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Psych Meds after Gastric Bypass



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I've been taking Wellbutrin for years and post-surgery it works just as well as it did before at the same dosage.

But I also take Xanax (anti-anxiety) and after losing 105 lbs. I found that the dosage had to be reduced because it was now having a stronger, more sedating effect. I'm now at an optimal dosage though.

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I had to switch one of my psych meds from extended release to immediate release after my bypass. Fortunately, I didn’t notice any difference in effectiveness after the switch.

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I have an appt with my Dr. next week to discuss this exact question. I take Prozac and have been very stable for a while, so I'm nervous about impact from surgery (9/21). From what I've researched, and as others have said, the biggest issues seem to arise from extended/delayed release meds and the dosage of rescue meds. Neither of those apply to me, but I want to have a game plan in place, just in case. As with many things, its likely to be highly variable from person to person, so having a convo with your doctor ahead of time, being prepared, and really being mindful of your mental health post-op are all great strategies.

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2 hours ago, Kenda0928 said:

I have an appt with my Dr. next week to discuss this exact question. I take Prozac and have been very stable for a while, so I'm nervous about impact from surgery (9/21). From what I've researched, and as others have said, the biggest issues seem to arise from extended/delayed release meds and the dosage of rescue meds. Neither of those apply to me, but I want to have a game plan in place, just in case. As with many things, its likely to be highly variable from person to person, so having a convo with your doctor ahead of time, being prepared, and really being mindful of your mental health post-op are all great strategies.

@Kenda0928 I could not agree more to you le statement. Thank you for your feedback I helps

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14 hours ago, Prestonandme said:

I've been taking Wellbutrin for years and post-surgery it works just as well as it did before at the same dosage.

But I also take Xanax (anti-anxiety) and after losing 105 lbs. I found that the dosage had to be reduced because it was now having a stronger, more sedating effect. I'm now at an optimal dosage though.

@Prestonandme really Interesting 🧐 everyone’s body is different. Thank you so much for taking out of your time and sharing you experience and congratulations on your 105 pounds loss

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I've already discussed this with my therapist that prescribes Webutrin XL. She says that most XL medications are switched to regular release and I can take two smaller doses 2x a day, instead of the one XL in the morning.

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37 minutes ago, crpowers said:

I've already discussed this with my therapist that prescribes Webutrin XL. She says that most XL medications are switched to regular release and I can take two smaller doses 2x a day, instead of the one XL in the morning.

@crpowers thank you for your reply.

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I have VERY SEVERE bipolar so this was a huge concern for me. To the point that I did sleeve anyways but I did not find this community until a day or two pre surgery and I did not get the feedback that I have seen since then.
One thing I did do, which you may consider to help ease some anxiety, is to go ahead and try another combination of meds NOW. Pre-surgery. One of my meds needed 350 calories to absorb fully so I knew it may not work as well post surgery so while I was waiting my 6 months anyways I tried another medication. (I also started the immediate release version of my Wellbutrin because extended release meds seem to cause the most issues just so I knew other than taking it twice a day it was no different). For me, Just knowing that there was in fact another medication combination that worked for me allowed me to go into surgery with a lot less fear.

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Hey, I actually just registered this very moment b/c I wanted to reply to you. I've been reading these boards for a few months and these people have the most valuable information, experience and research!

To be completely candid, I have bipolar type 2 and anxiety, with a sprinkling of insomnia on top. I take different meds to help with all these issues, and after extensive research in the form of white papers, speaking with doctors and pharmacists, as well as my own, albeit short, experience (I'm just about 4 weeks post-op) I was only concerned about the bipolar medicine, Depakote Delayed Release 500mg tablets.

I maintained my PRN anti-anxiety and insomnia meds as these are immediate release, and I can report they have worked well for me in the past few weeks since my surgery. I did get switched over to the oral liquid form of the Depakote, however; Valproic Acid Oral Solution 250mg/5ml. I have to take it 3x a day to get the dose I was getting before with the DR tabs, but I had my bloodwork done last week and my serum levels are actually higher than they were on the tabs, so I may be able to come down a bit on the dose after a few months (I want to be sure, as I know I'm still in early recovery and only time will tell.)

I think you are doing the right thing by asking questions. Definitely speak with your surgeon, and prescribing physician as my surgeon didn't really have the first clue about the Bipolar med. Maybe even talk to your pharmacist if you feel comfortable with that. I made sure to have my script filled prior to my surgery date so it would be waiting at home for me after discharge. Good thing too b/c the hospital was out of the liquid form and I would have been out-of-luck.

I'd be happy to talk more if you like. Hope everything goes well for you. :)

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2 hours ago, boogie2dope said:

Hey, I actually just registered this very moment b/c I wanted to reply to you. I've been reading these boards for a few months and these people have the most valuable information, experience and research!

To be completely candid, I have bipolar type 2 and anxiety, with a sprinkling of insomnia on top. I take different meds to help with all these issues, and after extensive research in the form of white papers, speaking with doctors and pharmacists, as well as my own, albeit short, experience (I'm just about 4 weeks post-op) I was only concerned about the bipolar medicine, Depakote Delayed Release 500mg tablets.

I maintained my PRN anti-anxiety and insomnia meds as these are immediate release, and I can report they have worked well for me in the past few weeks since my surgery. I did get switched over to the oral liquid form of the Depakote, however; Valproic Acid Oral Solution 250mg/5ml. I have to take it 3x a day to get the dose I was getting before with the DR tabs, but I had my bloodwork done last week and my serum levels are actually higher than they were on the tabs, so I may be able to come down a bit on the dose after a few months (I want to be sure, as I know I'm still in early recovery and only time will tell.)

I think you are doing the right thing by asking questions. Definitely speak with your surgeon, and prescribing physician as my surgeon didn't really have the first clue about the Bipolar med. Maybe even talk to your pharmacist if you feel comfortable with that. I made sure to have my script filled prior to my surgery date so it would be waiting at home for me after discharge. Good thing too b/c the hospital was out of the liquid form and I would have been out-of-luck.

I'd be happy to talk more if you like. Hope everything goes well for you. :)

@boogie2dope I can appreciate the fact you took out of your time to redact and provide feedback. Thank you very much the sentiment is reciprocated.

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I took Nefazodone, an atypical antidepressant, worked fine. I also took extended release generic Xanax. I had to switch to regular. It was an adjustment but manageable.

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I just spoke to my psychiatrist and she put me on standard (not immediate) release bupropion (Wellbutrin) in advance of my surgery next week (AAAAAAA NEXT WEEK). I'm a bit nervous about it. But since so much of my depression is bound up in my weight, I'm hoping to be able to titrate down a bit.

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12 hours ago, vikingbeast said:

I just spoke to my psychiatrist and she put me on standard (not immediate) release bupropion (Wellbutrin) in advance of my surgery next week (AAAAAAA NEXT WEEK). I'm a bit nervous about it. But since so much of my depression is bound up in my weight, I'm hoping to be able to titrate down a bit.

Good luck with your surgery! You'll do amazing!!!

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17 hours ago, JessLess said:

I took Nefazodone, an atypical antidepressant, worked fine. I also took extended release generic Xanax. I had to switch to regular. It was an adjustment but manageable.

@JessLess that is good to know thank you for sharing

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