From the Research
Sertraline can generally be continued before surgery, as the benefits of maintaining mood stability and preventing discontinuation symptoms typically outweigh potential risks. The decision to hold sertraline pre-operatively should be individualized based on the patient's psychiatric stability, the specific surgical procedure, and other medications being used 1. Sertraline has minimal impact on surgical outcomes, bleeding risk, or anesthetic interactions, and its pharmacokinetic profile is favorable, with a half-life of about 26 hours and minimal effects on the cytochrome P450 system 2. However, in specific situations such as procedures with high bleeding risk or when combining with other medications that might increase serotonin levels (like certain pain medications), a brief pause might be considered. If discontinuation is deemed necessary, it should ideally be tapered rather than stopped abruptly to avoid withdrawal symptoms. Key considerations include:
- The patient's psychiatric stability and history of depression or anxiety disorders
- The specific surgical procedure and potential risks associated with it
- Other medications being used, including those that may interact with sertraline or increase serotonin levels
- The potential benefits of maintaining mood stability and preventing discontinuation symptoms Always communicate with both the psychiatric provider and surgical team when making this decision to ensure the best outcome for the patient's mental and physical health 1, 2.