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psychiatric medication after bariatric surgery

By Johanna Kolodziej posted 11-13-2023 10:35 AM

  

Does anyone recommend a resource or advice for psychiatric medication management after a patient has bariatric surgery? 

Thanks

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12-27-2023 01:48 PM

Hello, 

I appreciate these items:  

Mitchell, J. E., Wolfe, B. M., Shikora, S. A., Sarwer. D., Blackstone, R. P, & Maher, J. W. (2019). Bariatric surgery and psychiatry: A review. American College of Surgeons. Bariatric surgery and psychiatry: A review | ACS (facs.org) 

Simmons, T., Vrolijk, H., & Nagala, M. (n.d.). Antidepressants after bariatric surgery: A case report and literature review. PowerPoint Presentation (pinerest.org)

Sockalingam, S., Leung, S. E., Wnuk, S., Cassin, S., Yanofsky, R., & Hawa, R. (2020). Psychiatric management of bariatric srugery patients: A review of psychopharmacological and psychological treatments and their impact on postoperative mental health and weight outcomes. Psychosomatics, 61(5), 498-507. Psychiatric Management of Bariatric Surgery Patients: A Review of Psychopharmacological and Psychological Treatments and Their Impact on Postoperative Mental Health and Weight Outcomes - ScienceDirect

The benefit of various psychotherapy modalities are also addressed. I utilize such psychotherapy interventions with my bariatric clientele in addition to prescribing their psychotropic medication(s). Research recommends a minimum of one year for follow up with psychiatric care (which I view includes  psychotherapy) due to increased depression symptoms and/or suicidality risk. 

In my 18 years of performing 1300+ psychological bariatric evaluations (lap-band, Sleeve Gastrectomy, Roux-en-Y Gastric Bypass), four years ago I formulated this psychiatric nurse practitioner hypothesis: Does bariatric surgery impact vagus nerve function resulting in increased anxiety symptomology? 

I am acutely aware I am not a bariatric surgeon, medical clinician, nor a neurologist. I commend the expertise of these colleagues. Although multiple factors impact anxiety disorders, anecdotal material presented with follow up for several bariatric clientele may be true. 

Breit, S., Kupferberg, A., Rogler, G., & Hasler, G. (2018). Vagus nerve as modulator of the brain–gut axis in psychiatric and inflammatory disorders. Frontiers in Psychiatry, 9. https://doi.org/10.3389/fpsyt.2018.00044

Thank you for your question shared with this group. Thank you for taking the time to review my material.

Leigh Alexander, MSN, CNS, PMHNP-BC

Topeka, KS 

Private Practice and adjunct professor for PMHNP course (Graceland University-Independence, MO location)