Frequency of Psychotropic Medication Management in Patients Undergoing Metabolic and Bariatric Surgery

Overview

This study investigates the prevalence of psychotropic medication-related interventions in patients undergoing metabolic and bariatric surgery (MBS).

Background

Metabolic and bariatric surgery can significantly alter the pharmacokinetics of oral medications, particularly psychotropic drugs. There is limited understanding and insufficient monitoring practices regarding psychotropic medication management following MBS.

Data Highlights

This study is a retrospective analysis conducted from January 2017 to December 2023, focusing on patients using lithium, tricyclic antidepressants, and clozapine.

Key Findings

• Pharmacokinetic changes following MBS can lead to increased or decreased drug exposure for psychotropic medications.
• Patients undergoing MBS are at high risk for psychiatric decompensation.
• Standardized monitoring practices for psychotropic medications post-MBS are lacking.
• Research indicates that lithium exposure increases post-MBS, while tricyclic antidepressants may show decreased plasma concentrations.
• Close monitoring of clozapine is warranted due to its variable pharmacokinetics after MBS.

Clinical Implications

Healthcare providers should be aware of the potential pharmacokinetic alterations in psychotropic medications following MBS.

Conclusion

The findings highlight the need for improved monitoring practices for psychotropic medications in patients undergoing metabolic and bariatric surgery.

Related Resources & Content

1. Obesity Surgery, 2020 -- The Impact of Psychotropic Medications on Vitamin Levels Following Bariatric Surgery: A Long-Term Evaluation
2. Obesity Surgery, 2023 -- Effects of Bariatric Surgery on Drug Pharmacokinetics: The Importance of Adjusting Dosage Over Time
3. Obesity Surgery, 2022 -- Effectiveness of a Pharmacist in a Bariatric Surgery Clinic Setting
4. Obesity Surgery, 2025 -- Pharmaceutical Usage Prior to and Following Various Bariatric Surgical Interventions: Insights from a Population-Based Cohort Analysis
5. American Society for Metabolic and Bariatric Surgery: postoperative care pathway guidelines for Roux-en-Y gastric bypass, 2025
6. Recommendations for the Deprescribing of Psychotropic Medications: A Consensus Statement From the American Society of Clinical Psychopharmacology Task Force, 2025
7. American Society for Metabolic and Bariatric Surgery: postoperative care pathway guidelines for Roux-en-Y gastric bypass - PubMed
8. Recommendations for the Deprescribing of Psychotropic Medications: A Consensus Statement From the American Society of Clinical Psychopharmacology Task Force | Clinical Pharmacy and Pharmacology | JAMA Network Open | JAMA Network
9. https://jmbs.org/pdf/10.17476/jmbs.2025.14.3.193
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11. Plasma concentrations of SSRI/SNRI after bariatric surgery and the effects on depressive symptoms - PMC
12. Psychiatric and Cognitive Functioning After Metabolic and Bariatric Surgery: A Systematic Review and Meta‐Analysis - PMC
13. Pharmacokinetic Changes in Medications After Bariatric Surgery: A Scoping Review - PMC