Cymbalta--better absorbed than most by RNY patients...who uses it and what do you think?

waitinggame
on 2/2/11 12:10 am - Bowie, MD

My counselor just gave me a copy of a study that showed how much of certain anti-depressants, anti-anxiety meds, etc., are absorbed by the gut of a gastric bypass patient. Apparently only 3% of Zoloft is absorbed (which is less than 1/3 the normal amount), but Cymbalta and Pristique were well absorbed.

I'm confused because Cymbalta is time released and everyone says timed release doesn't work as well for us.

It was recommended that I switch to Cymbalta to address not only anxiety, but chronic pain that I have and I'd love to think it will work for me. Anyone taking Cymbalta successfully?

Thanks for any stories!

Denise

Check out my blog--menumealplanning.com. Tales of making meal planning managable, family fodder, and everything else under the sun.

RNY 2/3/09, LBL/BL w/Augmentation 9/16/11
Start weight: 335 Current weight: 185 Goal weight: Whatever the hell I can maintain without driving myself insane!

*6.5 lost preop

Rejoyce
on 2/2/11 12:16 am - Dayton, OH

RNY on 03/14/11

I'm on cymbalta, but haven't had my surgery yet. I discussed this issue with my psychiatrist and he wasn't concerned. I didn't quite understand what he said about how much would initially be absorbed and how that would be acceptable, but he said something in that regard. But, the short version is he had no concerns about any of my psych meds except concerta, which is also time-released, but even that he said we would play by ear.

Joyce
Life is just a stage I'm going through...
HW:253 SW: 230 CW: 170 GW: 140

waitinggame
on 2/2/11 12:39 am - Bowie, MD

Good to hear--thanks! Good luck with your surgery!!

Denise

Check out my blog--menumealplanning.com. Tales of making meal planning managable, family fodder, and everything else under the sun.

RNY 2/3/09, LBL/BL w/Augmentation 9/16/11
Start weight: 335 Current weight: 185 Goal weight: Whatever the hell I can maintain without driving myself insane!

*6.5 lost preop

siberiancat
on 2/2/11 1:16 am - COLUMBIA CITY, IN

RNY on 03/25/09

I took Cymbalta pre-op and have continued it at 60mg each am since RNY 22 mo ago. I'm doing fine on it,

It also helps with fibromyalgia.

Penny
Highest Weight 255 * Wt loss includes 19 lb lost before surgery

waitinggame
on 2/2/11 2:17 am - Bowie, MD

My friend takes it for fibromyalgia and it really helps. Glad to hear it is serving you well!

Check out my blog--menumealplanning.com. Tales of making meal planning managable, family fodder, and everything else under the sun.

RNY 2/3/09, LBL/BL w/Augmentation 9/16/11
Start weight: 335 Current weight: 185 Goal weight: Whatever the hell I can maintain without driving myself insane!

*6.5 lost preop

Carebearny1999
on 2/2/11 1:34 am - Rochester, NY

RNY on 09/28/10

I took 30mg twice daily for my fibromyalgia pre-op and am continuing in post-op. For awhile I wasn't sure it was still working right for me as I've had some aches and pains but I'm honestly thinking those are related to the weather now! I wondered too since it is time-released. I don't open it or anything, just swallow it whole--smaller than a Tylenol!

Kaitlin N.
on 2/2/11 2:07 am - Dallas, TX

Which study would that be? I'm guessing it was one called "Dissolution of Common Psychiatric Medications In a Roux-en-Y Gastric Bypass Model." Is that right?

--Kaitlin Start - 285 / Surgery - 267 / Current - 177 / Goal - 170

waitinggame
on 2/2/11 2:19 am - Bowie, MD

I remember there being something about it being a model in the study--so I'm guessing you are right. Then there was apparently some very small study on actual patients that was done recently. I'll have to find the paper he gave me. Do you have information about it?

Thanks!

Check out my blog--menumealplanning.com. Tales of making meal planning managable, family fodder, and everything else under the sun.

RNY 2/3/09, LBL/BL w/Augmentation 9/16/11
Start weight: 335 Current weight: 185 Goal weight: Whatever the hell I can maintain without driving myself insane!

*6.5 lost preop

Kaitlin N.
on 2/2/11 2:28 am - Dallas, TX

Oh, do I ever! Unfortunately, I'm going to say your counselor was wrong, so I'm hoping you'll bear with me. This is an area that I'm very connected to and up-to-date with.

Since I'm 99% sure that's the study he gave you, I'm going to go ahead and give you my response based on that before my power goes out again. (I'm in Texas, and we've got rolling black outs today due to an overtaxed power grid.)

First of all, the study he gave you does not address the absorption of psychiatric medications at all. It addresses the dissolution of medications, which is how they dissolve. So, it is only concerned with what would happen in your pouch, not with what would take place in your intestines.

The number he quoted you for Zoloft is incorrect. First, it's not absorption. Second, the researchers found that 10% of the Zoloft dissolved in the RNY environment, as compared to 16% in the non-op environment. It was Paxil where only 3% of the drug dissolved in the RNY environment, but that was compared with 9% in the non-op environment.

Also, Cymbalta is not even included in the study! So I'm not sure where that recommendation came from...

I have a full write-up of the study on my blog, if you're interested. Here's the link. I go through it step by step.

There is a small study that will be published later this year. It's already available online. It looks at serum sertraline (Zoloft) levels in RNY patients. There's also info on my blog on that one.

For most people, adjusting dosage works to counteract dissolution and malabsorption problems. That's what I would try before switching meds.

--Kaitlin Start - 285 / Surgery - 267 / Current - 177 / Goal - 170

waitinggame
on 2/2/11 3:45 am - Bowie, MD

Interesting...thanks for the thorough response. Looks like I'll be able to clue him in next time we meet! It is the same study and I see that he was looking at the line above Zoloft--oops. I think the Cymbalta recommendation came from the fact that he was hoping it would address anxiety/chronic pain in a way that Zoloft doesn't. I was actually having a lot of stomach pain recently when taking the Zoloft, so I was looking forward to changing the meds since it didn't matter if I'd eaten or not--I'd still get the pain sometimes.

I'll definitely take a look at your blog. Glad to have a resident expert!!

Thanks again for your time!

Denise

Check out my blog--menumealplanning.com. Tales of making meal planning managable, family fodder, and everything else under the sun.

RNY 2/3/09, LBL/BL w/Augmentation 9/16/11
Start weight: 335 Current weight: 185 Goal weight: Whatever the hell I can maintain without driving myself insane!

*6.5 lost preop

Cymbalta--better absorbed than most by RNY patients...who uses it and what do you think?

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Cymbalta--better absorbed than most by RNY patients...who uses it and what do you think?