Continuation of psychoactive agents in the perioperative period is supported to prevent exacerbation of psychiatric illness, despite potential drug interactions and hemodynamic effects.
Should psychoactive agents be continued in the perioperative period for patients with psychiatric disease presenting for surgery?
Psychoactive agents should generally be continued in the perioperative period for surgical patients with psychiatric comorbidities to avoid exacerbation during high-stress times.
PURPOSE OF REVIEW: Psychiatric illness is common in patients presenting for surgery. Overall health and surgical outcomes are adversely affected by the presence of psychiatric comorbidities. RECENT FINDINGS: As new treatment modalities become available, their perioperative implications need to be evaluated. These implications include drug-drug interactions, hemodynamic effects, bleeding risk, and factors affecting perioperative exacerbation of the underlying psychiatric illness. SUMMARY: From our review of the recent literature we continue to support the continuation of psychoactive agents in the perioperative period, taking into consideration the effects these agents have on concomitant drug use in the perioperative period; and the risks of withholding them at a high-stress time.
Guthrie et al. (Tue,) conducted a review in Psychiatric illness in patients presenting for surgery. Continuation of psychoactive agents vs. Withholding psychoactive agents was evaluated. Continuation of psychoactive agents in the perioperative period is supported to prevent exacerbation of psychiatric illness, despite potential drug interactions and hemodynamic effects.
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