absorption of psych meds after RNY

Apr 07, 2009

I am bipolar and I thought this chart would help others with bipolar disorder that are worried about the absorption rate of their psych meds after surgery.

I've had to have several medication changes after RNY surgery because of issues of absorption.  If you have questions, please print the chart out and take it with you at your next doctor's appt.

Twelve of the 22 medication preparations were found to dissolve differently across the two environments. Ten of the 12 dissolved more in the control model, and only two dissolved to a greater degree in the RYGB model. Although not reported, variability within each sample of three pills was minimal. In no case did a value stray beyond 10% difference from the median weight change. (Variability data are available from the authors.) We chose not to report standard deviations, as we could not confirm that the data were parametric. Reporting the high and low values in addition to the median seemed unhelpful, considering that there were only three pills in each sample.

Within the antidepressant class, bupropion was the only agent that dissolved to a greater degree in the RYGB model (a median of 450 mg dissolved, compared with 320 mg in the control model, p<0.05). The dissolution of citalopram and venlafaxine did not differ between conditions. The remaining antidepressant medications (amitriptyline, fluoxetine, paroxetine, sertraline) dissolved more in the control model than in the RYGB model (Table 1).

Among the anxiolytic/sedatives, only one of the six medications varied between the conditions. Clonazepam was found to dissolve slightly more in the control model (a median of 100 mg dissolved, compared with 90 mg in the RYGB model, p<0.05). Dissolution of the remaining agents (buspirone, diazepam, lorazepam, trazodone, zolpidem) did not differ between conditions (Table 1).

For the antipsychotic/miscellaneous category, lithium carbonate dissolved significantly more in the RYGB model (median of 280 mg dissolved, compared with 130 mg in the control model, p<0.05). The dissolution of haloperidol, oxcarbazepine, and methylphenidate did not vary between conditions. Five newer antipsychotics (clozapine, olanzapine, quetiapine, risperidone, and ziprasidone) had greater dissolution in the control condition (Table 1).



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San Antonio, TX
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Sep 23, 2008
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