Malabsorption of medications

fattyfattyboomstix
on 10/16/11 3:09 pm
Hey there everyone. I have a question that I know has been discussed before (because I did a little research from previous posts and have seen info posted). My issue is that I guess I'm looking for more specific information and perhaps a source that I can literally quote from a text instead of the information coming from my WLS forum (which is great but my psych seems to require more than this). First off, I LOVE my psych. I only started seeing her after I had lost all my weight and could finally look at other issues I had been dealing with and not have everything 'clouded' by my weight.
Anyway, the issue is, she has prescribed a few meds for me. One is citalopram for depression and I'm on the max daily dose for that. We just kept increasing the dose until it felt 'right.' The other one is vyvanse which people take for ADD related symptoms. The problem is, I have spoken with my psych a few times about malabsorption and how my body may not be absorbing this particular med in the same way that a regular person would. She hasn't really changed anything though. The dose has been going up and I have only just started to see a difference, but the effectiveness wears off after about 3 hours and it is supposed to be a long- release (or medication that lasts in your body for 12 hours).
The other issue I'm having is with Lunesta. This is a sleep aid which she prescribed because I have insomnia (since I was a child - it's not a new condition after surgery). The Lunesta is supposed to be long-acting, and it does a great job of getting me off to sleep - but doesn't keep me asleep.
Any advice about how I can better communicate with my psych about my needs in medication? My assumption is that she needs to switch me to a vyvanse (or similar) with short release that I take twice a day. The same goes for the Lunesta, perhaps a short release that I can take twice. Any information would be greatly appreciated. Sorry for the long post!
Ms. Cal Culator
on 10/16/11 3:48 pm - Tuvalu


Take a diagram of your rearranged guts to your pharmacist and ask him or her to contact the doctor on your behalf?

There ARE pharmacists who will, for a fee, research this stuff and write a "To Whom It May Concern" letter...which MIGHT not be a bad idea since it's something we will all have to deal with forever.


airbender
on 10/16/11 7:03 pm
every person is different as every medication is different, not all medications need to be modified for a DSer, since not all medication is absorbed via the SM., the section that has been bypassed.   A good source is the medication insert, or you could ask to speak to the pharmacist, a good question to ask the pharmacist is ....does this medication get absorbed the same in a short gut patient (as most know what that is, and no clue about DS) as it would in the general population? but remember that information is contained in the package insert, that is your best information.    those are a couple options for you....hope you feel better
Julie R.
on 10/16/11 9:16 pm - Ludington, MI
 I do not have a great amount of experience with psych meds, although my daughter takes vyvanse, and it has really saved her life!   She was diagnosed at age 16 with ADHD and the turnaround that the medication has given to her is a gift from heaven.....

I do know that I cannot take long-acting drugs, however.     I can feel them wear off after about four hours.     I've taken the 12-hour Sudafed formula before, and it is ineffective, as well as Alleve (an otc anti-inflammatory).      

Hopefully others will provide more specfic assistance.    Good luck!
Julie R - Ludington, Michigan
Duodenal Switch 08/09/06 - Dr. Paul Kemmeter, Grand Rapids, Michigan
HW: 282 - 5'4"
SW: 268
GW: 135
CW: 125

DianaRR
on 10/17/11 5:13 am - CA
I wish I could help. I just remember reading that the surgery makes time released medicines not work right.
Have you checked with your surgeon--he/she may have some medical journal references for the psych doctor.
            
fattyfattyboomstix
on 10/17/11 6:44 am
 Thanks for the responses. I will look at the medical inserts and perhaps also speak with the pharmacist. My surgeon was in Mexico so doesn't really have much to do with patients once they return home. I'll do some of my own medical journal research and see what I can pass on to my psych. I'll make sure I post again with anything I think may help someone else in this position.

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