University of Miami, Miller School of Medicine, Miami, FL.
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
J Acad Consult Liaison Psychiatry. 2024 May-Jun;65(3):261-270. doi: 10.1016/j.jaclp.2024.01.001. Epub 2024 Jan 12.
Bariatric surgery affects the absorption of medications including antidepressants, but data regarding these effects are limited.
Our objectives were to review publicly available data regarding changes in antidepressant serum concentration following bariatric surgery in order to develop medication dosing recommendations in this patient population.
A comprehensive literature review was performed utilizing key search terms in Pubmed. Additional data were retrieved from the Food and Drug Administration and DrugBank Online resources.
A total of twelve published articles were included in addition to the publicly available data from the Food and Drug Administration and DrugBank. The serum concentration of antidepressants following bariatric surgery demonstrated considerable variability between and within drug classes due to unique pharmacokinetic features, drug preparation, and formulation. Recommendations were developed from published data regarding changes in serum concentration and drug-specific pharmacokinetic data.
To our knowledge, this is the first study to propose medication dose-adjustment recommendations for patients on antidepressants undergoing bariatric surgery. We were limited by the relatively small amount of data available and recommend monitoring patients and use of clinical judgment along with this guidance.
减重手术会影响包括抗抑郁药在内的药物的吸收，但关于这些影响的数据有限。
我们旨在回顾减重手术后抗抑郁药血清浓度变化的公开可用数据，以便为该患者人群制定药物剂量建议。
利用 Pubmed 中的关键搜索词进行全面的文献综述。还从食品和药物管理局以及 DrugBank 在线资源中检索了其他数据。
除了食品和药物管理局以及 DrugBank 的公开数据外，还纳入了十二篇已发表的文章。由于独特的药代动力学特征、药物制剂和配方，减重手术后抗抑郁药的血清浓度在药物类别之间和内部存在相当大的差异。建议是根据血清浓度变化和药物特异性药代动力学数据的已发表数据制定的。
据我们所知，这是第一项针对接受减重手术的抗抑郁药患者提出药物剂量调整建议的研究。我们受到可用数据相对较少的限制，并建议在使用本指南的同时监测患者并运用临床判断。
