Posted by Vincent_QC on November 5, 2012, at 11:40:29
In reply to Considering gastric bypass - med questions, posted by prettygoodpatient on November 4, 2012, at 19:40:56
> Hello all,
> I'm considering gastric bypass surgery and I'm concerned about my body's ability to take in meds afterwards. I know many of the meds I take can be gotten in liquid form. Does anyone on this board have experience with psych medication and gastric bypass surgery?
>
> I'm biplor and I currently take Depakote, Saphris, Risperdal and Klonopin.
>Hi, I had a gastric by-pass surgery back in 2001... to be honnest its the worse thing I do and too bad I cant return back.
Are you sure you want that surgery? Did you try everything like protein diets, change in diet, regular exercises? Did you gain your weight from the meds???
I ask all of this because if you dont have a real metabolic problem who lead to morbid obesity then try first to go on a healthy diet and regular exercise cause a gastric by-pass is a drastic surgery and can change your life for the good or the worse...
What kind of gastric by-pass you will have? If its the kind of usually reduce stomach to a very small pounch size without reducing the lenght of the intestine (usually done in the USA), meds will be well absorb since the intestine stay normal and the stomach size dont affect the med.
If you want to have a roux-en-y type of gastric by-pass, they will by-pass a long part of the intestine, the part who absorb the proteins and fat (so fat solube vitamins or meds are not well absorb), so all the meds who are long release, slow release, XR, SR or CR release.will not be well absorb for sure... dont know for the other meds you take but try the Saphris 1 time and its absorb under the tongue so no problem for it...
I had a different type of gastric by-pass made only in Quebec city (Canada, Quebec province, Quebec city), its call a ''derivation bilo-pancreatique''...they remove 2/3 of the stomach and only keep 1.5 meters of working intestine, they remove the gallbalder as well... its a drastic method and it lead to severe malabsorbtion, had 8 to 10 liquid stools a day for 8 years after the surgery.
I have to take very high dose of fat solube vitamins every day until I will die (Vit D 50 000, Vit A 30 000 units, 1 strong Centrum, 2 x 300 mg or Iron, 3 x 500 mg of Calcium) have to take those uge amount of vitamins every day and still have problems with some of my vitamins levels...
Before my gastric by-pass surgery I had only social phobia and panic disorder who was under control with the help of Paxil and a 2 years coghitive therapy with a Psychologist. I did tried other AD like Celexa, Zoloft and some atypical antipsychotic at low dose but the Paxil completly eliminate the panic and stop my anxiety and fears...
My panic disorder but not the social phobia was under control for 5 years prior the surgery and the Paxil was stop 4 years prior the surgery.
For the psych meds, after my surgery, I had A LOT of problems with all the meds... in fact most of them didnt work like in the past, for example SSRI'S AD, all the XR or SR or CR release are not working and most of them are not offer in liquid or normal release ( effexor-xr, cymbalta, pristiq, wellbutrin...) in the Canada they are not offer in oral suspension or immediate release.
In fact we dont know how the body absorb the meds after a gastric by-pass, sometimes it can increase the effect of meds like it do with me and the SSRI's, sometimes meds dont work or need higher dose of them like with the benzo meds, sometimes meds only give rare side effects who appear normally in less than 0.1 % of the peoples who take them...
So be sure to ask what kind of surgery they will do and the effect on meds...Most of the Docs who do that kind of surgeries dont even know how it affect the meds absorbtiion and efficacity... but overall it will affect all meds in one or another way, different peak time, low or high level in the blood, no effect or too strong effect...change in the half life who lead to short or too long time of action of the med and not stable blood level...
Also having a gastric by-pass is not easy, not only physically but mentally! Be sure to have a PDoc who will follow you and understand the process of having a gastric by-pass and the effect on the self esteem and body image...
For me, it was a mistake, before the surgery I had morbid obesity but my life was a lot better. My self esteem was better, I was happy all the time and not depress, I was strong physically and had a lot of strenght. Was working in a big restaurant for 12 hours a day with no problem, I had only sleep apnea but wasnt aware of it before I had the surgery. Ok I tried all the kind of diets, I think at 10 yo I was already on the Weight Watcher diet, was doing a lot of physical activities and regular exercises but at the end I was tired to starve myself all the time to stay on a normal weight...so I stop taking care of eating good foods and jump into the junk foods bad habit and return in the 450 pounds boat and morbid obesity.
I was at 450 pounds before the gastric by-pass...I was single at the time and never had a BF or a relation ship... I go down to 180 pounds in less than 9 months... I was ok for 3 years after the surgery, my anxiety was under control without taking meds... in fact I felt very good for the first time of my life for that 3 years period of time.
I was more confident and my self esteem was a lot better... but I had my first relationship who was a disaster, social phobia was still there but was happy with how good I look and my body, but the lack of energy hit me like never before after the 3 years happy period... its when I start drinking tons of coffee to stay awake and alert...I had to stop working cause I had no muscles strenght...and was tired all the time...
