Antidepressant agents in short bowel syndrome

Clin Ther. 2014 Dec 1;36(12):2029-2033.e3. doi: 10.1016/j.clinthera.2014.09.018. Epub 2014 Oct 29.

Abstract

Purpose: This study aimed to determine whether short small intestine modifies antidepressant concentrations.

Methods: The Css values and concentration-dose ratios (CDRs) of citalopram or escitalopram, administered orally or intravenously, were determined in patients with short bowel syndrome.

Findings: Eight patients (6 males and 2 females) were included in the study. High CDRs were obtained in orally treated patients with >180 cm of small bowel and in those with >80 cm of small bowel and 50% of colon. Three patients had low Css values, including 1 patient who received intravenous treatment.

Implications: The variability of drug absorption and metabolism makes prescribing SSRIs challenging in these patients.

Keywords: absorption; citalopram; escitalopram; short bowel syndrome; therapeutic drug monitoring.

MeSH terms

  • Adult
  • Aged
  • Antidepressive Agents / pharmacokinetics*
  • Antidepressive Agents / therapeutic use
  • Citalopram / pharmacokinetics*
  • Citalopram / therapeutic use
  • Depressive Disorder / complications
  • Depressive Disorder / drug therapy*
  • Depressive Disorder / metabolism
  • Female
  • Humans
  • Male
  • Middle Aged
  • Selective Serotonin Reuptake Inhibitors / pharmacokinetics*
  • Selective Serotonin Reuptake Inhibitors / therapeutic use
  • Short Bowel Syndrome / complications
  • Short Bowel Syndrome / metabolism*

Substances

  • Antidepressive Agents
  • Serotonin Uptake Inhibitors
  • Citalopram