TY - JOUR
T1 - Decreased escitalopram concentrations post-roux-en-Y gastric bypass surgery
AU - Marzinke, Mark A.
AU - Petrides, Athena K.
AU - Steele, Kimberley
AU - Schweitzer, Michael A.
AU - Magnuson, Thomas H.
AU - Reinblatt, Shauna P.
AU - Coughlin, Janelle W.
AU - Clarke, William
N1 - Publisher Copyright:
© 2014 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2015/6/26
Y1 - 2015/6/26
N2 - Background: There is a high coincidence between obesity and psychiatric disorders including depression. Depressive disorders are commonly treated with antidepressants, including the selective serotonin reuptake inhibitor Lexapro (escitalopram). Although candidates for elective Roux-en-Y gastric bypass (RYGB) surgery may be treated with escitalopram, drug dosing strategies are typically not adjusted postoperatively. Therefore, studies are needed to better characterize escitalopram drug concentrations in a postsurgical setting. Methods: Turbulent flow-liquid chromatographic-tandem mass spectrometric methods were used to quantify escitalopram concentrations in serum in study participants approved for RYGB. Blood was collected from study subjects 2 weeks before surgery, and 2 and 6 weeks postoperatively, to assess the impact of RYGB on systemic drug concentrations. Results: Twelve samples from 4 study participants were collected and analyzed for serum escitalopram concentrations. Two weeks post-RYGB, although there were minimal changes in each participant's body mass index (<5%), drug concentrations were 33% (4%-71%) decreased as compared with presurgical serum concentrations. There were further decreases in drug concentrations 6 weeks postsurgery. All clinical laboratory values were within normal reference intervals. Conclusions: RYGB significantly alters the gastrointestinal tract and impacts escitalopram drug concentrations, even shortly after surgery.
AB - Background: There is a high coincidence between obesity and psychiatric disorders including depression. Depressive disorders are commonly treated with antidepressants, including the selective serotonin reuptake inhibitor Lexapro (escitalopram). Although candidates for elective Roux-en-Y gastric bypass (RYGB) surgery may be treated with escitalopram, drug dosing strategies are typically not adjusted postoperatively. Therefore, studies are needed to better characterize escitalopram drug concentrations in a postsurgical setting. Methods: Turbulent flow-liquid chromatographic-tandem mass spectrometric methods were used to quantify escitalopram concentrations in serum in study participants approved for RYGB. Blood was collected from study subjects 2 weeks before surgery, and 2 and 6 weeks postoperatively, to assess the impact of RYGB on systemic drug concentrations. Results: Twelve samples from 4 study participants were collected and analyzed for serum escitalopram concentrations. Two weeks post-RYGB, although there were minimal changes in each participant's body mass index (<5%), drug concentrations were 33% (4%-71%) decreased as compared with presurgical serum concentrations. There were further decreases in drug concentrations 6 weeks postsurgery. All clinical laboratory values were within normal reference intervals. Conclusions: RYGB significantly alters the gastrointestinal tract and impacts escitalopram drug concentrations, even shortly after surgery.
KW - Key Words: depression
KW - Roux-en-Y gastric bypass surgery
KW - escitalopram
KW - therapeutic drug monitoring
KW - turbulent flow-liquid chromatographic-tandem mass spectrometry
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U2 - 10.1097/FTD.0000000000000146
DO - 10.1097/FTD.0000000000000146
M3 - Article
C2 - 25970510
AN - SCOPUS:84929911023
SN - 0163-4356
VL - 37
SP - 408
EP - 412
JO - Therapeutic drug monitoring
JF - Therapeutic drug monitoring
IS - 3
ER -