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Impact of Sleeve Gastrectomy on Psychiatric Medication Use and Symptoms

机译:袖胃切除术对精神科用药和症状的影响

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Background. Sleeve gastrectomy (SG) has become the primary bariatric surgery procedure in the U.S. Over 50% of people presenting for surgery have psychiatric diagnoses. The study purpose was to evaluate change in anxiety and depression symptoms and medication use after SG. Methods. Subjects completing SG with a diagnosis of anxiety and/or depression treated with medication were retrospectively identified from the electronic medical record (EMR) of Synergy Bariatrics, a department of the Erie County Medical Center. Phone outreach was made to complete seven-point global impression of change scale classifying symptom improvement or worsening in the 3- to 6-month postoperative period. Improvement or worsening was defined as either all reported symptoms improving or worsening or ≥1 improving or worsening while remaining unchanged. If ≥1 symptom improved and worsened, it was classified as mixed. No change required the same profile before and after surgery. Medication, dose, and changes were identified by EMR, verified during interview and classified as no change, discontinued, decreased, or increased. Results. 59 subjects completed the interview. 21 subjects were diagnosed with anxiety. 13 (62%) had no change in therapy and 5 (24%) decreased. Symptoms improved in 12 (57%), worsened in 3 (14%), and mixed in 5 (24%). When symptoms improved, the same dose was present in 7/12 (58%) and dose decreased in 3 (25%). 51 subjects were diagnosed with depression. 32 (63%) had no change in therapy, 11 (21%) discontinued, and 4 (8%) decreased. Symptoms improved in 34 (67%), mixed in 10 (20%), worsened in 4 (8%), and unchanged in 3 (6%). When symptoms improved, the same regimen and dose was present in 21/34 cases (62%) and discontinued in 9 (26%). Conclusion. Anxiety symptoms improved in >50% of subjects at predominantly the same or reduced dosage. Depression symptoms improved in 67% and commonly without therapy change. These data suggest evidence that patients undergoing SG while on medication for anxiety or depression may have early symptom improvement on the same or lessened dosage.
机译:背景。袖胃切除术(SG)已成为美国主要的减肥手术方法。目前有超过50%的待手术者有精神病诊断。研究目的是评估SG后焦虑和抑郁症状的变化以及药物的使用。方法。从伊利县医学中心的Synergy Bariatrics的电子病历(EMR)中回顾性地确定完成SG诊断为焦虑和/或抑郁的药物治疗对象。在术后3到6个月内,电话外联完成了对变化量表的七点总体印象,以分类症状改善或恶化。改善或恶化定义为所有报告的症状改善或恶化或≥1改善或恶化,同时保持不变。如果≥1的症状改善和恶化,则归为混合。手术前后无变化都需要相同的轮廓。通过EMR识别药物,剂量和变化,在面试中进行验证,并分类为无变化,停药,减少或增加。结果。 59位受试者完成了访谈。 21名受试者被诊断患有焦虑症。 13例(62%)的治疗无变化,而5例(24%)的治疗减少。症状改善12例(57%),恶化3例(14%),混合5例(24%)。当症状改善时,在7/12(58%)中存在相同剂量,在3(25%)中降低剂量。 51名受试者被诊断患有抑郁症。 32例(63%)没有治疗改变,11例(21%)停药,4例(8%)减少。症状有所改善的有34(67%),有混合的有10(20%),有恶化的有4(8%),有3的没有变化(6%)。当症状改善时,在21/34例中有相同的治疗方案和剂量(62%),在9例中止使用(26%)。结论。在相同或减少剂量的情况下,> 50%的受试者的焦虑症状得到改善。抑郁症状改善了67%,通常无需改变治疗。这些数据表明,在因焦虑或抑郁而接受药物治疗的同时接受SG治疗的患者,在相同或减少剂量的情况下,其早期症状可能会有所改善。

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