DS and extended release medication

Hello All,

I need help.  I am 3 weeks post op from my DS.  prior to surgery I took both zoloft and effexor for treatment of depression and anxiety.  After my surgery I had to crush all of my pills for the first two weeks.  By doing this, the extended release effect of the effexor no longer worked and my psychiatrist doubled my dose because the med was going through my system and bottoming out.  Now I can swallow whole pills so we went back to my normal dose. Since I was able to take a whole pill I have been feeling withdrawal symptoms again (zing in my face).  My MD says that there isn't much research about how to dose extended release meds after a malabsorption surgery like a DS.  We are going to have to go slow and see what works.  I am now on almost twice as much as normal, but still experiencing depression symptoms.  This is extremely difficult and makes recovery 10 times worse.  Having said all of this, here are my questions.

-Does anyone have experience with extended release psych meds and DS?

-Did you dosage need to be changed and by how much?

-Will my body absorb my meds better as I heal?

Thanks for any and all help you guys can give me.

 

Rebecca

I'm sorry you're going through this. I have read here that folks have to tweak and try again to get the balance just right. Keep us posted, you never know when what you learn will help others.

--gina

Generally, extended release meds and the DS don't play well together. Think about it---your small intestine is now effectively less than half of its original length. You might be better off switching to a med that's not extended release.

I am also on Zoloft, but not Effexor.  The strange thing is, the Zoloft is my only med I cannot swallow with water- it makes me nauseated and causes foamies.  Nobody can figure it out.  I'm fine if I hide it in yogurt.  I was able to decrease the dose post op from 100 to 50.

I know that doesn't help you, just a strange occurrence.  That being said, since you've obviously been treated, you know that tweaks and adjustments sometimes need to be made.  And I did suffer a rough bout of depression the first month after my DS.  Very, very dark days.  They passed.  Keep in mind, too, that depression can also be a side effect of general anesthesia.

Hang in there, follow your DR's orders, surround yourself with love and support, and don't hesitate to ask for help.  This, too, shall pass.

I take Effexor, and was told to ask for non extended release pills.  I now take regular Effexor, 75mg., 3 times a day.  It seems to do the same as my ER did.

I can't provide any guidance with your dosage, but it is very common for all DSers to have mood swings and changes in personality during the first year. The rapid weight loss causes big changes in our hormones.   It is unlikely that you will find that yesterday or today's dosage will be the same as tomorrows.  Try and keep that in mind when you feel a bout of depression.  It might be a bit more difficult to control in the short run.  

I think there are differing opinions on time released meds.  You need to look at the fine details of the drug- when is it released and where is it absorbed?

I was on paxil cr before surgery for SAD.  I weaned myself off after surgery and haven't used it for a year and a half (two winters).  I did have noticeable personality changes the first six months or so.  

I am not familiar with your particular drugs, but my PCP refused to prescribe some meds for my SAD because by merely missing a dose, you can have big mood swings.   Do a search on this site of your drug name and the DS and you should find more specific information.

I hope you find relief soon.

I was on Extended Release Welbutrin 200 mg twice a day. I switched to regular 100 mg four times a day before surgery because I was worried about that. I never noticed a change in my mood. It's been 2 1/2 months since my surgery and still doing fine.

I took Er (extended release) Effexor pre-op, one pill every morning. Since I heard about issues with Er meds post-op, I simply asked the doc to give me the non-Er ones. I have to take it twice a day but the total dose is the same and the pills are small. You should be able to switch over easily. And I know the 2x a day ones are working just fine. I was off of them for 2 weeks around surgery and boy howdy, I was a witch. Personally, I wouldn't take a chance on this med, just change to non-Er. Everyone around you will probably thank you too.