Abstract
The anatomic and physiologic changes in the gastrointestinal (GI) tract after bariatric
surgery may significantly affect the pharmacokinetics of medications taken by the
patients for various reasons. Unfortunately, there is little information regarding
changes in drug absorption after bariatric surgeries, limiting the ability of medical
professionals to produce clear recommendations on what changes should be made to the
formulations and dosing regimens of drugs after bariatric surgery. In this article,
we report and analyze a case of 52-year-old male patient with morbid obesity and attention-deficit/hyperactivity
disorder (ADHD) who experienced lack of methylphenidate efficacy after Roux en-Y gastric
bypass (RYGB), which was eventually resolved by using the transdermal patch instead
of an oral product. Interestingly, in the same patient, a prior gastric band had no
effect on the drug’s efficacy. Especially in light of a recent case report of methylphenidate
toxicity after RYGB, these 2 cases suggest that bariatric surgeries may alter the
absorption of orally administered methylphenidate in an unpredictable manner; hence,
it is prudent to closely monitor the therapeutic/toxic effects of methylphenidate
after bariatric surgery, and to be aware of nonoral treatment options of this medication.
Keywords
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Article info
Publication history
Published online: March 09, 2017
Accepted:
March 6,
2017
Received in revised form:
March 2,
2017
Received:
February 23,
2017
Identification
Copyright
© 2017 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
