Psych meds post DS
Some docs know psych meds, some understand gastric bypass surgery, nobody seems to know about dealing with both issues. The psych docs seem to understand it a little better in regards to RNY - but that assumes that the stomach doesn't function normally, and that most of the bypasses that they see are short-limbed. They that deer-in-the-headlights look when I assure them that I have all of the stomach acids/function that God gave me to start with, but a long-limbed bypass.
The docs just don't know anything about medicine absorptions issues re: DS. That means I have to do my own research and teach them. So I'd like to know what anyone else has learned - or experienced - with their medicine absorption issues, particularly with SSRI antidepressants and with ADHD meds. I'd especially like to see any web sites with actual research papers.
Twenty-five years of history has proven that I will ALWAYS need an SSRI antidepressant. It's the only ongoing prescription I have needed in 3.5 years since DS. The effexor XR serves, although not as well as it did pre-DS. I can look at the past couple of years and see that its effectiveness is continuing to diminish, so it's time to change something. And now I need to address some other issues and we are looking at adult ADD meds as well.
Here's the kicker to the whole thing: My thinking is fractured so badly that I can't remember jack. I already have issues remembering to take supplements and meds now. Switching to non-time release meds brings into play problems remembering multiple times per day.
Does anyone have thoughts or recommendations regarding this problem?
Denise from Ark
I can't scientifically prove it but I honestly believe we do absorb MOST XR meds. Vites are harder to absorb than most medications and we break those down just fine. Dosages may need to be tweaked but we do get most of what we take in the prescription department. Aspirin, tylenol, ibuprophen, and antibiotics work the same for me now as they did before surgery.
A lot of medication absorbtion depends on transit time. How long it takes for us to eliminate what we eat. For me it varies from 10 to 15 hours. That's long enough for almost all meds. What matters is how long they are in your GI system. I am talking about people who are some time postop. In the beginning, for the new postop, all bets are off!
As to the time thing, I would buy several digital alarm clocks and set them when I woke up in the morning. Some people do have great success with a daily list they can check off, usually posted on the fridge.
Nice to see you! How are both of you doing?
Thanks Patty. I am so glad that you said this; it's what I've suspected. I'd already been on the effexorXR for several years, although I tried Cymbalta for about 4 months right about the same time as surgery. As many different ones as I've used before (most of 'em), it was the only one that I thought was well-nigh worthless. Went back to the effexor although she did up the dose from 75 to 150, and it's served, just that I know that I can have more benefit than I've been getting. The difference in how well it's working could just be an accident of the timing of how long I'd already been on it before the surgery.
I've been doing the coping exercises with the ADD thing for a long time; the only reason I'm even going with meds now is because it's just no longer enough. I'm a kept woman now because Les has become a travel nurse and we're traveling together, so I don't have the structure or accountabilty that a job provided. Oh yeah...and I turned 50 this year and my ovaries aren't playing nice anymore either.
We are doing so very well, and I am an unofficial ambassador for the DS wherever we go LOL. Both of us are keeping our weight off and our health up, but without having to worry obsessively about every bite in our mouths.
Every time I talk to a person whose diabetes is killing her/him, I tell them about you and your husband. Hope that's ok. It's frustrating to think how many people I know are dying with it without ever trying the one treatment most likely to save their lives. If I ever talk to someone who "gets" it and wants more info, is it ok to have them send you an email?
Denise from Ark
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Oh I know I have heard terrible horror stories. I have never had the electric shocks, thank God, but I have spent more than a year feeling dizzy when I'm within a few hours of the next dose. When it's really overdue, then you'd swear I'm stoned, my head hurts like crazy, and I can't even see straight. Then I get so dizzy I can't walk straight, either.
I asked specifically for a starter pack of samples - it starts you with the 37.5 for a week then a week of 75. I am using it, only backwards. I'd been taking 150(XR) a day, just took the 7th one of the 75 mg today. Will start the 37.5 mg tomorrow. The problem is, I am needing an SSRI right now. The circling thoughts, the anxiety, inability to concentrate on anything, period...nope. Need to get back on meds ASAP. I have asked for Wellbutrin this time, since it is often used in conjunction with ADHD meds anyway. One thing I know for certain, now...the Effexor actually does help with things that seem like ADHD but it just isn't going the whole way all by itself.
I hope you have better experiences if you ever have to get off of the lexapro.
Denise in Ark
Effexor has a much longer half life than Paxil, so I would think that even more caution is warranted in dose changes or discontinuation.
Regular effexor .... 2xs a day.
For ADD/ADHD - strattera normally dosed at 1 or 2x's a day ... my doc broke it down to 3 just to ensure I got the benefits.
I just put them all in my vites and pop em by the handfull with them.
Tom
HW 341/SW 309/CW 169/GW 190 172 lb. loss with my DS - Subscribe to me on YouTube!
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Yes, I do know that XR means extended release. What I'd like to find is "why." Here's the thing: All of the actual research I found indicated that the problem is in the stomach, not lower in the gut. AND it's specific to the RNY pouch, because the stomach acids that the timed-release coatings need aren't present in the RNY pouch. However, that's not an issue with the DS because the sleeve preserves all normal stomach function and excretions.
As Patty said, we do need to pay attention to how quickly (or not) the things we ingest passes through our systems completely. But, also like she said, I don't see things passing through my system all that quickly. I can eat something like spinach or beets that makes itself pretty obvious when it's all done, and it takes a full 24 hours and sometimes even longer before it shows up in my stool.
So the question I'd like to find the answer to is whether we, as DS-ers, are living under a restriction that doesn't apply to us because the procedure we had doesn't do the same things to our body that an RNY procedure would do. It seems like a logical question unless I can find some reason *why* besides the explanation that the medicine coatings need exposure to stomach acid. Gastric sleeve allows that exposure, and there's no sudden emptying of the stomach contents too quickly when your stomach still performs normally.
