Plasma concentrations of SSRI/SNRI after bariatric surgery and the effects on depressive symptoms
BackgroundDepression and treatment with antidepressants SSRI/SNRI are common in people with morbid obesity who are candidates for bariatric surgery. There is few and inconsistent data about the postoperative plasma concentrations of SSRI/SNRI. The aims of our study were to provide comprehensive data...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-04-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1132112/full |
| _version_ | 1797840003759341568 |
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| author | Patrick Pasi Dino Kröll Alena Siegfried Martin Sykora Alessandro Wildisen Cristiana Milone Gabriella Milos Laura Horka Stefan Fischli Christoph Henzen |
| author_facet | Patrick Pasi Dino Kröll Alena Siegfried Martin Sykora Alessandro Wildisen Cristiana Milone Gabriella Milos Laura Horka Stefan Fischli Christoph Henzen |
| author_sort | Patrick Pasi |
| collection | DOAJ |
| description | BackgroundDepression and treatment with antidepressants SSRI/SNRI are common in people with morbid obesity who are candidates for bariatric surgery. There is few and inconsistent data about the postoperative plasma concentrations of SSRI/SNRI. The aims of our study were to provide comprehensive data about the postoperative bioavailability of SSRI/SNRI, and the clinical effects on depressive symptoms.MethodsProspective multicenter study including 63 patients with morbid obesity and therapy with fixed doses of SSRI/SNRI: participants filled the Beck Depression Inventory (BDI) questionnaire, and plasma levels of SSRI/SNRI were measured by HPLC, preoperatively (T0), and 4 weeks (T1) and 6 months (T2) postoperatively.ResultsThe plasma concentrations of SSRI/SNRI dropped significantly in the bariatric surgery group from T0 to T2 by 24.7% (95% confidence interval [CI], −36.8 to −16.6, p = 0.0027): from T0 to T1 by 10.5% (95% 17 CI, −22.7 to −2.3; p = 0.016), and from T1 to T2 by 12.8% (95% CI, −29.3 to 3.5, p = 0.123), respectively.There was no significant change in the BDI score during follow-up (−2.9, 95% CI, −7.4 to 1.0; p = 0.13).The clinical outcome with respect to SSRI/SNRI plasma concentrations, weight change, and change of BDI score were similar in the subgroups undergoing gastric bypass surgery and sleeve gastrectomy, respectively. In the conservative group the plasma concentrations of SSRI/SNRI remained unchanged throughout the 6 months follow-up (−14.7, 95% CI, −32.6 to 1.7; p = 0.076).ConclusionIn patients undergoing bariatric surgery plasma concentrations of SSRI/SNRI decrease significantly by about 25% mainly during the first 4 weeks postoperatively with wide individual variation, but without correlation to the severity of depression or weight loss. |
| first_indexed | 2024-04-09T16:07:20Z |
| format | Article |
| id | doaj.art-4dafcae940384d899ccdf27c8dd40a3d |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-04-09T16:07:20Z |
| publishDate | 2023-04-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Psychiatry |
| spelling | doaj.art-4dafcae940384d899ccdf27c8dd40a3d2023-04-25T04:40:15ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402023-04-011410.3389/fpsyt.2023.11321121132112Plasma concentrations of SSRI/SNRI after bariatric surgery and the effects on depressive symptomsPatrick Pasi0Dino Kröll1Alena Siegfried2Martin Sykora3Alessandro Wildisen4Cristiana Milone5Gabriella Milos6Laura Horka7Stefan Fischli8Christoph Henzen9Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zürich, University of Zürich, Zürich, SwitzerlandDivision of Visceral Surgery, University Hospital Bern, University of Bern, Bern, SwitzerlandDepartment of Surgery, Division of Visceral Surgery, Cantonal Hospital, Lucerne, SwitzerlandDepartment of Surgery, Division of Visceral Surgery, Cantonal Hospital, Lucerne, SwitzerlandDepartment of Surgery, Division of Visceral Surgery, Cantonal Hospital, Lucerne, SwitzerlandDepartment of Surgery, Division of Visceral Surgery, Cantonal Hospital, Lucerne, SwitzerlandDepartment