In 2004 I start dating guys and most of them wasnt able to deal with how my body look without clothes on me and with all the extra skin (plastic surgery cost too much and cant afford it) and then I discover that even if I was now slim, I had no energy, lost all my muscles even with physical exercises and high amount of proteins, start having self esteem problems again with strong social phobia and body dismorphic disorder... panic attacks in public places...
Was put on the Klonopin for my anxiety in 2005 after I trail several AD's and some atypical antipsychotic meds with no success and was ok with very high dose of Klonopin 8 mg day until 2007, when the 8 mg day of Klonopin stop working...since then im addicted to the benzo meds, was off them 2 times and had to return on them, sometimes lowering the dose of klonopin, sometimes being on Valium or Xanax or Ativan...or being on 2 differents benzo at the same time.
I had to try again AD meds, try all of them, find out they wasnt working as good as before the surgery, only the Paxil work again in 2009 but had a weight gain of 40 pounds with it so I was scare about the weight gain and stop it... big mistake... I try older AD's like Nardil or Parnate or tricyclics and had heart problems with them...
I start having problems of internal bleeding hemmorhoids back in 2006, the Gastro Doc didnt wanted to perform a surgery for the hemmorhoids on me cause I had too many liquid stools each day. So between 2006 and november 2009 I needed weekly IM iron treatment (infufer) at first and then IV iron treatments (venofer) for 2 years, had severe anemia, needed blood transfusions at some point cause of the very low hemoglobin level, had finally a surgery for the hemmorhoids and I start having severe anxiety again at the end of 2009... constipation, bad constipation hit me after the hemorrhoids surgery, me who had 8 to 9 liquid stools a day prior to the hemorrhoids surgery, now 10 glycerin suppositories will not do anything to help me to pass stools...also all the other laxatives dont work...
I had 2 intestinal obstructions cause of the gastric by pass last year who add a lot of anxiety and pain on my shoulder, needed 3 surgeries in 1 year cause of that, was and still be underweight now and only weight 150 pounds...if you remove the 20 pounds or more of extra skin im really underweight. I had a jejunostomy tube for enteral feeding pluged directly into my small intestine for 4 months but never gain weight, still have to drink Peptamen AF enteral feeding bootles 4 times a day with my normal food intake and cant gain weight...constipation is worse than ever, IBS - C, have very severe anxiety (agoraphobia, somatisation disorder, chronic headache, insomnia, 0 energy, panic disorder, heart problems like tachycardia and low blood pressure, orthostatic hypotension, jaw pain, have this all the time every day)... I live now in a constant panic attack spiral and fears everything...
Now im highly sensitive to meds...need to be back on the Paxil but take right now 1 mg dose (had to order it from the internet to have it in liquid), and even at 1/10 the starting dose I have side effects...
I have bad self esteem, my body look like im 90 years old with all the extra skin and im only 36 yo, I cant do physical exercises cause I have no energy and all my muscles are in pain. Im so weak that just climbing the stairs or taking a shower take all my energy and cant do anything else afer that.
I cant drive my car since 2 years, cant go out the house, cant stay alone (live with my parents), cant work, take high dose of rivotril (klonopin) 7 mg day, take 20 mg day of Inderal for my heart, my Gastric Doc increase my dose of Vitamins for the energy but its doing nothing...
Im in pain all the time and anxiety is now so severe that I have no life, wake up in the morning with all my chronic symptoms and scare and go to the bed in the same high anxiety state...
I do around 6 therapies since 2010 with no improve.
That surgery destroy my life.
Dont want to scare you but I saw a lot of peoples with the same problems than me when I was at the hospital for 1 month last year when I had my 2 intestinal obstructions... its frequent to have health and mental problems after a gastric by-pass, more than what the Doc will told you. I saw a lot of peoples with intestinal obstructions, pancreatic or liver diseases...
So be sure you really want a gastric by-pass before having it and be sure to try to change your foods habit before having it. Eliminate sugars, fast foods, go to the gym, do a strict diet like a protein one, try everything before having the surgery. Too much peoples have the surgery cause its an easy option but its not the good option. Also peoples think it will solve all their problems but its not true at all... if you choose the surgery then make sure its because you have a real metabolic problem and that its not linked to the meds you take...if the meds make you gain weight you can go to the gym and eat a healthy diet, it will make you loose all the weight and be better for you than a risky surgery...
If you choose the surgery then take care of yourself ok. See a psychologist for the body changes, be sure that your meds works like before and eat more protein and fiber with a lot of pre and probiotics to prevent liquid stools and stick to the diet, dont over eat or eat sugar or fat meal...
Take care of you, Vincent
poster:Vincent_QC
thread:1030679
URL: http://www.dr-bob.org/babble/20121029/msgs/1030728.html