Fluoxetine and Lamictal dosing after Gastric bypass?

[ara96]

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

---

Members don't see this ad.

 

[lyla]

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.

 

[ara96]

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]

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.