Malabsorption of Anti Depressants

[Aloo77 1]

Hello! I am about a little over a month since my gastric bypass surgery. I am starting to notice changes in my mental health. I am prescribed an anti depressant/anti anxiety medication and I don’t think I am fully absorbing the medication the way I should be. Has anyone else experienced this? What helps you through this time? I’ve lost all motivation in life it feels like. I feel extreme sadness. I get overly emotional and I need some input

thank you so much

[Jonathan Carlson 75]

Hi, yes I take a prescription for mental health. The doctor said it shouldn't matter that I had a gastric bypass, but I noticed a change in my mood after the surgery. Thankfully I wasn't on the max dose so I talked to my psychiatric nurse and she upped the dosage and things got better.

From what I've heard, the only medications that matter are extended release ones. Otherwise, it should be absorbed normally. But that wasn't the case for me.

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[BlondePatriotInCDA 593]

5 minutes ago, Jonathan Carlson said:

Hi, yes I take a prescription for mental health. The doctor said it shouldn't matter that I had a gastric bypass, but I noticed a change in my mood after the surgery. Thankfully I wasn't on the max dose so I talked to my psychiatric nurse and she upped the dosage and things got better.

From what I've heard, the only medications that matter are extended release ones. Otherwise, it should be absorbed normally. But that wasn't the case for me.

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Exactly, the only meds that won't absorb well are extended release meds. After surgery you're losing weight and hormones are stored in your fat which starts to release with fat loss making emotions fluctuate horribly. It's completely normal to be emotional especially when you add to the mix less calories than you're used to and surgery recovery! More emotional, tired, run down depressed etc.!

[ShoppGirl 5,072]

I would reach out to your prescribing dr. They can up your dose or add another drug to help. It could just be temporary hormone changes but it could be the absorption issues. Regardless your dr should be able to help. This is really common with the extended release meds but it’s known to happen occasionally with a variety of meds. (It depends on where and how they are absorbed mostly) I was on one med Before surgery that requires you eat 350 calories For it to absorb properly so my dr changed me to another med until I was eating enough. Tried to switch back and all of a sudden the med caused me really intense anxiety. Tried to tough it out hoping it would lessen and go away but even with anxiety meds it was so bad I was up pacing the floors all night because I couldn’t sit still. This was a med I was on for through years before surgery without any issue. I don’t think they really can predict how our bodies are going to react to any meds post surgery. Just like it varies from one person to the next it’s like we are another person once our anatomy is altered.

Edited May 3, 2024 by ShoppGirl

[Aloo77 1]

Thank you all! I’m going to call my PCP and see if I can try tablets as my surgeon stated it could be cuz they are capsules

[ShoppGirl 5,072]

1 hour ago, Aloo77 said:

Thank you all! I’m going to call my PCP and see if I can try tablets as my surgeon stated it could be cuz they are capsules

Yea sometimes it’s the way they dissolve. There was something about tablets that have a special coating on them too that I vaguely remember reading about. I did this research three years ago before I had the sleeve because I am on meds too. People definitely do have issues with certain types of meds commonly and then a much smaller percent have issues with other types of meds that are fine for most people. I guess it’s kind of like the small percentage that have more issues getting enough Vitamins no matter what they try. You will Just need to keep working with your doctor until they will figure it out. In the meantime just try to remember that it is just a medication issue and you will feel more like yourself soon. 💜

[catwoman7 11,278]

could be either - hormones or absorption issues. Some people have to get their dosage adjusted after bypass.

[Arabesque 7,594]

Definitely go back to your prescribing doctor. Meds are absorbed in different parts of your body (stomach, intestines, kidneys & liver). It may mean changing to a more rapid release vs slow release or a different med.

My experience was the absorption of my HRT but after my gall was removed. My doctor switched me to a patch to ‘completely avoid my digestive system’ & all was good again. But that likely won’t be an option for the meds you are on.

[Dk2181 1]

just so I understand SSRI capsules were making you sick? I have been trying to take my Zoloft tablets and every time I’m nauseous and vomit and I take with crackers plenty Water sit up and everything.. 15 min later I’m 🤮 I hate this I have a liquid script but lost the instructions 🤦‍♀️

[JennyBeez 289]

How was your Iron on your last blood test? My pharmacist figured out that both my SSRI and my post-op antacid were lowering my iron to a ridiculously low level even with my multi-V supplements -- and anemia can both exacerbate and cause depression and other mental health symptoms. (Also, my doctor said there'd be no problems taking extra iron with my SSRI and NDRI, but my long time pharmacist & my post-op nutritionist both said while there's no clinical proof that it interferes, iron can affect the absorption of so many things that I'm better of scheduling my MH meds at least 2 hours before/after any iron (whether seperate or in the Multi-V. A few days after making that 2 hr gap, I could feel the difference).

[Arabesque 7,594]

I recently read about not taking your PPI within an hour or two of taking Iron (or calcium) because of the impact on absorption too @JennyBeez. Very interesting! Also don’t take your iron with or around the same time you have any caffeine. Caffeine can reduce the absorption of iron by 60% or more. There is scientific evidence about this just not well publicised. Also the iron added to iron enhanced foods like breads, cereals, etc. isn’t absorbed well.

Lot more research & education needed around all this.

[Dk2181 1]

16 hours ago, JennyBeez said:

That is interesting. You mentioned that because my pre surgery labs had my Iron really low .. and my bariatric Vitamins has my 45mg of iron .

How was your Iron on your last blood test? My pharmacist figured out that both my SSRI and my post-op antacid were lowering my iron to a ridiculously low level even with my multi-V supplements -- and anemia can both exacerbate and cause depression and other mental health symptoms. (Also, my doctor said there'd be no problems taking extra iron with my SSRI and NDRI, but my long time pharmacist & my post-op nutritionist both said while there's no clinical proof that it interferes, iron can affect the absorption of so many things that I'm better of scheduling my MH meds at least 2 hours before/after any iron (whether seperate or in the Multi-V. A few days after making that 2 hr gap, I could feel the difference).

[JennyBeez 289]

2 hours ago, Dk2181 said:

That is interesting. You mentioned that because my pre surgery labs had my Iron really low .. and my bariatric Vitamins has my 45mg of Iron .

Mine too! My team strongly pushed Centruum Prenatal Vitamins (2 per day) because of the iron and folic acid , and told me there'd be no problems taking the multiVs with my other meds (ssri & ndri, blood pressure meds, etc). I was -- for once in my life -- NOT anemic going into surgery but all my blood panels since (even after adding an additional iron supplement) were all still ridiculously low. The iron just wasn't taking. Now that I've started timing it better, hopefully we'll see an improvement there too. Just had another draw done on Friday, so we'll see what the results are at my next follow up.

[Dk2181 1]

I am 2 months post op and have had erratic emotions . zoloft tablets make me extremely nauseous/vomiting post op. I also take adhd meds and now the dose has to be modified.. I'm not sleepy or drinking,eating enough.. so I definitely think I have absorption issues like it's hitting bloodstream too fast. 😕