64 - References

References

Drug treatment of psychiatric symptoms in the context of other conditions CHAPTER 10 Alcohol55,56 Gastric bypass surgery is associated with accelerated alcohol absorption, higher maximum alcohol concentrations and a longer time to elimination. There is also an increased risk of alcohol misuse disorders after gastric bypass. Data are less clear for sleeve gastrectomy and there is no evidence that gastric banding leads to any changes. Wider considerations14,57 Despite severe mental illness often being considered a contraindication for bariatric surgery it has been shown to be effective in those with schizophrenia and bipolar affective disorder. Because of the variability of pharmacokinetic changes of psychiatric medicines, it is important to monitor patients closely for adverse effects and loss of efficacy, and medicines should be adjusted accordingly if required. Significant improvements in mental health are well documented following surgery, however deterioration can also occur. Depression and/or eating disorders may persist, re-­emerge or newly develop and there is an increased risk of self-­harm, suicide, alcohol disorder and opioid misuse following bariatric surgery. References

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