Effect of bariatric surgery on nutritional and metabolic parameters: does the type of antidepressant medication matter?

Purpose: Depression is prevalent in patients undergoing bariatric surgery (BSx). Long-term use of antidepressant is associated with weight gain, particularly the use of selective serotonin reuptake inhibitors (SSRIs). Little is known about whether different types of antidepressants affect the response to BSx. The purpose of this study was to determine the relationship between SSRI use and nutritional and biochemical measurements in those with obesity pre-/post-BSx.

Methods: This is a cross-sectional and prospective cohort study. Patients were enrolled pre-BSx and divided into 3 groups: SSRI, non-SSRI and no antidepressant. Nutritional, biochemical and pharmacological data were collected pre- and 6 months post-BSx.

Results: Pre-BSx, 77 patients were enrolled: 89.6% female, median age 45 years and body mass index (BMI) of 45.3 kg/m. 14.3% were taking SSRIs and had a significantly higher BMI (52.1 kg/m) compared to 62.3% in no antidepressant (46.0 kg/m) and 23.4% in non-SSRI antidepressants (43.1 kg/m). At 6 months post-BSx (n = 58), the SSRI group still had significantly higher BMI in comparison to the other two groups. No other significant differences found between groups.

Conclusion: Despite higher BMI, patients taking SSRI and undergoing BSx had similar responses, based on nutritional and biochemical parameters, to those on non-SSRI or no antidepressants.

Level Of Evidence: Level III: Evidence obtained from well-designed cohort or case-control analytic studies.