减肥手术后抗抑郁药血清浓度的变化以及减肥手术后抗抑郁治疗的建议。

IF 2.7 4区 心理学 Q2 PSYCHIATRY Journal of the Academy of Consultation-Liaison Psychiatry Pub Date : 2024-05-01 DOI:10.1016/j.jaclp.2024.01.001
Daniel Maass M.D. , Drew Cumming M.D. , Haniya Raza D.O. , Ted Liao M.D. , Joyce Chung M.D. , Maryland Pao M.D.
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引用次数: 0

摘要

目的我们的目标是回顾有关减肥手术后抗抑郁药血清浓度变化的公开数据,以便为这一患者群体制定用药剂量建议 方法:利用 Pubmed 上的关键搜索关键词进行了全面的文献回顾。从 FDA 和 DrugBank 在线资源中检索了其他数据:结果:除了从 FDA 和 DrugBank 获取的公开数据外,还收录了 12 篇已发表的文章。由于独特的药代动力学特征、药物制备和配方,减肥手术后抗抑郁药的血清浓度在药物类别之间和药物类别内部都存在相当大的差异。根据已公布的血清浓度变化数据和特定药物的药代动力学数据提出了建议:据我们所知,这是第一项针对接受减肥手术的抗抑郁药物患者提出药物剂量调整建议的研究。我们受到可用数据量相对较少的限制,建议对患者进行监测,并在使用本指南的同时使用临床判断。
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Changes in Serum Concentration of Antidepressants After Bariatric Surgery and Recommendations for Postbariatric Surgery Antidepressant Therapy

Background

Bariatric surgery affects the absorption of medications including antidepressants, but data regarding these effects are limited.

Objectives

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.

Methods

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.

Results

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.

Conclusions

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.

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