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Seek emergency help immediately (call 999 or go to your nearest emergency department) if you experience: Severe chest pain, a racing or irregular heartbeat, or collapse Sudden severe headache, difficulty speaking, or loss of consciousness Acute confusion, mania, psychosis, or thoughts of harming yourself or others Yellowing of the skin or whites of the eyes, very dark urine, or severe upper abdominal pain (possible signs of liver problems, particularly if you are taking atomoxetine) Contact your GP or ADHD specialist promptly but not as an emergency if you notice: A noticeable decline in ADHD symptom control that coincides with or follows your surgery Side effects that feel more intense than usual, such as palpitations, chest discomfort, persistent insomnia, or significant appetite suppression Difficulty swallowing tablets or capsules post-operatively your pharmacist or prescriber can advise on licensed alternatives such as liquid preparations or capsules that may be opened as permitted by the product's SmPC Concerns about weight loss interacting with your medication, as stimulant medicines can independently suppress appetite, which may be a particular concern in the context of post-bariatric nutritional requirements Any new mental health symptoms, including low mood, anxiety, or irritability, which may reflect altered drug levels or the psychological adjustment to surgery It is also worth noting that bariatric surgery itself can have a significant psychological impact, and some patients may experience changes in mood or mental health that are independent of their ADHD medication

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