Bi Polar more intensive since WLS?
I am going through one of the hardest cycles I have ever been in. Very extreme...racing thoughts...mood swings...not sleeping...or then never feeling like I've had enough sleep.
I had my RNY April 1, 2008....is this to be expected so far out?
Any information is appreciated.
On meds faithfully.... Pristiq, AmbienCR and Lamictal
I had my RNY April 1, 2008....is this to be expected so far out?
Any information is appreciated.
On meds faithfully.... Pristiq, AmbienCR and Lamictal
I'm pre op so I have no experience, but because of my history I've looked at how my meds would be effected with surgery. Because of the mal absobtion component your meds may need to be adjusted to account for your new inner workings. I would definately contact your psychiatrist to start adjusting your meds.
Good luck!
Good luck!
Cheri I
the DS!
I had the Duodenal Switch! Do yourself a favour and check out www.dsfacts.com - especially if your BMI is over 50!
HW: 426/SW: 421/CW: 165/ GW: 150 Current BMI is 26.6!
the DS!I had the Duodenal Switch! Do yourself a favour and check out www.dsfacts.com - especially if your BMI is over 50!
HW: 426/SW: 421/CW: 165/ GW: 150 Current BMI is 26.6!
I am just realizing that my relapses with alcohol might be attributed to my bipolar being off since my surgery. It just never occurred to me that malabsorption might be part of my problem. I need to discuss this with my psychiatrist.
Malabsorption issues are part of that problem with bypass surgery patients. That is why the need for vitamins and minerals and I get B12 shots because of it.
Talking to your psychiatrist is the best route to take.
Trish
Malabsorption issues are part of that problem with bypass surgery patients. That is why the need for vitamins and minerals and I get B12 shots because of it.
Talking to your psychiatrist is the best route to take.
Trish
Seek always to do some good, somewhere. Every man has to seek in his own way to realize his true worth. You must give some time to your fellow man. For remember, you don't live in a world all your own. Your brothers are here too.
Albert Schweitzer
Albert Schweitzer
this was posted on Rny board by puggy dawn
Post Date: 12/17/08 2:36 pm
Large numbers of Roux-en-Y gastric bypass (RYGB) surgery patients have psychiatric illnesses that are in part treated with medications preoperatively, but there are no objective data to guide psychiatric drug dosing postoperatively.An in vitro dissolution model was developed to approximate the gastrointestinal environment of the preoperative (control) and post-RYGB states.Medication tablets were placed in the two environments, and the median calculated weights of the dissolved portions were compared.Ten of 22 psychiatric medication preparations had significantly less dissolution and two had significantly greater dissolution in the post-RYGB environment, compared with the control environment.The results suggest a need for an in vivo study of serum drug levels after RYGB surgery in patients taking psychiatric medications.Differences in the pharmacokinetics of the postoperative RYGB patient may necessitate adjustments in dosing. (Psychosomatics 2005; 46:250-253)
This has beend edited the following table to (a) make it easier to read, (b) to use brand names rather than generics, and (c) be reflective of the more commonly used meds.Please see the cited article, here, to view the table in its original form. Please remember that this study used modeled environments.The study authors used crushed and immediate release formulas of these medications.PLEASE, remember, that extended release versions of psych meds behave totally differently, and really should not be used in a person with an RNY (this is being said by the author of the article~ not myself ~ PuggyDawn).Remember also, that you may not see the effects of decreased bioavailability for several weeks postop, as the half lives for some of these meds can be quite long.I encourage you to use this data to open a dialog with your psychiatric provider. As you can see from the table, the amount of dissolved medication is higher in the preop environment for Prozac, Paxil, and Zoloft.Effexor and Celexa are pretty much the same for both environments.Wellbutrin, oddly enough, appears to have a higher amount of dissolved medication in the post-RYGB environment.The anti-anxiety/sedatives don’t have much difference between environments.The atypical antipsychotics, however, do show differences.Seroquel has the most difference between pre and post op (I can definitely speak to that—I’ve had to almost double my dose), with Geodon right behind.Risperdal and Zyprexa do show a difference as well.Lithium has increased amount of dissolved med in the post-op model, which makes me wonder about how ones lithium levels would be effected. Please check out the article, cited here.Thanks to the author for allowing me to use it J Table 1.Weights of Dissolved Portions of Psychiatric Medications in Standardized Dissolution Test Models of the Gastrointestinal Environments of Preoperative and Postoperative Roux-en-Y Gastric Bypass (RYGB) Patients.
