Anxiety After Bariatric Surgery

Eric Beard, May Joseph, Vivian Kadus

Pharmacy Residents
Lutheran Hospital
Objectives

● Describe the symptoms and causes of anxiety

● Analyze different ways to manage these symptoms without medications
● Explain which medications can be used to help treat anxiety
● Brainstorm ways you can reduce anxiety in your own life
Why might you feel anxious?
What does anxiety feel like?

● Feeling nervous, restless or tense

● Trouble concentrating or thinking about anything other than the present
worry
● Having trouble sleeping
● Having difficulty controlling worry or trying to avoid things that trigger anxiety
● Physical symptoms: sweating, fast heart rate, rapid breathing, trembling,
difficulty sleeping
Deep breathing
How can food help?

● Diet plays an important role in how we feel

● How do diet restrictions after surgery make
you feel?
● How does water intake affect your mood?
● Complex carbohydrates vs simple
carbohydrates
● Carbonation/Alcohol intake
● Food sensitivities
What is talk therapy?
What are the medication options?
● For the treatment of generalized anxiety:

○ Selective serotonin reuptake inhibitors (SSRI)

■ Sertraline (Zoloft), Fluoxetine (Prozac), Citalopram (Celexa), Escitalopram (Lexapro), Paroxetine (Paxil)

○ Serotonin and norepinephrine reuptake inhibitors (SNRI)

■ Venlafaxine (Effexor), Duloxetine (Cymbalta), Desvenlafaxine (Pristiq)

○ Benzodiazepines

■ Diazepam (Valium), Lorazepam (Ativan), Alprazolam (Xanax), Clonazepam (Klonopin)

○ Buspirone (BuSpar)

○ Hydroxyzine (Atarax)
What should you know about these medications?

● Side effects:
○ GI upset, dizziness, lack of sleep, headache, fatigue, reduced sex drive

● How to take:
○ All medication options are oral and taken daily or as needed for anxiety
○ SSRIs are taken daily while benzodiazepines are taken daily or as needed
○ Take as directed, do not stop abruptly without consulting with your doctor
○ Missed dose: take as soon as you remember. If it is almost time for your next dose, wait until then and take a
regular dose. Do not take two doses at the same time.

● Special things to know

○ SSRI and SNRI will take time to have effect (~2-6 weeks)
○ Benzodiazepines, buspirone are short term
When to see your doctor about anxiety?

● Difficulty concentrating
● Restlessness
● Irritability
● Sleep disturbance
● Muscle tension
Deciding what is best for you!

● You are your own biggest advocate

● Surround yourself with people who uplift you and
not add to your anxiety

● Know your triggers

● Seek help early!

● Embrace this journey

Conclusion

● Reviewed the symptoms of anxiety

● Discussed different non-medication ways to manage anxiety

● Reviewed several medication options that can be used and important
information to know about them
References
1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6050001/#:~:text=Studies%20have%20suggested
%20a%20substantial,conducted%20at%20different%20times%20postoperatively
2. https://www.nice.org.uk/guidance/cg113/resources/generalised-anxiety-disorder-and-panic-
disorder-in-adults-management-pdf-35109387756997
3. https://adaa.org/resources-professionals/practice-guidelines-gad
4. https://www.psycom.net/anxiety
5. https://www.bmiut.com/blog/controlling-anxiety-after-bariatric-surgery-16644.html#:~:text=Take%20
deep%20breaths%3A%20At%20the,focus%20on%20improving%20your%20health
6. https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961
7. https://www.google.com/url?q=https://www.palmyrasurgical.com/lifestyle-activity/manage-anxiety-
after-bariatric-surgery&sa=D&source=editors&ust=1662045316543260&usg=AOvVaw1-
xp6DAXGr2EpEwFGG8kWe
8. https://www.absspecialists.com/2019/06/anxiety-fear-before-bariatric-surgery/#:~:text=Anxiety%20
before%20any%20surgical%20procedure,loss%20to%20pursue%20and%20maintain
Anxiety After Bariatric Surgery
Eric Beard, May Joseph, Vivan Kadus
Pharmacy Residents
Lutheran Hospital