Psychopharmacotherapy after restrictive gastrointestinal surgery

Details

Serval ID
serval:BIB_DE27EBD62A76
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Psychopharmacotherapy after restrictive gastrointestinal surgery
Journal
Psychopharmakotherapie
Author(s)
Baumann Pierre, Tregouet Olivier
ISSN
0944-6877
Publication state
Published
Issued date
2013
Volume
20
Number
1
Pages
31-37
Language
german
Notes
(Baumann) Departement de Psychiatrie (DP-CHUV), Site de Cery, 1008 Prilly-Lausanne, Switzerland (Tregouet) Centre Neuchatelois de Psychiatrie (CNP), Rue Sophie-Mairet 29, 2300 La Chaux-de-Fonds, Switzerland
Psychopharmakotherapie nach restriktiven gastrointestinalen eingriffen.
Abstract
Bariatric surgery in morbidly obese patients, restrictive gastrointestinal resection in patients, who suffer from gastric cancer or who, for suicidal purposes, ingested toxic substances has an influence on the absorption process of drugs in the gastrointestinal tract. A 77-year-old patient with gastric cancer is described, who was submitted to total gastrectomy. While he was hospitalised in a somatic hospital because of severe undernutrition due to malabsorption, a depressive episode accompanied by a somatic syndrome (F32.11) was diagnosed. Only a treatment with 45 mg/day mirtazapine resulted in a clearcut clinical response. Although the antidepressant was administered as whole tablets, plasma concentrations of mirtazapine were within those observed in patients not submitted to surgery. A review of the literature about the pharmacokinetics of antidepressants and antipsychotics in patients submitted to surgery in the gastrointestinal tract is presented. Treatment recommendations are proposed which should help to minimise risks for pharmacotherapy and optimise treatment response in these patients. In particular, therapeutic drug-monitoring is recommended before and after surgery, as adaptation processes may modify the fate of the drug in the organism.
Keywords
aged, case report, depression/dt [Drug Therapy], drug blood level, drug monitoring, gastrointestinal tract, hospitalization, human, malnutrition, psychopharmacotherapy, psychosomatic disorder/dt [Drug Therapy], review, stomach cancer/su [Surgery], total stomach resection, treatment response, mirtazapine/cr [Drug Concentration], mirtazapine/dt [Drug Therapy], mirtazapine/pk [Pharmacokinetics], 61337-67-5 (mirtazapine)
Create date
12/01/2021 17:17
Last modification date
15/01/2021 7:26
Usage data