ara96

2+ Year Member
Jan 21, 2016
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Hi everyone,

I have a patient who is on Fluoxetine and Lamictal, she is fairly stable. She will be having gastric bypass surgery soon as she has failed all other weight loss methods. Would dosing of Fluoxetine and Lamictal need to be reduced in this instance? Could not find any articles out there on this.

Thanks
 

lyla

2+ Year Member
Jan 5, 2015
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The last time I treated someone who was s/p gastric bypass with fluoxetine. I don't recall if we lowered the dose but we ended up using fluoxetine elixir rather than the standard caps.
 
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ara96

2+ Year Member
Jan 21, 2016
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I'm bumping this thread to see if anyone knows about Lamictal. I'm just concerned about my patient getting steven's johnson after gastric bypass.
 

JustAGuy

7+ Year Member
Oct 9, 2009
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I'm bumping this thread to see if anyone knows about Lamictal. I'm just concerned about my patient getting steven's johnson after gastric bypass.
Stevens Johnson is usually associated with rapid dose escalation. Lamictal is largely absorbed in the stomach, so you should see a possible decreased in serum levels because of reduced absorption. I think typical strategies would be to split the dose to BID dosing. You could consider checking a lamictal level now and then again after the procedure if you are looking for justification for dose escalation.
 
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