Decreased Escitalopram Concentrations Post-Roux-en-Y Gastric Bypass Surgery.

Abstract:

BACKGROUND:There is a high coincidence between obesity and psychiatric disorders including depression. Depressive disorders are commonly treated with antidepressants, including the selective serotonin reuptake inhibitor Lexapro (escitalopram). Although candidates for elective Roux-en-Y gastric bypass (RYGB) surgery may be treated with escitalopram, drug dosing strategies are typically not adjusted postoperatively. Therefore, studies are needed to better characterize escitalopram drug concentrations in a postsurgical setting. METHODS:Turbulent flow-liquid chromatographic-tandem mass spectrometric methods were used to quantify escitalopram concentrations in serum in study participants approved for RYGB. Blood was collected from study subjects 2 weeks before surgery, and 2 and 6 weeks postoperatively, to assess the impact of RYGB on systemic drug concentrations. RESULTS:Twelve samples from 4 study participants were collected and analyzed for serum escitalopram concentrations. Two weeks post-RYGB, although there were minimal changes in each participant's body mass index (<5%), drug concentrations were 33% (4%-71%) decreased as compared with presurgical serum concentrations. There were further decreases in drug concentrations 6 weeks postsurgery. All clinical laboratory values were within normal reference intervals. CONCLUSIONS:RYGB significantly alters the gastrointestinal tract and impacts escitalopram drug concentrations, even shortly after surgery.

journal_name

Ther Drug Monit

authors

Marzinke MA,Petrides AK,Steele K,Schweitzer MA,Magnuson TH,Reinblatt SP,Coughlin JW,Clarke W

doi

10.1097/FTD.0000000000000146

subject

Has Abstract

pub_date

2015-06-01 00:00:00

pages

408-12

issue

3

eissn

0163-4356

issn

1536-3694

pii

00007691-201506000-00022

journal_volume

37

pub_type

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