving your home, excessive sleeping, etc. , I'd strongly urge some type of counseling too, as medication alone may not resolve these issues. DAVE

Due to an increase in depressive symptoms post-surgically (very common), the doc increased the dose of my antidepresant, but to no avail.  I am currently off meds, doing a wash-out period before trying something else.  The psychiatrist at my bariatric centre suggested wellbutrin, as it is weight-neutral; in fact, some people even lose small amounts of weight on it.  It also has a low side effect profile.  You might want to do a bit of research on it and discuss it with your doc.  Good luck!

Pristiq is a tablet with an extended release formula and is not appropriate for an RNY post-op. You are likely not absorbing meaningful amounts of this drug, leading to your 'downhill' feelings. A very similar drug is Effexor, it only comes in 'extended release' capsules, but you can break these open and mix the drug in a drink or sauce to take (you can't do this with most extended release drugs, you can only do this with Effexor because it is the capsule and not the drug itself which makes it 'extended release'. Do NOT do this with your Pristiq tablets). If you go back to Cymbalta, it comes is both extended release and regular - make sure your doc prescribes the non-extended release formulation!

Thanks PatXYZ for explaining this in a way that makes sense to me.   I just looked at my Cymbalta bottle and it says "Delayed Release Capsules".   Not to appear stupid, but is that the same as "extended release"?  

Yep, delayed release or extended release are the same thing. The only difference is that sometimes it is the drug formulation itself that is extended release (like the Pristiq) and sometimes it is only the capsule holding the drug that makes it extended or delayed release and the drug is just a regular formulation (like with Effexor). Speak to your pharmacist and ask whether the Cymbalta is actually a regular release formulation in a delayed release capsule - if it is, then it is the same as Effexor and the capsule can be broken open and the drug taken in a drink or applesauce. If it is actually an extended release formulation, you should be able to have your doc prescribe the regular release instead, as it comes in both. I hope this info has been helpful and you can get back on track soon. Good luck!

Effexor (venlafexine) does come in tablets (I currently take 75mg 3x/day- although it is not always stocked) as opposed to the XR (extended release).

I've been on 75  mg TABLET 3 times/day of Effexor.  I've been on this dosage since my 1st surgery in 2003.  Effexor (NOT the XR) stays a short amount of time in your system which is why I take it 3x a day.    I had a medial bypass and did not have to adjust my dosage.  I was miserable though for a few days when I couldn't get my meds in the hospital.  But once I got it I was golden.  Here's an paper that was published several years ago and the newer meds are not on there.  http://psy.psychiatryonline.org/cgi/reprint/46/3/250  But you may find it helpful.  Don't let the depression get a hold of you! 

I was on Zoloft prior to RNY...then it upset my stomach. I am now on Lexapro (generic version) and I feel a lot better. Good luck...I totally understand that "going downhill fast" feeling!

Oh how I understad what you are going through... I was on Lexapro but do to some economic hard times I am not able to afford that and the klonopin.. The klonopin helps my anxiety so I just take that. I need to call my physican and see if I can get some sampled until I get out of this financial rut I am in.. Hopefully, next month I will be out of this...
But I take my klonopin, go to sleep sit at home and stay depressed and do nothing else. get on my computer, go to work.. maybe cook twice a week for my sons but other then that nothing... Although I have only gained between 3-5lbs back i dont overeat but sad part is I have turned to Laxatives to make sure I maintian my weight. Not that what I am doing is right,, but we all have some skeltons in our closet and I just have to get out of this rut.. so you are not alone my dear trust me.