{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T19:07:14Z","timestamp":1789499234353,"version":"build-2803163510"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2021,7,16]],"date-time":"2021-07-16T00:00:00Z","timestamp":1626393600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,7,16]],"date-time":"2021-07-16T00:00:00Z","timestamp":1626393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005760","name":"University of Gothenburg","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005760","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Clin Pharmacol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>As a substantial proportion of bariatric surgery patients use psychotropic\/antiepileptic drugs, we investigated the impact of this procedure on serum concentrations.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>In a naturalistic, longitudinal, prospective case series, we compared dose-adjusted trough concentrations of antidepressants, antipsychotics, or antiepileptics in consecutive patients before and after bariatric surgery. Adherence to treatment over 2\u00a0weeks preceding each sampling was considered.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In all, 85 participants were included (86% female, median age 45\u00a0years, median body mass index 42\u00a0kg\/m<jats:sup>2<\/jats:sup>). They were being treated with 18 different psychotropic\/antiepileptic drugs (7 substances: 6\u201317 individuals, 11 substances: 1\u20134 individuals) and contributed 237 samples over a median of 379\u00a0days after surgery. For four out of seven substances with pre-\/post-surgery samples available from six or more individuals, the dose-adjusted concentration was reduced (sertraline: 51%, mirtazapine: 41%, duloxetine: 35%, citalopram: 19%). For sertraline and mirtazapine, the low-calorie-diet before surgery entirely explained this reduction. A consistent finding, irrespective of drug, was the association between the mean ratio of the post-\/pre-diet dose-adjusted concentration and the lipophilicity of the drug (logD; correlation coefficient:\u2009\u22120.69, <jats:italic>P<\/jats:italic>\u2009=\u20090.0005), the low-calorie diet often affecting serum concentration more than the surgery itself.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Serum concentrations of psychotropic\/antiepileptic drugs vary after bariatric surgery and can be hard to predict in individual patients, suggesting that therapeutic drug monitoring is of value. Conversely, effects of the pre-surgery, low-calorie diet appear generalizable, with decreased concentrations of highly lipophilic drugs and increased concentrations of highly hydrophilic drugs. Interaction effects (surgery\/dose\/concentration) were not evident but cannot be excluded.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00228-021-03182-1","type":"journal-article","created":{"date-parts":[[2021,7,16]],"date-time":"2021-07-16T07:03:36Z","timestamp":1626419016000},"page":"1875-1885","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Serum concentrations of antidepressants, antipsychotics, and antiepileptics over the bariatric surgery procedure"],"prefix":"10.1007","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7238-1680","authenticated-orcid":false,"given":"Susanna M.","family":"Wallerstedt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Nyl\u00e9n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus A. 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