NCT01317147

Brief Summary

The morbidly obese frequently present with mood and anxiety disorders, which are often treated with serotonin reuptake inhibitors (SRI) antidepressant drugs. The investigators hypothesized that gastric bypass surgery would decrease the absorption of SRI. The investigators also wished to determine whether a reduction in SRI levels would increase the likelihood of worsening depressive symptoms.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
12

participants targeted

Target at below P25 for all trials

Timeline
Completed

Started Aug 2007

Typical duration for all trials

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

August 1, 2007

Completed
3 years until next milestone

Study Completion

Last participant's last visit for all outcomes

August 1, 2010

Completed
8 months until next milestone

First Submitted

Initial submission to the registry

March 15, 2011

Completed
2 days until next milestone

First Posted

Study publicly available on registry

March 17, 2011

Completed
Last Updated

March 17, 2011

Status Verified

March 1, 2011

First QC Date

March 15, 2011

Last Update Submit

March 15, 2011

Conditions

Gastric BypassDepressionAnxiety Disorder

Keywords

pharmacokineticsserotonin reuptake inhibitorsgastric bypassdepressionbioavailabilitydrug absorptionarea under curve

Study Arms (1)

Gastric bypass patients

Procedure: Roux-en-Y gastric bypass (RYGBP)

Interventions

Roux-en-Y gastric bypass (RYGBP)PROCEDURE
Gastric bypass patients

Eligibility Criteria

Age18 Years - 70 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

Bariatric surgery clinic- Morbidly obese patients seeking RYGB who met criteria for bariatric surgery (BMI ≥ 40 kg/m2 or ≥ 35 kg/m2 with severe obesity-related comorbidities) and were received maintenance treatment with an SRI for primary mood or anxiety disorder.

You may qualify if:

  • Able to tolerate general anesthesia
  • Able to document prior unsuccessful attempts at weight loss under medical supervision during the last 6 months
  • Able to provide informed consent
  • Cleared for surgery by primary care MD, dietician, and psychiatrist
  • SRI treatment specifically for depression for ≥6 wks at constant dose for last 2 out of 6 wks

You may not qualify if:

  • pregnancy
  • Unwilling or unable to comply with postoperative requirements for diet, supplements, exercise, or followup

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University of Pittsburgh

Pittsburgh, Pennsylvania, 15213, United States

Location

Related Publications (31)

  • Onyike CU, Crum RM, Lee HB, Lyketsos CG, Eaton WW. Is obesity associated with major depression? Results from the Third National Health and Nutrition Examination Survey. Am J Epidemiol. 2003 Dec 15;158(12):1139-47. doi: 10.1093/aje/kwg275.

    PMID: 14652298BACKGROUND

  • Sarwer DB, Cohn NI, Gibbons LM, Magee L, Crerand CE, Raper SE, Rosato EF, Williams NN, Wadden TA. Psychiatric diagnoses and psychiatric treatment among bariatric surgery candidates. Obes Surg. 2004 Oct;14(9):1148-56. doi: 10.1381/0960892042386922.

    PMID: 15527626BACKGROUND

  • Alciati A, D'Ambrosio A, Foschi D, Corsi F, Mellado C, Angst J. Bipolar spectrum disorders in severely obese patients seeking surgical treatment. J Affect Disord. 2007 Aug;101(1-3):131-8. doi: 10.1016/j.jad.2006.11.008. Epub 2007 Jan 16.

    PMID: 17229468BACKGROUND

  • Ali MR, Rasmussen JJ, Monash JB, Fuller WD. Depression is associated with increased severity of co-morbidities in bariatric surgical candidates. Surg Obes Relat Dis. 2009 Sep-Oct;5(5):559-64. doi: 10.1016/j.soard.2008.10.015. Epub 2008 Nov 21.

    PMID: 19342306BACKGROUND

  • Serretti A, Mandelli L. Antidepressants and body weight: a comprehensive review and meta-analysis. J Clin Psychiatry. 2010 Oct;71(10):1259-72. doi: 10.4088/JCP.09r05346blu.

    PMID: 21062615BACKGROUND

  • Malinowski SS. Nutritional and metabolic complications of bariatric surgery. Am J Med Sci. 2006 Apr;331(4):219-25. doi: 10.1097/00000441-200604000-00009.

    PMID: 16617238BACKGROUND

  • Miller AD, Smith KM. Medication and nutrient administration considerations after bariatric surgery. Am J Health Syst Pharm. 2006 Oct 1;63(19):1852-7. doi: 10.2146/ajhp060033.