I don't know why you think your body will not absorb it after surgery...I am bipolar and have taken my meds everyday..even the day of surgery and there had to be some adjustments but I absorb them fine.
I used to take Trazadone to help me sleep...but it always gave me like a "hang over" feeling in the mornings..so my doc changed me to ambien..but I take Trileptal, Pristqe and abilify for my bipolar.
There is actually a chart that shows that some people absorb more of their depression medication and the dose has to be cut back..so not everyone malabsorbs...
Cymbalta and Pristqe were too new of a medication to be included in this chart..but I hope it helps....
Dawn
Post Date: 12/17/08 2:36 pm
Large numbers of Roux-en-Y gastric bypass (RYGB) surgery patients have psychiatric illnesses that are in part treated with medications preoperatively, but there are no objective data to guide psychiatric drug dosing postoperatively.An in vitro dissolution model was developed to approximate the gastrointestinal environment of the preoperative (control) and post-RYGB states.Medication tablets were placed in the two environments, and the median calculated weights of the dissolved portions were compared.Ten of 22 psychiatric medication preparations had significantly less dissolution and two had significantly greater dissolution in the post-RYGB environment, compared with the control environment.The results suggest a need for an in vivo study of serum drug levels after RYGB surgery in patients taking psychiatric medications.Differences in the pharmacokinetics of the postoperative RYGB patient may necessitate adjustments in dosing. (Psychosomatics 2005; 46:250-253)
This has beend edited the following table to (a) make it easier to read, (b) to use brand names rather than generics, and (c) be reflective of the more commonly used meds.Please see the cited article, here, to view the table in its original form. Please remember that this study used modeled environments.The study authors used crushed and immediate release formulas of these medications.PLEASE, remember, that extended release versions of psych meds behave totally differently, and really should not be used in a person with an RNY (this is being said by the author of the article~ not myself ~ PuggyDawn).Remember also, that you may not see the effects of decreased bioavailability for several weeks postop, as the half lives for some of these meds can be quite long.I encourage you to use this data to open a dialog with your psychiatric provider. As you can see from the table, the amount of dissolved medication is higher in the preop environment for Prozac, Paxil, and Zoloft.Effexor and Celexa are pretty much the same for both environments.Wellbutrin, oddly enough, appears to have a higher amount of dissolved medication in the post-RYGB environment.The anti-anxiety/sedatives don’t have much difference between environments.The atypical antipsychotics, however, do show differences.Seroquel has the most difference between pre and post op (I can definitely speak to that—I’ve had to almost double my dose), with Geodon right behind.Risperdal and Zyprexa do show a difference as well.Lithium has increased amount of dissolved med in the post-op model, which makes me wonder about how ones lithium levels would be effected. Please check out the article, cited here.Thanks to the author for allowing me to use it J Table 1.Weights of Dissolved Portions of Psychiatric Medications in Standardized Dissolution Test Models of the Gastrointestinal Environments of Preoperative and Postoperative Roux-en-Y Gastric Bypass (RYGB) Patients.
