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10.1128/aem.67.6.2718-2722.2001 3 AmachiS.KasaharaM.FujiiT.ShinoyamaH.HanadaS.KamagataY.et al (2004)
Anyone with a health condition that might have made it unsafe or challenging to participate was left out of the semaglutide clinical trials, for example, according to the study protocol, a precaution similar to other clinical trials
NICE NG87 on ADHD sets out specific monitoring requirements that remain applicable after surgery, including: Baseline cardiovascular assessment (blood pressure and pulse) before starting or changing ADHD medication Blood pressure and pulse monitoring after each dose change and at least every six months during ongoing treatment Weight and height monitoring in children and young people, with growth plotted on a centile chart at least every six months Weight monitoring in adults, particularly relevant given the appetite-suppressant effects of stimulant medicines in the context of post-bariatric nutritional requirements From a practical standpoint, the following steps are broadly aligned with NHS, NICE, BOMSS, and SPS principles: Pre-operative medication review : Patients should have all regular medicines reviewed before surgery, with a plan in place for post-operative management Post-operative reassessment : A structured review of ADHD medication efficacy and tolerability should occur within the first few weeks following surgery and at regular intervals thereafter Communication between teams : The bariatric surgical team, GP, and ADHD specialist (psychiatrist or paediatrician) should communicate clearly about any medication changes Formulation guidance : BOMSS and the UK Specialist Pharmacy Service (SPS) provide authoritative UK-specific advice on which formulations are appropriate after bariatric procedures and how modified-release preparations may behave differently post-surgery clinicians should consult these resources rather than assuming standard pharmacokinetic behaviour Patients are encouraged to bring a full list of their current medications to every post-operative appointment to facilitate thorough review
