Psychiatric Medication Use and Weight Outcomes One Year After Bariatric Surgery

Psychosomatics. 2020 Jan-Feb;61(1):56-63. doi: 10.1016/j.psym.2019.10.009. Epub 2019 Nov 5.

Abstract

Background: Given the high rates of psychiatric comorbidity in bariatric surgery patients, pharmacotherapy is common and could potentially influence weight loss outcomes.

Objective: We aimed to identify the impact of psychotropic medication use on percent total weight loss (%TWL) 1 year after bariatric surgery.

Methods: In this prospective cohort study, 190 patients were compared based on demographic variables (age, sex, relationship status, employment status), body mass index, %TWL, and psychotropic medication use before and 1 year after bariatric surgery. An analysis of variance test was used as a global test of significance for psychotropic medication comparisons related to %TWL. Significance of post hoc comparisons was calculated with the Tukey's Honestly Significance Difference test.

Results: Sixty-one of 190 (32.1%) patients were taking psychiatric medications before surgery; of those, 82% (50/61) continued to take psychiatric medications 1-year after surgery. %TWL did not significantly differ between patients taking no psychiatric medications, one medication, or more than one medication 1 year after surgery (31.4% vs. 29.9% vs. 34.4%, respectively). Among patients taking antidepressants, those taking serotonin-norepinephrine reuptake inhibitors had a significantly higher %TWL than those taking selective serotonin reuptake inhibitors (36.4% vs. 27.8%; P = 0.032).

Conclusion: This longitudinal study suggests that psychiatric medication use was not associated with poorer %TWL at 1 year after bariatric surgery. Within class, antidepressant use may have differential effects on weight loss after bariatric surgery and warrants further investigation.

Keywords: bariatric surgery; medication; obesity; psychotropic.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antidepressive Agents / therapeutic use
  • Antimanic Agents / therapeutic use
  • Antipsychotic Agents / therapeutic use
  • Bariatric Surgery*
  • Benzodiazepines / therapeutic use
  • Central Nervous System Stimulants / therapeutic use
  • Female
  • Humans
  • Hypnotics and Sedatives / therapeutic use
  • Male
  • Mental Disorders / complications
  • Mental Disorders / drug therapy*
  • Middle Aged
  • Obesity / complications
  • Obesity / surgery*
  • Psychotropic Drugs / therapeutic use*
  • Selective Serotonin Reuptake Inhibitors / therapeutic use
  • Serotonin and Noradrenaline Reuptake Inhibitors / therapeutic use
  • Treatment Outcome
  • Weight Loss*

Substances

  • Antidepressive Agents
  • Antimanic Agents
  • Antipsychotic Agents
  • Central Nervous System Stimulants
  • Hypnotics and Sedatives
  • Psychotropic Drugs
  • Serotonin Uptake Inhibitors
  • Serotonin and Noradrenaline Reuptake Inhibitors
  • Benzodiazepines