I have only learned recently that Serotonin is not only produced in the brain but that it is mainly produced in the stomach. Although my PCP, surgeon and GI doctor all concur, they do not know how this affects or connects with the brain and use of SSRI medication. I don't want to make this personal but I am 4+ months out of surgery (VGS) and have since day one been suffering with both anxiety and depression. I am under treatment with a psychologist and have tried 2 antidepressants, Wellbutrin, and Zoloft, both of which immediately raised anxiety and zapped my appetite. I was taken off both and am now on Trazadone before bed and generic Klonopin as needed during the day. Myself aside, can you clarify what is going on chemistry wise since my stomach is no longer producing serotonin. I am trying desperately to figure this out and get adequate help, as I am barely able to cope with my life since the surgery. Thank you.

The effect of weight loss surgery and weight loss on depression and anti-depressant medications is very complex and not well understood. The only additional input I can offer is that sometimes the dosing of a medication needs to be changed while losing weight due to a change in absorption and a change in the distribution of the drug within the decreasing fat mass.

Thank you kindly for addressing my complex question. I am on the hunt for a psychiatrist who will have ample understanding of this concept. I know this will take perserverance especially on my part but as I am sure you understand I am in a very difficult position as I can not afford to have any decreases in appetite, yet am in dire need of relief from the morbid thoughts and at times unbearable anxiety. Please inform me if you come across any additional information that may be instrumental in helping me to gain a healthy mind and functional life. Thanks again. Regards, Lisann