Antidepressant agents in short bowel syndrome

Abstract

Purpose: This study aimed to determine whether short small intestine modifies antidepressant concentrations.

Methods: The Css values and concentration-dose ratios (CDRs) of citalopram or escitalopram, administered orally or intravenously, were determined in patients with short bowel syndrome.

Findings: Eight patients (6 males and 2 females) were included in the study. High CDRs were obtained in orally treated patients with >180 cm of small bowel and in those with >80 cm of small bowel and 50% of colon. Three patients had low Css values, including 1 patient who received intravenous treatment.

Implications: The variability of drug absorption and metabolism makes prescribing SSRIs challenging in these patients.

Keywords: absorption; citalopram; escitalopram; short bowel syndrome; therapeutic drug monitoring.