Background: Roux-en-Y gastric bypass (RYGB) is the most frequent bariatric procedure performed in the United States, with thousands performed. Because of the changes to the gastrointestinal tract, the potential exists for clinically significant alterations in the absorption/bioavailability of ingested medications. The purpose of the present pilot trial was to determine to what extent RYGB alters the area under the plasma concentration/time curve (AUC 010.5) of the antidepressant, sertraline at a community research center. Methods: After an overnight fast, 5 postbariatric surgery and 5 nonsurgical control subjects matched for body mass index, age, and gender received 100 mg of sertraline. Plasma samples were obtained for 10.5 hours. The mean AUC 010.5, maximal plasma concentration, and the interval to the peak plasma level were obtained for both groups. Results: The mean AUC 010.5 was significantly smaller for the postbariatric surgery group (124.4 ± 55.5 ng-hr/mL, range 62.0198.1; P =.043) compared with the nonsurgical control group (314.8 ± 129.6 ng-hr/mL, range 194.8508.7). The maximal plasma concentration was also significantly smaller for the postbariatric surgery group than for the nonsurgical control group (P =.043). Conclusion: To our knowledge, this is the first reported study exploring antidepressant pharmacokinetics after bariatric surgery. In the present trial, the AUC 010.5 and maximal plasma concentration were significantly smaller in the subjects who had undergone RYGB than in the matched subjects who had not. Additional investigation of the effects of bariatric surgery (RYGB, sleeve gastrectomy, and gastric banding) on the antidepressant pharmacokinetic parameters is warranted.
Bibliographical noteFunding Information:
Supported by a Faculty Research Seed Money grant from the University of North Dakota .
K. Steffen received K23, R03 grants from the National Institutes of Health as the principal investigator; J. L. Roerig received a research grant as the principal investigator from Lilly Pharmaceuticals . C. Zimmerman participated in a three month sabbatical as a visiting scientist at Eli Lilly and Co.
- Area under the concentration time curve
- Bariatric surgery