Question:
Depression and med absorption

many of you know of all the problems I am having after 3 years postop but this is something no docs seem to know the answer to. Obviously I don't absorb vitamins and minerals well anymore but I am on many many drugs for the lupus and Sjogrens, one being an antidepressant, Serzone. It just doesn't seem to be doing the job as well as I think it should be. I used to be on prozac long ago and it worked great but the doc doesn't want me on that right now. (many reasons due to the diseases). I want to know if antidepressants are absorbed differently after surgery? Do we need higher doses due to malabsorption? No docs seem to be able to give me a definative answer to that question and they hem and haw around it. Anyone else have this problem? Thanks to all of you for your help. I am going on an 1800 mile trip this week to see specialists about everything from the surgery to the other problems.    — Barbara H. (posted on July 21, 2001)

July 21, 2001
I am curious also about the malabsorption aspect of the surgery with regard to Serzone. I had taken Serzone in the past and seemed to do very well with it. Much better than with Paxil. But after surgery, I needed to go back on an antidepressant and the doc wanted to stick with what had worked in the past. It didn't seem to be as effective in controlling the symptoms of depression. I talked to my psychiatrist, my PCP and my WLS surgeon and no one seemed to have the answer. My surgeon suggested contacting the drug company that makes Serzone to find out if there are any data showing what theraputic levels of Serzone in the bloodstream would be. However, even if we were to contact the drug manufaturer, we'd then have to find a lab that could do a test for Serzone levels and my psychiatrist and pcp aren't too sure that there is one. I've not actually contacted the manufacturer at this point as the Serzone seems to have kicked in, but if anyone happens to get a reasonable answer from a physician or a psychiatrist, I'd love to hear it.
   — Maria H.

July 21, 2001
Have your pharmicsit ask exactly where in the gut this one is absorbed. Each one. Are they timed released? If so, perhaps they can put you on the plain version. Depending upon where the absorption takes place, you might need more OR less. You could try drawing a sketch of your sugery for your pharm & see if he can corelate what the drug mfr say.
   — vitalady

July 22, 2001
Hi Barbara-My first question would be, is it your family doctor, your surgeon or a psychiatrist that has given you the Serzone? Being a psych nurse, my first concern is that a psychiatrist be the one to be giving you antidepressants. Serzone should not be any different than any other medication in the way it absorbs. If you are having problems with the rest of your meds and with your supplements, then it sounds reasonable to me that you would also have problems with the Serzone. Defineatly check with a psychiatrist who is more in tune to the psych meds. Marie
   — Marie K.

July 22, 2001
Although I don't know about the absorptio of Serzone, I do know that with many antidepressant meds the effective dose will gradually increase over time (with or without WLS). I believe your body develops a tolerance to a dosage and then it needs to be increased. Maybe that is what is happening here. I know that with prozac, many times the dose will need to be increased as the patient develops a "tolerance" of that dose. I am sorry about your medical problems that have developed post op. I am anxiously waiting to hear about the results of your trip. I hope you get your much needed answers! Shelley
   — Shelley.