Decreased escitalopram concentrations post-roux-en-Y gastric bypass surgery

Mark A. Marzinke, Athena K. Petrides, Kimberley Steele, Michael A. Schweitzer, Thomas H. Magnuson, Shauna P. Reinblatt, Janelle W. Coughlin, William Clarke

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Background: There is a high coincidence between obesity and psychiatric disorders including depression. Depressive disorders are commonly treated with antidepressants, including the selective serotonin reuptake inhibitor Lexapro (escitalopram). Although candidates for elective Roux-en-Y gastric bypass (RYGB) surgery may be treated with escitalopram, drug dosing strategies are typically not adjusted postoperatively. Therefore, studies are needed to better characterize escitalopram drug concentrations in a postsurgical setting. Methods: Turbulent flow-liquid chromatographic-tandem mass spectrometric methods were used to quantify escitalopram concentrations in serum in study participants approved for RYGB. Blood was collected from study subjects 2 weeks before surgery, and 2 and 6 weeks postoperatively, to assess the impact of RYGB on systemic drug concentrations. Results: Twelve samples from 4 study participants were collected and analyzed for serum escitalopram concentrations. Two weeks post-RYGB, although there were minimal changes in each participant's body mass index (<5%), drug concentrations were 33% (4%-71%) decreased as compared with presurgical serum concentrations. There were further decreases in drug concentrations 6 weeks postsurgery. All clinical laboratory values were within normal reference intervals. Conclusions: RYGB significantly alters the gastrointestinal tract and impacts escitalopram drug concentrations, even shortly after surgery.

Original languageEnglish (US)
Pages (from-to)408-412
Number of pages5
JournalTherapeutic drug monitoring
Issue number3
StatePublished - Jun 26 2015


  • Key Words: depression
  • Roux-en-Y gastric bypass surgery
  • escitalopram
  • therapeutic drug monitoring
  • turbulent flow-liquid chromatographic-tandem mass spectrometry

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)


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