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Malabsorption of psych meds? Or any meds?

I recently discovered, 4 months post RNY, that my antidepressant is no longer being absorbed. (I was having withdrawals).

Has anyone else experienced this? I have been crushing the meds and it seems to be helping, but I fear other meds are also not being absorbed!

Any tips or suggestions?

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  • Darktowerdream
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  • mediocreoblongata
    mediocreoblongata

    Definitely follow up with the doc ASAP, I would want to know if the liquid absorbs differently and IF that was why you were instructed a lower than normal dose.

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For me, my psychiatrist originally prescribed me Zoloft, and when I had the surgery, she just switched me from the pill Zoloft to the liquid concentrate of Zoloft. It still works well... for my Schizoaffective, I'm on Saphris (sublingual twice a day) and Zoloft Concentrate (with 8 oz of Crystal Light Lemonade, twice a day).

  • Author
For me, my psychiatrist originally prescribed me Zoloft, and when I had the surgery, she just switched me from the pill Zoloft to the liquid concentrate of Zoloft. It still works well... for my Schizoaffective, I'm on Saphris (sublingual twice a day) and Zoloft Concentrate (with 8 oz of Crystal Light Lemonade, twice a day).

Thank you for your post, and for sharing what meds you take. Is the Zoloft concentrate just once a day? I'm taking Effexor, not XR, but because of the short half life I have to take it 3 times a day, which is a pain!!
  • Author
I’ve made an appointment with my Dr for Tuesday so I can update my meds if needed.
Good luck, and let us know how you make out!

I had wanted to post on this subject before but didn’t know how to approach it. I live with daily chronic pain amongst many other things and I have high pain tolerance, but after surgery in the hospital, it set off everything all at once, nerves firing, sensory overload, every chronic pain in my body screaming. It started with spasms and pain in my neck and lower spine. And I couldn’t move my body to get out of bed, I could barely maneuver in bed. At that point I nearly broke. But I did my best to hold back. The nurses didn’t understand pain beyond surgical pain. Nor do the surgeons understand anything beyond the surgery recovery. And the assumption that all health issues will go away with weight loss. While true for some, not true for all.

i didn’t find out until afterward that nsaids were to be avoided. I had liquid pain medication from the hospital but according to them it should be stopped immediately or not taken. I stretched it out by taken it sparingly twice a day, then once a day until it ran out. I have no pain management. I cope the best I can. But need to function through fatigue. Higher pain levels. Higher fatigue. NSAID didn’t do much but took the edge off.

I think that the surgery effects how the meds are utilized. We aren’t told that crushing the pills or opening capsules will effect how they are processed. I tried to tell my doctor I can’t take the proton pump inhibitors especially having to open the capsules but he didn’t listen. I’m already extremely sensitive to medication (multiple chemical sensitivities)

its been extremely hard to find medication that comes in a liquid form. AND that my insurance covers. I’m still trying to find a muscle relaxer. Plus I don’t know how to take something that has to be slow release ... it’s hard enough to get my insurance to cover a name brand vs generic. I had to stop an important medication because of that. Sometimes Name brand causes less side effects.

I can’t say I would have not had the surgery had I known. My metabolism is slower than a sloth and my body wasn’t burning enough calories that even eating 800 calories and low carb I was steadily gaining weight. And quickly. The surgery was my last grasp to find a tool to help me. Either that or give up.

  • Author
I’ve made an appointment with my Dr for Tuesday so I can update my meds if needed.
FrouFrou. How did your appointment go?
Has anyone experienced their psychiatrist being very against bariatric surgery due to the perceived “malabsorption problems” associated with it?
My bariatric surgeon recommended gastric bypass (roux-en-y) for me over the gastric sleeve specifically because I have a long history with metabolic disorders (hypothyroidism/Hashimoto’s) and also have PCOS. However, I also have dealt a lot with depression and anxiety over the years and was already seeing a psychiatrist before considering bariatric surgery. I was surprised with my psychiatrists reaction to me telling her I am considering the surgery. Her opinion is that the surgery will cause “malabsorption” issues with the medicine I take - cymbalta is the only one I take routinely and I am in fact trying to wean off of it (medically supervised) completely. She honestly made me feel very uncomfortable about the whole situation, and of course I’m second guessing everything now. Long story short, I have really only been to her twice now (drs keep quitting) and really thinking about asking for a different person to see maybe because of how she made me feel about the surgery.
On 7/21/2019 at 6:48 AM, Briswife15 said:

Good luck, and let us know how you make out!

Hi - I went for my appointment. It was with a dr I don't know and I am having some issues... He gave me a prescription for liquid sertraline, but the pharmacist says that the amount that's been prescribed is HALF of my usual dose. I have called the doctor's office and they say it's the correct dose. The pharmacist says it's not. So... I'm confused. I can't get hold of the doctor's office today and so... not sure what to do now.

Just to follow up - I read this...

"ZOLOFT oral concentrate is available in a multidose 60 mL bottle. Each mL of solution contains sertraline hydrochloride equivalent to 20 mg of sertraline."

I was on 100mg of tablet form. I have been told to take 2.5ml of liquid, but that would only add up to 50mg of Sertraline. The doctor is WRONG. gah! That's downright dangerous.

On 07/24/2019 at 14:20, froufrou said:



Just to follow up - I read this...




"ZOLOFT oral concentrate is available in a multidose 60 mL bottle. Each mL of solution contains sertraline hydrochloride equivalent to 20 mg of sertraline."




I was on 100mg of tablet form. I have been told to take 2.5ml of liquid, but that would only add up to 50mg of Sertraline. The doctor is WRONG. gah! That's downright dangerous.


Definitely follow up with the doc ASAP, I would want to know if the liquid absorbs differently and IF that was why you were instructed a lower than normal dose.
Just now, mediocreoblongata said:

Definitely follow up with the doc ASAP, I would want to know if the liquid absorbs differently and IF that was why you were instructed a lower than normal dose.

I will once I can get through to them - nobody is answering. So annoying! However, don't pharmacists know dosage better than doctors? I kind of trust them more... Doctor didn't mention anything about it absorbing any differently. I have a large suspicion he is just wrong.

On 7/21/2019 at 8:48 AM, Briswife15 said:

Thank you for your post, and for sharing what meds you take. Is the Zoloft concentrate just once a day? I'm taking Effexor, not XR, but because of the short half life I have to take it 3 times a day, which is a pain!!

The Zoloft Concentrate that I'm on I take it twice a day, two pill drops full (i think it equates to 10 ml - it's the equivalent of 100mg of Zoloft twice a day), because before I was on 200mg of Zoloft once a day, the doctor decided to break it up. The bottle comes with droppers that measure out everything.

6 minutes ago, froufrou said:

I will once I can get through to them - nobody is answering. So annoying! However, don't pharmacists know dosage better than doctors? I kind of trust them more... Doctor didn't mention anything about it absorbing any differently. I have a large suspicion he is just wrong.

The liquid does in fact absorb differently. I don't know how, but because it is in a liquid form, it doesn't dissolve in the stomach like before. It's probably also just an adjustment phase... see how you do on it. My doctor did the same thing for the first month.

On 07/24/2019 at 14:31, froufrou said:





I will once I can get through to them - nobody is answering. So annoying! However, don't pharmacists know dosage better than doctors? I kind of trust them more... Doctor didn't mention anything about it absorbing any differently. I have a large suspicion he is just wrong.


Yup, doctors can definitely make mistakes but so can pharmacists :) hope it gets figured out soon!

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