Question:
Mental illness

Hi. I'm having surgery in June and I have a mental illness. Very bad depression. My question is this. Will I still be able to take the medications that I'm taking now? I take the following: Effexor, Tegretol, Zoloft, and Ambian for sleep. Will I experence post-op depresstion? Will the doses of my meds need to be rearaanged? Any help on this would be GREAT!!!!! Thanks!!!!!!!!!!    — [Anonymous] (posted on May 12, 2000)


May 12, 2000
Hi there. I had clinical depression, too, prior to my surgery. You didn;t mention what type of surgery you are seeking. If there is any intestinal bypass included, you may need a revision in your dosages, etc. My advice to you is to ask your psychiatrist for his answer to this. All of the helpful folks on this site have been extremely informitive, I've found... but you need to do what YOUR doctor(s) think is the best course in this. You may wish your psych person to contact your surgeon to conference on this, if he or she is not sure how medications will be absorbed post-op, in order to decide the best dosages of your meds, for when you come home post-op. I wish you the very best of luck, and a cessation of your symptoms!
   — lisadiehl

May 12, 2000
Hi, I also have clinical depression and am 11 weeks postop. I met with my psychiatrist prior to surgery and she said I should have no trouble taking my meds. I can take pills now no problem, even capsules. I'm on prozac, welbutrin and depakote. Beware of liquid anti-depressants though, I hear they taste awful and can cause you to not want to take them. Some people have postop depression because of the trauma of having surgery and the effects of the anesthesia. Just make sure you keep in touch with your therapist if you're feeling down.
   — Elizabeth M.

May 12, 2000
I just yesterday asked my doctor's nurse this question. I take zoloft and she said I could just crush it up or get it in liquid form if it comes that way. She said this would only be necessary at the beginning when on liquids.
   — Denise K.

May 12, 2000
I take Remeron and Ambien and have took them crushed for the first 10 days after surgery through my tube, crushed for the next 2 weeks orally, and now don't have to do anything to take them orally. Ask if you can split the dosage if malabsorbtion is going to be a problem, just to make sure you stay at a therapeutic level.
   — Alicia B.

May 12, 2000
No you meds should not be adjusted or changed. I have bipolar and also on several medications. I was able to take all of them after the surgery. The only time they have been adjusted is when I went through a depression, not from the surgery or its affects. Because of my meds I did not have post op depression. Iam not saying you wont, but chances are you may not because of your meds. Tegretol is one of my meds as well, Your meds should not change. Good luck to you.
   — chris M.

May 12, 2000
First of all, good luck with your surgery. One question I have for you is: Is your depression caused in part by your obesity? I work in mental health and have for nearly 13 years. With nearly every person I have worked with who has depression, we have been able to identify often concrete thinking processes that cause the depression. I think medications can be helpful for a time, but they are NOT curative and very often have disasterous side-effects. I, personally, do not buy into the theory that depression is caused by a chemical imbalance. I think a chemical imbalance may just as well be the result of depression as opposed to the cause of it. People covit. We covit what we cannot have. We covit what we see every day. Most problems of depression IMHO stem from things in our lives that prevent us from being the person we want to be. With obesity, there seems to be a certain comfort it eating which fulfills a basic need. The pathology also seems to include control issues with respect to one's own body. Perhaps the weight itself gives us a mass to hide behind. I would encourage you to do some real soul searching with a therapist. I know many of you are probably going to site research that supports chemical imbalances. Please check the funding sources - often such research is funded by pharmaceutical companies who have done a massive sell job on this nation. Psychiatrists are often reduced to being agents for pharmaceutical companies practicing medication management only and completely leaving out the social context or environmental influences that lead to feelings of worthlessness, hopelessness, helplessness, etc. Most problems of living can be directly related to our relationships with other people. WE NEED PEOPLE! We need to belong. We need to love and be loved. We need to love ourselves. In obesity we seem to gain comfort from food which carries a major side-effect - weight gain. In American society the more weight gained, the less acceptance we experience. With little acceptance, we sometimes (maybe often) feel we don't belong. This message is reinforced in a society that builds theater seats and resturaunt seats too small for folks of our stature. We glamorize being anorexically thin. I remind you all discrimination is not seen nearly as much as it is felt and I dare say everyone on this list has felt that or we would not even be considering such a major surgery to rectify the problem. I hope I have not confused the issue even more. Please, please, please follow up with your therapist and/or psychiatrist. Best of luck to you and all who read this. Depression is not a hopeless thing. We have to get really honest with ourselves I think to actually overcome it. Again, I think medication can be helpful, but psychotrophic meds are NOT curative and often have very bad side-effects.
   — [Anonymous]

May 12, 2000
Jeff - I have to agree with you. I was diagnosed with major clinical depression and on everything (SSRIs, MAO's (its been a couple years so I don't recall the lingo - prozac, effexor, paxil, wellbutrim, zoloft etc). The only thing I knew after 2 years was that I was exactly the same as when I started the meds and knew that it wasn't me. Against medical advice, I stopped all meds cold turkey and had a few psychotherapy sessions-and I do mean few. There was an enormous dissatisfaction and dissapointment with my life, and mostly with my body. Keeping myself focused on changing my body and my life keeps me sane. I have short 'relapses' - a day or two of feeling sorry for myself - usually premenstral. I've seen too many people given antidepressants instead of directed to the real problem - their unhappiness with their current life situation. I think people that believe they have a problem and that their depression is valid should continue whatever they believe it is that helps them. You create your own reality.
   — Toni B.

