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Lithium toxicity after bariatric surgery

Published online by Cambridge University Press:  23 March 2020

L. De Jonge ,
S. Petrykiv ,
J. Fennema  and
M. Arts
L. De Jonge
Affiliation:
Leonardo scientific research institute, geriatric psychiatry, Bergen op Zoom, The Netherlands
S. Petrykiv
Affiliation:
University of Groningen- university medical center Groningen, department of clinical pharmacy and pharmacology, Groningen, The Netherlands
J. Fennema
Affiliation:
GGZ Friesland, geriatric psychiatry, Leeuwarden, The Netherlands
M. Arts
Affiliation:
University of Groningen- university medical center Groningen, department of old age psychiatry, Groningen, The Netherlands

Abstract

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Introduction

Bariatric surgery is globally increasingly being applied in patients with morbid obesity to achieve permanent weight reduction. More than fifty percent of these patients have a psychiatric disorder in their history and over thirty percent take psychotropic medication. The prevalence of bipolar disorder in patients who undergo bariatric surgery is around four percent, and most of them are treated with lithium.

Objectives & aims

To report and discuss the effect of bariatric surgery on changes in lithium absorption.

Methods

We present all published case studies and literature review on lithium toxicity after bariatric surgery.

Results

To date; only two case-reports were published with dramatic changes in lithium level after vertical sleeve gastrectomy and Roux-en-Y bariatric surgery. Within a period of two to five weeks, the patients were presented to the emergency department with signs of dehydration and acute kidney failure.

Conclusion

Clinicians should be aware of dramatic and possibly even life-threatening pharmacokinetic changes in drug absorption that may occur after bariatric surgery. Careful monitoring and even reduction of lithium dosage before and after surgery could potentially prevent serious complications.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
e-Poster viewing: Consultation liaison psychiatry and psychosomatics
Information
European Psychiatry , Volume 41 , Issue S1: Abstract of the 25th European Congress of Psychiatry , April 2017 , pp. S491
Copyright
Copyright © European Psychiatric Association 2017
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