| |
|
Median weight of | Median weight of |
| Medication | Dose (mg/day) | Dissolved portion (mg)--Pre-Op | Dissolved portion (mg)-Post-Op |
| |
|
|
|
| Antidepressants | |
|
|
| Prozac | 20mg | 110 | 40 |
| Paxil | 20mg | 30 | 10 |
| Zoloft | 100mg | 50 | 30 |
| Wellbutrin | 100mg | 320 | 450 |
| Effexor | 75mg | 180 | 180 |
| Celexa | 20 | 70 | 80 |
| |
|
|
|
| Anti-anxiety/Sedatives | |
|
|
| Klonopin | 0.5mg | 100 | 90 |
| Buspar | 10mg | 120 | 120 |
| Valium | 5mg | 10 | 10 |
| Ativan | 1mg | 10 | 0 |
| Trazodone | 100mg | 330 | 330 |
| Ambien | 5mg | 100 | 90 |
| |
|
|
|
| Atypical Antipsychotics | |
|
|
| Zyprexa | 10mg | 190 | 160 |
| Seroquel | 200mg | 270 | 120 |
| Risperdal | 2mg | 130 | 100 |
| Geodon | 80mg | 280 | 210 |
| |
|
|
|
| Mood Stabilizers | |
|
|
| Lithium | 300mg | 130 | 280 |
| Trileptal | 300mg | 20 | 10 |
| |
|
|
|
I used to take Trazadone to help me sleep...but it always gave me like a "hang over" feeling in the mornings..so my doc changed me to ambien..but I take Trileptal, Pristqe and abilify for my bipolar.
There is actually a chart that shows that some people absorb more of their depression medication and the dose has to be cut back..so not everyone malabsorbs...
Cymbalta and Pristqe were too new of a medication to be included in this chart..but I hope it helps....
Dawn
Corgi Mom
RNY
3/16/05
287/129 bmi 20.2 height 5'7"
Loss is good Maintanance is GREAT
Friends are angels who lift us to our feet when our wings have trouble remembering how to fly
RNY
3/16/05
287/129 bmi 20.2 height 5'7"
Loss is good Maintanance is GREAT
Friends are angels who lift us to our feet when our wings have trouble remembering how to fly
PLEASE make sure you are getting levels checked more often for anyone on Depakote, Lithium salts. WLS not only affects the absorption of some minerals, but also with the changes in body chemistry autonomic and sympathetic systems can be affected by slight changes. Meds that worked before may need to be re-evaluated. Hang in there. Chart your changes in cycling and discuss with your doc. Also helpful to note any new or changing stressors.
Best of luck-
Best of luck-
Every morning in Africa
It knows it must outrun the fastest lion or it will be killed.
Every morning inAfrica
It knows that it must run faster than the slowest gazelle, or it will starve.
It doesn't matter whether you're a lion or a gazelle
when the sun comes up you'd better be running.
RNY 2/9/09 Buh bye Gallbladder 8/28/09; 100% EWL (181 lbs.) on 2/19/10;
It knows it must outrun the fastest lion or it will be killed.
Every morning in
It knows that it must run faster than the slowest gazelle, or it will starve.
It doesn't matter whether you're a lion or a gazelle
when the sun comes up you'd better be running.
RNY 2/9/09 Buh bye Gallbladder 8/28/09; 100% EWL (181 lbs.) on 2/19/10;
My husband had RNY on June 25, 2009 and is down 155 pounds. I would have thought this would be an exciting time in his life, and it was for the first 5 months or so, but now he is one of the deepest depressions I've ever witnessed. Normally he is outgoing and fun loving. For the last month and a half he has been mopping around, not going anywhere, gets anxious around people, and has become obsessive about being around me all the time. He is going to his psych doctor and is on Zoloft for the depression, but he is bipolar. They had him on depokene (liquid form of depokote), but it wasn't touching his depression. They will put him back on that as soon as he is leveled out, but this adjustment has been over two weeks now and I'm not seeing an improvement. I'm really starting to worry that he isn't going to pull out of this. I can't help but feel it has something to do with the RNY surgery and the major changes to his body. Does anyone have information on this type of thing as it relates to the chemical imbalance that may be going on here?
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