Continued anti-depressant and anti-anxiety medication use during surgery?

Question

I am currently on Wellbutrin and Buspar. My question is, will I be asked to taper off of these medications for a rhinoplasty surgery, and if so, how long will most doctors ask that I be off them (before and after surgery)? I've seen some concerning research on SSRI's and surgery but not so much on NDRI's. What can I expect my doctor will recommend?

Tanveer Janjua, MD · Answer

It is important to continue antidepressants in the perioperative period.  However, you need to make your anesthesiologist aware of these medications as they can lead to increase in blood pressure during anesthesia.  Also keep in mind that surgery can lead to a depressive episode because of the stress of healing process.  If that happens you might have to consult your psychiatrist or psychologist to make appropriate changes in your medication.RegardsDr. J

Robert L. Kraft, MD, FACS · Answer

Patients stay on their anti-depressants.  This is something which should be disclosed to your surgeon who will confer with the anesthesiologist but these are standard psychiatric medications.  The anesthesiologist will take this into account.  As these are "level" drugs, abstaining on the morning of surgery when you must be NPO would not have an effect on their efficacy and you may resume the next day.

William Portuese, MD · Answer

Yes, it is best to stay   on those medications before and after surgery.  Those medication should not interfere with elective rhinoplasty  surgery.

Steven Wallach, MD · Answer

You should be able to take your anti-depressant meds. If you want to be absolutely sure, then check with the anesthesiologist helping out.

Michael M. Omidi, MD, FACS · Answer

Thank you for the question. There is no evidence to suggest that taking anti-depressant and anti-anxiety medication increases the risk of bleeding or other complications for plastic surgery patients. That being said you should disclose the list of your current medications to your plastic surgeon. 
An in-person exam with a board certified plastic surgeon is always the best way to fully assess your needs and address your concerns. Best of luck!

Ian MacArthur, MD, FRCSC · Answer

Thanks for your question. In general, medications such as the ones you mentioned can be continued throughout the surgical process. The medications that we as surgeons tend to ask patients to discontinue are those that could contribute to excess bleeding or wound healing complications. Be sure to discuss these concerns with your operating plastic surgeon. All the best.

Richard M. Levin, MD (retired) · Answer

Most plastic surgeons encourage you to continue the use of anti depressant meds, both before and after your planned rhinoplasty to ensure your continued mood balance. You should also discuss or make your anesthesiologist aware of these medications to allow consideration of the medications he uses while you are asleep. There is no absolute contraindication to their usage otherwise.

Continued anti-depressant and anti-anxiety medication use during surgery?

Answers (7)

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