May 12, 2000
My prior message sounds too brief and flippant - I am talking about my own experience. I think mental illness is a very real disease. I question whether it is as 'common' as the docs & pharmeceuticals would like us to think it is. I never had major depression. 3 psychiatrists liked this diagnosis, and as long as I kept believing them, I was depressed and compliant with the meds.
   — Toni B.

May 12, 2000
the thing that always bothers me is - specifically, what chemical is unbalanced? What is my current level? what should it be? If these questions can't be answered, how can I buy into this chemical imbalance argument. I mean, when my thyroid is disfunctional, they can tell me exactly what my tsh factor is and what the normal range is. Chemical imbalance - they need better info to convince me that I have one.
   — Toni B.

May 12, 2000
I am on Welbutrin, Neurontin and Klonopin for Bipolar Illness (moods go from high to low, etc). I ckd w/ my surgeon and my shrink. I found out that I need to crush the pills for a short time after surgery. The pills that can not be crushed have to be changed to kind that can be crushed. Fortunately, all my meds come in dosages that can be crushed. I was told that I have to be off all medication for the entire week after surgery. In order to do this, I have to decrease my meds slowly one wk prior to surgery. My shrink does not think that being off the meds for one wk will be harmful to me. As others have stated, the effects of emotional stress due to surgery, etc can activate some problems. My shrink is working w/ me prior to surgery to make sure I am "well adjusted" at the time of surgery. Af far as bipolar being caused by elements in our environment, I do not buy that concept. It is a chemical imbalance in the brains function. Anyone telling you differently, beware of..depression can sometimes be caused by things "outside of ourselves" other times it is caused by chemical imbalances in the brain, too. Do not let any non physician tell you that you do not need meds. Leave that to the professional psychologists and psychiatrists to determine. I have seen people have disasterous consequences after following the lead of people not qualified to access their real needs. I, too worked in the field of mental health yet do not in anyway consider myself qualified to act as a professional doctor and tell anyone if they really have a chemical imbalance that requires meds or not. It is too dangerous to do! I leave this to qualified physicians and psychologists. I know that the reasons that I ate a lot of the time was due to the feelings that I experienced a lot of the time. When I was angry, sad, lonely, frustrated..I found that food helped me to cope w/ the feelings...at least for the moment. It was a QUICK FIX. I have to learn to use other more positive things to put in the place of food to help me to cope or I will gain the wt back again slowly. I do not want that to happen.
   — [Anonymous]

May 13, 2000
Ava - thanks for the explanation, but I have heard all the chemical imbalance theories. Its not my intention to invalidate people's beliefs, particularly when they are working for them - for me, unless they can specifically measure whats imbalanced - seratonin, dopamine, etc. like they can with cholesterol, calcium, etc. - they can keep their theories out of my brain matter and medicine cabinet.
   — Toni B.

May 14, 2000
You have received a variety of answers....let me add to them... I as well suffer from clinical depression. My WLS was in Sept. of 1998. I had been taking zoloft prior to surgery and discontinued it 3 weeks prior to surgery. All went fine, as it usually does for me, until my depression crept back into my daily life. I started on Wellbutrin and now take 200mg BID... the highest dose allowed. But I also talked with many different doctors with different beliefs which lead me to adding specific supplements to my regimen. This doctor advised that I add (1). a soy supplement (2). the supplement DHA and (3). high potency Bcomplex vitamin. So I did.... and I can't tell you that I felt noticably different but I do not get depressed as often and when I do, I am able to catch it right away and talk to my Dr. or Psychologist as needed. I also take vitamin C and of course the Multi Vitamin w/minerals. My bloodwork is great.... I have been taking this combination, including the Wellbutrin for a year + now and I am feeling good. My cholesteral when last checked was 148!!!! my BP is 100/55, which I thought was low but my Doc says I am very healthy!!!!! I am human, I still get down, believe me it is not always easy.....but it's better ; I just had my abdominoplasty surgery on May 2, and have the post op blues...but I know this to shall pass. When it does I will be on top of my game - living my life for me. Won't you join me? and enjoy your life as well, the good with the bad, the happy with the sad, and everything else that goes with LIVING!!
   — Edith B.

May 14, 2000
Ava - I think you missed my point - I never was depressed - I was misdiagnosed with depression -- as I believe many people who are dissatisfied with their current life situation (and their obesity, as was I) are. Docs love to attach a label (that stays forever) and prescribe meds.
   — Toni B.

May 14, 2000
Hi. I am diagnosed Bipolar. However, I took many of the same meds that you list, Tegretol, Zoloft, i took Klonopin instead of ambien, same principle. I had trouble getting my meds down following surgery. I had to crush them and inject them into the g tube with a syringe. This went on about 2 1/2 months to 3 months. But I took a lot of other meds too. I had surgery 10/4/2000. I started at 419.5 pounds. Today I weigh 253. I did have a lot of trouble when the psychiatrist did not take into account how much weight I lost and adjust the meds. Instead of decreasing, she kept increasing. I had to do a psych hospital stay to get it straightened out. However, now I am maintained with good control on 300 mg. seroquel and 150 mg. Wellbutrin Sr. This is amazing for me. LOL Beth
   — Elizabeth H.




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