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.
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.
Authors: Jurjen S Kingma; Desirée M T Burgers; Valerie M Monpellier; Marinus J Wiezer; Heleen J Blussé van Oud-Alblas; Janelle D Vaughns; Catherine M T Sherwin; Catherijne A J Knibbe Journal: Br J Clin Pharmacol Date: 2021-06-03 Impact factor: 3.716
Authors: Philip Carlo Angeles; Ida Robertsen; Lars Thomas Seeberg; Veronica Krogstad; Julie Skattebu; Rune Sandbu; Anders Åsberg; Jøran Hjelmesaeth Journal: Obes Rev Date: 2019-06-24 Impact factor: 9.213
Authors: Charlotte Ginstman; Helena Kopp Kallner; Johanna Fagerberg-Silwer; Björn Carlsson; Andreas Ärlemalm; Ylva Böttiger; Jan Brynhildsen Journal: Obes Surg Date: 2020-06 Impact factor: 4.129