    PMID: 16990631BACKGROUND

  • Pihlajamaki J, Gronlund S, Simonen M, Kakela P, Moilanen L, Paakkonen M, Pirinen E, Kolehmainen M, Karja V, Kainulainen S, Uusitupa M, Alhava E, Miettinen TA, Gylling H. Cholesterol absorption decreases after Roux-en-Y gastric bypass but not after gastric banding. Metabolism. 2010 Jun;59(6):866-72. doi: 10.1016/j.metabol.2009.10.004. Epub 2009 Dec 16.

    PMID: 20015521BACKGROUND

  • Ruz M, Carrasco F, Rojas P, Codoceo J, Inostroza J, Rebolledo A, Basfi-fer K, Csendes A, Papapietro K, Pizarro F, Olivares M, Sian L, Westcott JL, Hambidge KM, Krebs NF. Iron absorption and iron status are reduced after Roux-en-Y gastric bypass. Am J Clin Nutr. 2009 Sep;90(3):527-32. doi: 10.3945/ajcn.2009.27699. Epub 2009 Jul 22.

    PMID: 19625680BACKGROUND

  • Roerig JL, Steffen K, Zimmerman C, Mitchell JE, Crosby RD, Cao L. Preliminary comparison of sertraline levels in postbariatric surgery patients versus matched nonsurgical cohort. Surg Obes Relat Dis. 2012 Jan-Feb;8(1):62-6. doi: 10.1016/j.soard.2010.12.003. Epub 2010 Dec 15.

    PMID: 21256091BACKGROUND

  • Skottheim IB, Stormark K, Christensen H, Jakobsen GS, Hjelmesaeth J, Jenssen T, Reubsaet JL, Sandbu R, Asberg A. Significantly altered systemic exposure to atorvastatin acid following gastric bypass surgery in morbidly obese patients. Clin Pharmacol Ther. 2009 Sep;86(3):311-8. doi: 10.1038/clpt.2009.82. Epub 2009 Jun 3.

    PMID: 19494810BACKGROUND

  • Brolin RE. Update: NIH consensus conference. Gastrointestinal surgery for severe obesity. Nutrition. 1996 Jun;12(6):403-4. doi: 10.1016/s0899-9007(96)00154-2.

    PMID: 8875533BACKGROUND

  • First MB, Spitzer RL, Gibbon M, Williams JBW. Structured clinical interview for DSM-IV axis I disorders-patient edition. : New York State Psychiatric Institute; 1996.

    BACKGROUND

  • Williams JBW, Terman M. Structured Interview Guide for the Hamilton Depression Rating Scale with Ayptical Depression Supplement (SIGH-ADS). New York: New York State Psychiatric Institute; 2003.

    BACKGROUND

  • Schauer PR, Ikramuddin S, Gourash W, Ramanathan R, Luketich J. Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Ann Surg. 2000 Oct;232(4):515-29. doi: 10.1097/00000658-200010000-00007.

    PMID: 10998650BACKGROUND

  • Gubbins PO, Bertch KE. Drug absorption in gastrointestinal disease and surgery. Clinical pharmacokinetic and therapeutic implications. Clin Pharmacokinet. 1991 Dec;21(6):431-47. doi: 10.2165/00003088-199121060-00004.

    PMID: 1782738BACKGROUND

  • Padwal R, Brocks D, Sharma AM. A systematic review of drug absorption following bariatric surgery and its theoretical implications. Obes Rev. 2010 Jan;11(1):41-50. doi: 10.1111/j.1467-789X.2009.00614.x. Epub 2009 Jun 2.

    PMID: 19493300BACKGROUND

  • Magee SR, Shih G, Hume A. Malabsorption of oral antibiotics in pregnancy after gastric bypass surgery. J Am Board Fam Med. 2007 May-Jun;20(3):310-3. doi: 10.3122/jabfm.2007.03.060177.

    PMID: 17478665BACKGROUND

  • Wills SM, Zekman R, Bestul D, Kuwajerwala N, Decker D. Tamoxifen malabsorption after Roux-en-Y gastric bypass surgery: case series and review of the literature. Pharmacotherapy. 2010 Feb;30(2):217. doi: 10.1592/phco.30.2.217.

    PMID: 20099995BACKGROUND

  • Behrns KE, Smith CD, Sarr MG. Prospective evaluation of gastric acid secretion and cobalamin absorption following gastric bypass for clinically severe obesity. Dig Dis Sci. 1994 Feb;39(2):315-20. doi: 10.1007/BF02090203.

