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Some Antidepressants Linked to Bleeding Risk With Surgery
Date:4/29/2013

this point. We need more and better studies to answer questions such as when to stop taking these drugs, for how long and when it is safe to restart them again after surgery."

As it stands, people undergoing scheduled surgery are often told to avoid taking certain medications such as aspirin and nonsteroidal anti-inflammatory drugs (commonly called NSAIDs) in the days leading up to their procedure due to risk of bleeding.

"If the new findings hold up in future studies, SSRIs may be added to this list," Auerbach said. Until then, "I would lean toward stopping if my doctor thought it was fine to do so," but is not an easy decision, he added. "I would hate for recovery to be impeded because depression or anxiety is out of control, so it is important to strike a balance."

Dr. David Straker, an adjunct assistant clinical professor of psychiatry at Columbia University Medical Center, in New York City, said he routinely discusses this issue with his patients, and often their surgeons, too. There is no one-size-fits-all recommendation for who should stop taking an SSRI before surgery and who should not, said Straker, who was not involved with the new study.

"It depends on the surgical procedure, the type of SSRI they are taking and the severity of their depression or anxiety," Straker said. "Sometimes I recommend that they stop a week before the procedure or I lower the dose if the surgery is associated with a lot of blood loss."

All SSRIs are not created equal when it comes to bleeding risk and the amount of time they stay in the body (also known as their "half-life"), he pointed out. "It is individualized," Straker said. "Talk to your psychiatrist and, if need be, he or she can discuss your risks with your surgeon."

More information

Learn more about antidepressants at the U.S. National Library of Medicine.


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