Antidepressants and Anesthesia


Antidepressant drugs works well in treating persons with depression. However, antidepressant can lead to some certain problems once the patient is required to take anesthesia when he has to undergo certain surgery or operation. But in some cases where antidepressant is administered within at least 2 weeks before the operation, it has been said that it will not hamper the main purpose of anesthesia which is to overcome pain.

Before proper surgery or operation is performed, there are other medications like muscle relaxants, painkillers and blood pressure agents that needs to be administered to the patients along with anesthesia.  These drugs may interact with each other and may produce unwanted effects.

Here are the symptoms seen in patients who have been on anti-depressants before undergoing anesthesia:

  1. Severe palpitations
  2. Heart movement abnormalities
  3. ECG changes
  4. Extremely high blood pressure
  5. Complexity in temperature regulation
  6. Increased surgical bleeding
  7. Post-operative confusion
  8. Serotonin syndrome manifest sudden agitation, muscle rigidity high body temperature, seizure sometimes coma.

Because of withdrawal symptoms and relapse period, the patient cannot quickly stop taking antidepressant drugs prior to anesthesia. That is why it is recommended to always keep an attending psychiatrist throughout the process. It is also much beneficial to provide anesthetist a complete list of drugs being administered by the patient.

Defining Antidepressants

One of the most common issues in recent times is depression. It is also no wonder that many people are seeking and looking for relief from the symptoms of this condition.

Antidepressant is a drug most commonly administered to patients suffering from depression. Depression is an illness which is caused by various combinations of factors. These factors are environmental, biochemical, genetic and psychological. In this case, the brain has neurotransmitters but frequently it is imbalanced which in turn affects the thought, mood, appetite, sleep and behavior.

Antidepressant is responsible in treating depressive illnesses and rebalancing the neurotransmitters. However, the exact process why this happens is still not fully clear and understood. Antidepressants have many forms and each is designed to treat depression in many ways. Taking antidepressants might as well be difficult to some people since it can be difficult for the stomach because of its side effects.

Defining Anesthesia

Anesthesia is traditionally used to block or temporary take away the pain and sensation. It is a pharmacologically reversible and induced state of analgesia, amnesia, loss of responsiveness, decrease stress response and loss of skeletal muscle reflex.



Both anesthesia and antidepressant have something to do with each other once they are both used at the same time. When taking antidepressant, it must be weighed accordingly since it can interact with other drugs. According to the MedscapeWire in New York, medication used to treat mental problems such as antidepressant are increasing in effectiveness and numbers, means that many patients may benefit.

However, a researcher of a University warns that doctors should be aware of those drugs called psychotropic drugs’ possible interaction with other drugs, popular herbal medication that are over-the-counter and especially surgical anesthesia drugs.

Antidepressants or psychotropic drugs had been accounted more than 9% of prescription as written in the US. Nearly 6% of the US population are affected with depression and had been using the said psychotropic drug. The most common drugs used are tricyclic antidepressants which are known to be potentially toxic in the heart.

However, those drugs are used in the past and the recent new antidepressants are serotonin reuptake inhibitors or the SSRIs. Example of which is Prozac, a safe brand that is most commonly prescribed by doctors to more than 80% of patients.

  • An assistant professor on the Iowa College of Pharmacy had shown a vital example of interaction between anesthesia and antidepressant is the person treated with Prozac while having his wisdom tooth removed and was given Codeine for the pain as well. The reaction would be; the enzymes that trigger codeine to work effectively will be interfered by the antidepressant drug. In that case the codeine will no longer be effective or will produce a very little efficacy. It is also proven that aside from interacting with other drug, Prozac and other type of antidepressants can also interact with other medications used in surgery aside from anesthesia, causing the patient to suffer from seizures.  Another example would be infusion of ketamine (a general anesthetic agent), this medication relieves symptoms of depression in just 2 hours from the time it was taken and can remain effective for up to a week. This fact is according to the report of the “Archives of General Psychiatry.
  •  A doctor and his colleagues at the NIMH or National Institute of Mental Health had studied the effect of ketamine in 12 women and 6 men aging 40 plus undergoing an unsuccessful treatment of antidepressant. After 2 weeks of drug-free period, they received two intravenous ketamine infusion dissolved in saline and pure saline (placebo). Within the 110 minutes after infusing the medication, those patients who received ketamine had showed significant effect rather than those who received placebo. 29% of the respondents had met the criteria for reduction from depression. The effect of ketamine is positive to 35% to those who received it and its effect lasted one week. During the study, it was found out that no serious adverse event had occurred.

Now, it might be clear to you of what are the effects of undergoing to both antidepressant and anesthesia medication. However, before taking any of these medications, you must consult a doctor first. This will help you aware of the possible effects or side-effects of the medication. You must also consider the over all physical and mental health. Not only will you notice the changes but as well the people around you.

For some people, they might suffer from withdrawal effects and others might not. Doctor’s advice is always the best choice before taking any action. Always be reminded that your heath is not a joke. Be always certain of the things you are doing when it has something to do with your health. One must be:

  • Well informed about his/her condition
  • Must know the side effects of both anesthesia and antidepressant
  • Must consult a doctor before taking any of these drugs
  • Must be prepared of the possible adverse effects
  • Should take medicine according to the prescription



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