Drugs/Therapy

Taking Antidepressants Before Surgery Can Lead to Health Complications

By Cheri Cheng | Update Date: May 01, 2013 12:06 PM EDT

In a dicey scenario, researchers stated that people who need antidepressants might not be able to take them up to two weeks before surgery due to the risk the drugs pose on physical health. However, the risk of not taking these drugs before invasive surgery can also be dangerous to mental health. In a new study, researchers found that one of the most popular class of drugs that is currently used to treat depression known as selective serotonin reuptake inhibitors (SSRIs) might not be safe for people who will need to be hospitalized after an operation. Despite being a popular drug treatment, SSRIs have previously been studied for their possible side effects on pregnant women and suicidal adolescents. In this particular study, the researchers looked into the role of SSRIs in contributing to irregular heartbeats and a higher risk of bleeding during surgery, which would increase the patient's chances of needing to stay at the hospital longer, as well as an increased chance of death.

The study was conducted by researchers from the University of California, San Francisco, and it looked into SSRIs, which included Prozac, Zoloft and Paxil. The research team evaluated the data of 530 patients, with 416 of them being over the age of 18. These participants had operations at 375 different hospitals within the United States between January 2006 and December 2008. The researchers looked specifically at the usage of SSRIs before surgery and any possible negative effects during or post-surgery, which could have resulted in irregular heartbeats, excessive bleeding and transfusions during surgery as well as a prolonged hospital stay.

After adjusting and controlling for factors, such as age and gender, that could lead to these adverse effects, they found that the patients who took antidepressants before their operations had an elevated risk for bleeding, leading to a higher chance of being readmitted as well as a higher risk of death during the study. The discovery of the link between SSRIs and bleeding and irregular heartbeats is not completely new since SSRIs have been known to be responsible for prohibiting the nerve cells from absorbing serotonin, which is a hormone that can affect how the blood clots and whether it clots properly.

The researchers acknowledged that there are other possible factors that they did not control for. They noted that patients taking antidepressants tended to be obese or have respiratory complications, which could have contributed to bleeding and irregular heartbeat as well. Regardless, some hospitals recommend that patients stop taking their antidepressants two weeks before surgery, which can be hard for some people. This suggests that changes might need to be made to these popular drugs in order to continue to protect people's overall health.

The study was published in JAMA Internal Medicine.

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