Canadian Journal of Anesthesia

, Volume 49, Issue 2, pp 132–136

Antidepressant treatment for chronic depressed patients should not be discontinued prior to anesthesia

  • Akira Kudoh
  • Hiroshi Katagai
  • Tomoko Takazawa
General Anesthesia

Abstract

Purpose

To investigate whether antidepressants administered to patients for chronic depression patients should be continued or discontinued before anesthesia.

Results

We studied 80 depressed patients who were scheduled to undergo orthopedic surgery under general anesthesia. The patients were divided randomly into two groups; patients in Group A (n = 40) continued antidepressants before surgery and patients in Group B (n = 40) discontinued antidepressants 72 hr before surgery. Two (5%) out of 40 patients in Group A and eight (20%) out of 40 patients in Group B had deterioration of depressive symptoms (P = 0.04). Delirium or confusion during the perioperative course occurred in five patients (13%) in Group A and in 12 (30%) in Group B (P = 0.05). There were no significant differences in incidence (5 vs 6%) of hypotension and arrhythmias during anesthesia between the two groups.

Conclusion

Antidepressants administered to depressed patients should be continued before anesthesia. Discontinuation of antidepressants did not increase the incidence of hypotension and arrhythmias during anesthesia, but increased symptoms of depression and delirium or confusion.

Le traitement antidépresseur ne devrait pas être interrompu avant l’anesthésie de patients atteints de dépression chronique

Résumé

Objectif

Vérifier si le traitement antidépresseur administré aux patients atteints de dépression chronique devrait être ou non interrompu avant i’anesthésie.

Méthode

Nous avons étudié 80 patients déprimés qui devaient subir une intervention orthopédique sous anesthésie généraie. Les patients ont été répartis au hasard en deux groupes : ceux du groupe A (n = 40) ont poursuivi ie traitement antidépresseur jusqu’à i’opération et ceux du groupe B (n = 40) l’ont interrompu 72 h avant.

Résultats

Deux (5%) patients du groupe A et huit (20%) du groupe B ont subi une détérioration des symptômes dépressifs (P = 0,04). Le déiire et !a confusion ont été observés chez cinq patients pendant ia période périopératoire (13%) chez les patients du groupe A et chez douze patients du groupe B (30%) ( P = 0,05). Il n’y a pas eu de différence intergroupe significative quant à l’incidence (5 vs 6 %) d’hypotension et d’arythmie pendant I’anesthésie.

Conclusion

Le traitement antidépresseur administré aux patients déprimés devrait se poursuivre avant I’anesthésie. Son arrêt n’augmente pas l’incidence d’hypotension ou d’arythmie pendant I’anesthésie, mais accentue les symptômes dépressifs, le délire ou la confusion.

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Copyright information

© Canadian Anesthesiologists 2002

Authors and Affiliations

  • Akira Kudoh
    • 1
  • Hiroshi Katagai
    • 2
  • Tomoko Takazawa
    • 2
  1. 1.Department of AnesthesiologyHirosaki National HospitalAomoriJapan
  2. 2.Hirosaki National HospitalHirosaki, AomoriJapan

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