of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zürich, University of Zürich, Zürich, SwitzerlandDepartment of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zürich, University of Zürich, Zürich, SwitzerlandDepartment of Internal Medicine, Division of Endocrinology, Cantonal Hospital, Lucerne, SwitzerlandDepartment of Internal Medicine, Division of Endocrinology, Cantonal Hospital, Lucerne, SwitzerlandBackgroundDepression and treatment with antidepressants SSRI/SNRI are common in people with morbid obesity who are candidates for bariatric surgery. There is few and inconsistent data about the postoperative plasma concentrations of SSRI/SNRI. The aims of our study were to provide comprehensive data about the postoperative bioavailability of SSRI/SNRI, and the clinical effects on depressive symptoms.MethodsProspective multicenter study including 63 patients with morbid obesity and therapy with fixed doses of SSRI/SNRI: participants filled the Beck Depression Inventory (BDI) questionnaire, and plasma levels of SSRI/SNRI were measured by HPLC, preoperatively (T0), and 4 weeks (T1) and 6 months (T2) postoperatively.ResultsThe plasma concentrations of SSRI/SNRI dropped significantly in the bariatric surgery group from T0 to T2 by 24.7% (95% confidence interval [CI], −36.8 to −16.6, p = 0.0027): from T0 to T1 by 10.5% (95% 17 CI, −22.7 to −2.3; p = 0.016), and from T1 to T2 by 12.8% (95% CI, −29.3 to 3.5, p = 0.123), respectively.There was no significant change in the BDI score during follow-up (−2.9, 95% CI, −7.4 to 1.0; p = 0.13).The clinical outcome with respect to SSRI/SNRI plasma concentrations, weight change, and change of BDI score were similar in the subgroups undergoing gastric bypass surgery and sleeve gastrectomy, respectively. In the conservative group the plasma concentrations of SSRI/SNRI remained unchanged throughout the 6 months follow-up (−14.7, 95% CI, −32.6 to 1.7; p = 0.076).ConclusionIn patients undergoing bariatric surgery plasma concentrations of SSRI/SNRI decrease significantly by about 25% mainly during the first 4 weeks postoperatively with wide individual variation, but without correlation to the severity of depression or weight loss.https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1132112/fullselective serotonin reuptake inhibitor (SSRI)serotonin noradrenalin reuptake inhibitor (SNRI)laparoscopic Roux-en-Y gastric bypass (RYGB)sleeve gastrectomy (SG)Beck depression inventory (BDI)body mass index (BMI) |
| spellingShingle | Patrick Pasi Dino Kröll Alena Siegfried Martin Sykora Alessandro Wildisen Cristiana Milone Gabriella Milos Laura Horka Stefan Fischli Christoph Henzen Plasma concentrations of SSRI/SNRI after bariatric surgery and the effects on depressive symptoms Frontiers in Psychiatry selective serotonin reuptake inhibitor (SSRI) serotonin noradrenalin reuptake inhibitor (SNRI) laparoscopic Roux-en-Y gastric bypass (RYGB) sleeve gastrectomy (SG) Beck depression inventory (BDI) body mass index (BMI) |
| title | Plasma concentrations of SSRI/SNRI after bariatric surgery and the effects on depressive symptoms |
| title_full | Plasma concentrations of SSRI/SNRI after bariatric surgery and the effects on depressive symptoms |
| title_fullStr | Plasma concentrations of SSRI/SNRI after bariatric surgery and the effects on depressive symptoms |
| title_full_unstemmed | Plasma concentrations of SSRI/SNRI after bariatric surgery and the effects on depressive symptoms |
| title_short | Plasma concentrations of SSRI/SNRI after bariatric surgery and the effects on depressive symptoms |
| title_sort | plasma concentrations of ssri snri after bariatric surgery and the effects on depressive symptoms |
| topic | selective serotonin reuptake inhibitor (SSRI) serotonin noradrenalin reuptake inhibitor (SNRI) laparoscopic Roux-en-Y gastric bypass (RYGB) sleeve gastrectomy (SG) Beck depression inventory (BDI) body mass index (BMI) |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1132112/full |
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