Table 4: Psychopharmachological treatment after surgery.

Author and Publication year


Study features

N Participants

Mean age


Other features of the study




Roerig et al. 2013 [57]

Fargo, USA

Observational study

10 patients, 10 controls



To determine to what extent the RYGB procedure alters the area under the plasma concentration/time curve (AUC) of the antidepressant, duloxetine (60 mg/die): 1 year post-RYGB


Nineteen plasma samples were obtained during 72 hours to characterize the plasma level profile.

The bariatric surgery group was exposed to only 57.7% of duloxetine as compared to the nonsurgery group.

Roerig et al. 2012 [28]

Fargo, USA

Observational study

5 patients, 5 controls



To determine to what extent RYGB alters the area under the plasma concentration/time curve (AUC(0-10.5)) of the antidepressant, sertraline (100 mg /die).


Plasma samples were obtained for 10.5 hours.

The mean AUC(0-10.5)  and the maximal plasma concentration were significantly smaller for the postbariatric surgery group (compared with the nonsurgical control group.

Hamad GG et al. 2012 [58]

Pittsburgh, USA

Prospective, longitudinal study, 6- 12- months follow up



11 F, 1 M

Timed blood samples for SRI plasma levels were drawn for pharmacokinetic studies before surgery and 1, 6, and 12 months afterward. Maximum concentration, time to maximum concentration, and area under the concentration/time curve (AUC) were determined.


SCID-IV; Structured Interview Guide for the Hamilton Depression Rating Scale–Atypical Depression Symptom Version (SIGH-ADS)

AUC values 1 month after surgery dropped to an average of 54%  of preoperative levels; in 6 of these patients, AUC values returned to baseline levels (or greater) by 6 months. 4 patients had an exacerbation of depressive symptoms, which resolved by 12 months in three of them. 3 of the four patients had a reduced AUC level at 1 month and either gained weight or failed to lose weight between 6 and 12 months.

Tripp AC et al. 2011 [101]

Pittsburgh, USA

Case report




Treatment with Lithium at therapeutic dose



Alterations in drug dissolution and absorption as result of RYGB


 F: Female; M: Male; BS: Bariatric Surgery; BMI: Body mass Index; RYGB: Roux-Y-Gastric Bypass; LAGB: Laparoscopic Adjustable Gastric Banding; MDD: Major Depressive Disorder; BD: Bipolar Disorder; BED: Binge Eating Disorder; SCID-I: Structured Clinical Interview for DSM IV Axis I disorders; Ham-D: Hamilton Rating Scale for Depression; BDI: Beck Depression Inventory; Beck Depression Inventory-II (BDI-II); QoL: Quality of Life