med malabsorption???

i had rny 1/14/11. i was on zoloft and xanax pre op (for depression, anxiety, and ptsd symptoms). after surgery my meds were still working. then at about 2-3ish months post op they started to lose effectiveness. i first noticed it with my xanax...my dr upped my dosage and i still felt anxious. so instead of having her up my dosage again i tapered off of the xanax. then my zoloft started to lose effectiveness...i started getting depressed and losing motivation to do anything. i went to a physchiatrist and she switched me to lexapro and also propranolol for anxiety (i don't take it a lot b/c it is a bp med and i get dizzy a lot since about 2-3 months post op)...depression got worse and i started feeling numb. so she switched me to effexor (not the extended release one). i've been on it for a few weeks now and i still feel depressed and just do not have any motivation. i know meds can take a while to start working but it seems like none of them are working for me since about 2-3 months post op. could i have malabsorption issues with my meds? how can they figure that out? is it just if the meds are not working they are not being absorbed? i have also been seeing a therapist and her techniques reached a certain point and they are just not helping me anymore. she mainly does like talk / listen and trying to get me to change my thinking about things, but it's hard and just not working. i've seen her for a year and it feels like its the same old thing every time i go see her. so i have made an appt with a new therapist and see them today. anyone have experience with this? i just feel so blah and so down. i don't like feeling this way. i want to feel great. i've lost 96.5 lbs and i want to be happy.

I think it's often very hard to tell if it's a matter of the meds just not working now or that you're not absorbing them.  With some meds, they can do a blood test to see how much is in your system, but I don't think they can do that with all meds (I may be mistaken about that, though).  My personal experience with antidepressants is that sometimes I have what seems to be the perfect combo of drugs and then sometimes the depression just gets worse and all of a sudden the meds don't seem to help anymore.  It's very frustrating and I don't know why that happens, but it does.

It can take quite a while and many tries to find antidepressants that work for you, and that's frustrating because you have to be on them for several weeks before you can tell if they're going to work or not.

One thing you might not have thought of is B12.  Have you had labs done lately?  If your B12 is below 550, people usually get tired and depressed.  Otherwise it seems like you're doing the right things.

I saw a absorption chart from a medical group a couple of years ago. Antipsychotic drugs seemed to be malabsorbed much more than standard sleeping pills or antidepressants.  Antidepressants may not work with anyone after some time. The only thing you won't do well with is extended release forms of antidepressants. Sometimes it takes a combination of 2 or e meds and then varying the dosages over time. Each time an antidepressant is changed (or the dosage is changed), it takes the human body about 6 weeks to realize any noteceable changes for mnost patients.  Depression post op is a common issue, as you're in mourning from missing the foods you could eat prior to surgery.  Blood tests can determine the amount of antidepressant in your body.  You should likely speak to the doctor prescribing the antidepressant meds for the possible testing, to get full details. DAVE

I was worried about my meds as well. I get really sick without them. I can no longer take extended realease anything. Instead of getting my meds in one does in the morning I take them 3 times a day now. I see to be more stable and confident. I use a combo of 2 meds to make what I call my ****tail. If you like I can talk with you more about them.

Be kind to yourself, you will even out.

Mary~