Question:
Do I have to stop antidepressants prior to surgery or during liquid phase?
I've taken antidepressants for several years & a few years back when I was switched from Zoloft to Lexapro, I had a terrible time- aka breakdown almost. Will my meds be suspended during the days before or after surgey? Are they liquids available or injections, so the depression doesn't attack me when I cannot swallow pills? Thank you — dawnie125 (posted on June 16, 2007)
June 16, 2007
You didn't say whether your surgery will ber lapband or gastric bypass RNY.
But I work for a bariatric program and what I get from our Doctors is this:
most pills will be ground up and taken in stirred in sugar free jello, the
best advice I can give you is first speak to your Doctor, next your
pharmacist and make sure the pills can be crushed, some can not, also if it
is RNY surgery pills intened for extended release sometimes have to be
replaced with pills that are not and take more often. I had open RNY 14
years ago and no one addressed pills with me either, I started taking
hormone replacement before I had hot flashes so I did not know what one
was. I was told nothing solid by mouth for 4-6 weeks I took that to mean
pills. I was in the hospital for 7 days, about the 3rd day I felt like bugs
were crawling on me I was sick to my stomach mad at the world and being a
royal B to my bestfriend staying with me. Lucky for me a older nurse came
on shift and took one look at me and asked" are you on hormones?"
To which I replied roughly "yes but I can't have anything solid so I
have not taken them!" She left and can back with a hormone patch,
slapped it on my backside and that evening I felt like myself again. I
thought I was going crazy. I had a good little talk with my Doctor when he
made rounds about educationing his patient prior to surgery about home meds
and what to do about them in house and at home. It was a learning
experience, alot of meds you can take in liquid like pain meds but some are
not and you crush them until you are back on solids and if they are famous
"horse pills" you may still need to break them in half. Talk to
your Doctor and the pharmacy. Good luck!
— DonnaB.
June 16, 2007
There are drugs out there that come in liquid,topical,on the togue
dissolvable, chewable,etc. I could not grind up my meds,they were so
bitter,and since my intake was only 1-2 ounces at that time,the taste
lingered forever,it seemed! I contacted a pharmacisit & told them my
dilemna & they checked the PDR to see if 'my' meds came in other
routes. And I spoke with the different doctors after I found solutions
& changed my meds accordingly. I only had to change one med to
another,and the change has been satisfactory. I would have done one thing
differently,tho. I would have done all this before I had the surgery I was
fatigued already, after surgery,besides all the phone calls & running
back & forth to the pharmacy for new scripts. I hope that this helps
— peacelovecat
June 16, 2007
I have taken lexapro for years and never missed a dose, prior to surgery or
afterwards. They are very small pills and quite easily swallowed. Good
Luck.
— Kristi S.
June 16, 2007
Dawn, you pose a really good question, but you need to get with your
surgeon on this one. I don't know if a liquid form is available, but I can
say that they will do what they can to keep your medication cycle as normal
as possible. Just keep in mind that you may need less of this medication
after surgery. You will absorp only so much, and as your body loses
weight, you will need less for the same affect. This will mean changes
along the way. You have to really listen to your body and know the
symptoms of depression so you can pick up on them as you change in weight.
Also, you may find that if you get into a really good exercise routine,
that you are really helping the body deal with depression and you may want
less medication as well. It is amazing what the body will do for you if
you work it out. Getting all that stress out in sweat and fatigue makes a
huge difference. I don't know why you deal with depression and I won't
dare to guess, but I hope that those issues that have brought you down that
you have dealt with them prior to surgery. I will tell you that many men
and women who had depression issues prior to surgery and did not deal with
them can see a significant increase in depression and problems because they
didn't face their fears or pain. They didn't have food to run to any more
and that stripped them of their hiding place, which can cause a lot of
problems along the way. Please be sure you are ready for these changes and
are doing all the mental things you can to prepare for surgery. It will be
a better outcome for you if you do, even if the pain of dealing with the
past is hard for now. Take care and I wish you well. Patricia P.
— Patricia P
June 16, 2007
my surgeon said he wanted everyone on anti depressants to never miss a
dose. he is the head of the ASBS
— bob-haller
June 17, 2007
Those of us who suffer from clinical depression are often extremely
dependent on our antidepressants. This is not because we haven't dealt with
issues, but because we have a metabolic issue with neurotransmitters that
don't function properly. Surgery of any type WLS surgery, specific are put
us a risk for depressive episodes. It is very important that your meds are
continued. Check with your surgeon and phsychiatrist to determine the the
best way to ensure your mental and physical health during the post-surgery
period and as you continue through this life-changing process. I take
Cymbalta, which is a time-released medication, as well as others. The
Cymbaltha is a capsule and I have not had any issues swallowing it. I take
a couple of others that are small tablets. One of the things you'll need to
do is to work on scheduling your meds. I take one at a time at the bottom
of each hour. I am working closely with my phsychiatrist to monitor my
antidepressants and maintain the "sanity" I worked so hard to win
back. I also see a counselor every other week to address issues I have that
are related to my weight and my relationship with food.
It would probably be a good idea to have your phsychiatrist work directly
with your surgeon to determine how to best manage your medications to
protect you as you navigate your post-surgery journey. This way there won't
be guess work about absorbtion rates, appropriate substitutes, etc.
— Barbara C.
June 17, 2007
WE ARE NOT YOUR SURGEON!! It'd be BEST to check with them or/and your
Primary Doctor.
— Michael Eak
June 17, 2007
I also take Lexapro. I took it all through the liquid phase diet up until
the morning of surgery (05/14/07), once in the hospital they gave me the
liquid version, and then the first day home I was right back on the pill.
So if your experience is anything like mine, you should be fine and not
even miss a dose. Good luck.
— StacyL79
June 18, 2007
I have taken antidepresants for a long time. I did not stop even preop or
postop and inbetween. I cut them in smaller pieces. I have heard there are
liquid forms of some medications. Who ever prescribs these antidepresents
is who would know for sure. None of my medications were stopped pre,
during, or post op. I have also experieced the breakdown deal. But I am
so glad I did this surgery and working with my team thru out has helped me
to live and want to live. I wish you great success with your new way of
life. I had positively had no problems thru out. Email me and let me know
how it went...mTackett
— mtackett
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