Michael Hawkins1, Samantha E Leung2, Andrew Lee3, Susan Wnuk2, Stephanie Cassin4, Raed Hawa5, Sanjeev Sockalingam6. 1. Consultation Liaison Psychiatry Service, Scarborough Health Network - Centenary Site, Scarborough, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada. 2. Bariatric Surgery Program, Toronto Western Hospital, Toronto, Ontario, Canada; Centre for Mental Health, University Health Network, Toronto, Ontario, Canada. 3. Bariatric Surgery Program, Toronto Western Hospital, Toronto, Ontario, Canada. 4. Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Centre for Mental Health, University Health Network, Toronto, Ontario, Canada; Department of Psychology, Ryerson University, Toronto, Ontario, Canada. 5. Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Bariatric Surgery Program, Toronto Western Hospital, Toronto, Ontario, Canada; Centre for Mental Health, University Health Network, Toronto, Ontario, Canada. 6. Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Bariatric Surgery Program, Toronto Western Hospital, Toronto, Ontario, Canada; Centre for Mental Health, University Health Network, Toronto, Ontario, Canada; Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Electronic address: sanjeev.sockalingam@camh.ca.
Abstract
BACKGROUND: Given the high rates of psychiatric comorbidity in bariatric surgery patients, pharmacotherapy is common and could potentially influence weight loss outcomes. OBJECTIVE: We aimed to identify the impact of psychotropic medication use on percent total weight loss (%TWL) 1 year after bariatric surgery. METHODS: In this prospective cohort study, 190 patients were compared based on demographic variables (age, sex, relationship status, employment status), body mass index, %TWL, and psychotropic medication use before and 1 year after bariatric surgery. An analysis of variance test was used as a global test of significance for psychotropic medication comparisons related to %TWL. Significance of post hoc comparisons was calculated with the Tukey's Honestly Significance Difference test. RESULTS: Sixty-one of 190 (32.1%) patients were taking psychiatric medications before surgery; of those, 82% (50/61) continued to take psychiatric medications 1-year after surgery. %TWL did not significantly differ between patients taking no psychiatric medications, one medication, or more than one medication 1 year after surgery (31.4% vs. 29.9% vs. 34.4%, respectively). Among patients taking antidepressants, those taking serotonin-norepinephrine reuptake inhibitors had a significantly higher %TWL than those taking selective serotonin reuptake inhibitors (36.4% vs. 27.8%; P = 0.032). CONCLUSION: This longitudinal study suggests that psychiatric medication use was not associated with poorer %TWL at 1 year after bariatric surgery. Within class, antidepressant use may have differential effects on weight loss after bariatric surgery and warrants further investigation.
BACKGROUND: Given the high rates of psychiatric comorbidity in bariatric surgery patients, pharmacotherapy is common and could potentially influence weight loss outcomes. OBJECTIVE: We aimed to identify the impact of psychotropic medication use on percent total weight loss (%TWL) 1 year after bariatric surgery. METHODS: In this prospective cohort study, 190 patients were compared based on demographic variables (age, sex, relationship status, employment status), body mass index, %TWL, and psychotropic medication use before and 1 year after bariatric surgery. An analysis of variance test was used as a global test of significance for psychotropic medication comparisons related to %TWL. Significance of post hoc comparisons was calculated with the Tukey's Honestly Significance Difference test. RESULTS: Sixty-one of 190 (32.1%) patients were taking psychiatric medications before surgery; of those, 82% (50/61) continued to take psychiatric medications 1-year after surgery. %TWL did not significantly differ between patients taking no psychiatric medications, one medication, or more than one medication 1 year after surgery (31.4% vs. 29.9% vs. 34.4%, respectively). Among patients taking antidepressants, those taking serotonin-norepinephrine reuptake inhibitors had a significantly higher %TWL than those taking selective serotonin reuptake inhibitors (36.4% vs. 27.8%; P = 0.032). CONCLUSION: This longitudinal study suggests that psychiatric medication use was not associated with poorer %TWL at 1 year after bariatric surgery. Within class, antidepressant use may have differential effects on weight loss after bariatric surgery and warrants further investigation.
Authors: Katherine A Lygrisse; Vivek Singh; Christian T Oakley; Alex Tang; Stephen G Zak; Andrew J Clair; Claudette M Lajam Journal: Arch Orthop Trauma Surg Date: 2022-03-23 Impact factor: 3.067
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