    PMID: 8313814BACKGROUND

  • Seaman JS, Bowers SP, Dixon P, Schindler L. Dissolution of common psychiatric medications in a Roux-en-Y gastric bypass model. Psychosomatics. 2005 May-Jun;46(3):250-3. doi: 10.1176/appi.psy.46.3.250.

    PMID: 15883146BACKGROUND

  • Brandacher G, Winkler C, Aigner F, Schwelberger H, Schroecksnadel K, Margreiter R, Fuchs D, Weiss HG. Bariatric surgery cannot prevent tryptophan depletion due to chronic immune activation in morbidly obese patients. Obes Surg. 2006 May;16(5):541-8. doi: 10.1381/096089206776945066.

    PMID: 16687019BACKGROUND

  • Bodnar LM, Wisner KL. Nutrition and depression: implications for improving mental health among childbearing-aged women. Biol Psychiatry. 2005 Nov 1;58(9):679-85. doi: 10.1016/j.biopsych.2005.05.009. Epub 2005 Jul 25.

    PMID: 16040007BACKGROUND

  • Hanley MJ, Abernethy DR, Greenblatt DJ. Effect of obesity on the pharmacokinetics of drugs in humans. Clin Pharmacokinet. 2010;49(2):71-87. doi: 10.2165/11318100-000000000-00000.

    PMID: 20067334BACKGROUND

  • Kinzl JF, Schrattenecker M, Traweger C, Mattesich M, Fiala M, Biebl W. Psychosocial predictors of weight loss after bariatric surgery. Obes Surg. 2006 Dec;16(12):1609-14. doi: 10.1381/096089206779319301.

    PMID: 17217637BACKGROUND

  • Legenbauer T, De Zwaan M, Benecke A, Muhlhans B, Petrak F, Herpertz S. Depression and anxiety: their predictive function for weight loss in obese individuals. Obes Facts. 2009;2(4):227-34. doi: 10.1159/000226278. Epub 2009 Aug 17.

    PMID: 20054228BACKGROUND

  • Clark MM, Niaura R, King TK, Pera V. Depression, smoking, activity level, and health status: pretreatment predictors of attrition in obesity treatment. Addict Behav. 1996 Jul-Aug;21(4):509-13. doi: 10.1016/0306-4603(95)00081-x.

    PMID: 8830908BACKGROUND

  • Rusch MD, Andris D. Maladaptive eating patterns after weight-loss surgery. Nutr Clin Pract. 2007 Feb;22(1):41-9. doi: 10.1177/011542650702200141.

    PMID: 17242453BACKGROUND

  • Sanchez-Santos R, Del Barrio MJ, Gonzalez C, Madico C, Terrado I, Gordillo ML, Pujol J, Moreno P, Masdevall C. Long-term health-related quality of life following gastric bypass: influence of depression. Obes Surg. 2006 May;16(5):580-5. doi: 10.1381/096089206776945084.

    PMID: 16687025BACKGROUND

  • Adams TD, Gress RE, Smith SC, Halverson RC, Simper SC, Rosamond WD, Lamonte MJ, Stroup AM, Hunt SC. Long-term mortality after gastric bypass surgery. N Engl J Med. 2007 Aug 23;357(8):753-61. doi: 10.1056/NEJMoa066603.

    PMID: 17715409BACKGROUND

  • Reis M, Aberg-Wistedt A, Agren H, Akerblad AC, Bengtsson F. Compliance with SSRI medication during 6 months of treatment for major depression: an evaluation by determination of repeated serum drug concentrations. J Affect Disord. 2004 Nov 1;82(3):443-6. doi: 10.1016/j.jad.2004.02.003.

    PMID: 15555696BACKGROUND

MeSH Terms

Conditions

DepressionAnxiety Disorders

Interventions

Gastric Bypass

Condition Hierarchy (Ancestors)

Behavioral SymptomsBehaviorMental Disorders

Intervention Hierarchy (Ancestors)

Bariatric SurgeryBariatricsObesity ManagementTherapeuticsGastroenterostomyAnastomosis, SurgicalSurgical Procedures, OperativeDigestive System Surgical Procedures

Study Officials

  • Giselle Hamad, MD

    University of Pittsburgh

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
observational
Observational Model
CASE ONLY
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER

Study Record Dates

First Submitted

March 15, 2011

First Posted

March 17, 2011

Study Start

August 1, 2007

Study Completion

August 1, 2010

Last Updated

March 17, 2011

Record last verified: 2011-03

Locations

US(1)