From the Guidelines
You should not stop taking Wellbutrin (bupropion) before abdominoplasty and liposuction without consulting both your surgeon and the prescribing physician, as the decision to stop or continue the medication depends on various individual factors, including the patient's mental health status and surgical risks. The provided evidence does not directly address the management of Wellbutrin in the context of abdominoplasty and liposuction, as it focuses on the perioperative management of buprenorphine 1. However, considering the potential effects of Wellbutrin on blood pressure, heart rate, and bleeding risk, it is crucial to weigh these factors against the risks of withdrawal symptoms, such as anxiety, irritability, and mood changes, that may occur if the medication is stopped abruptly.
- Key considerations include:
- The potential impact of Wellbutrin on anesthesia management and surgical complications
- The risk of withdrawal symptoms if the medication is stopped
- The importance of balancing mental health needs with surgical safety considerations
- The need for a personalized plan developed in consultation with both the surgeon and the prescribing physician
- In general, the decision to stop or continue Wellbutrin before elective surgery like abdominoplasty and liposuction should be made on a case-by-case basis, taking into account the individual patient's health status, the specific surgical procedure, and the potential risks and benefits of continuing or discontinuing the medication.
From the Research
Wellbutrin and Surgical Procedures
- There is no direct evidence in the provided studies that suggests Wellbutrin should be stopped before abdominoplasty and liposuction 2, 3, 4.
- However, one study suggests that selective serotonin reuptake inhibitors (SSRIs) may increase the risk of bleeding complications during and immediately after surgery, but it does not specifically mention Wellbutrin, which is a norepinephrine-dopamine reuptake inhibitor (NDRI) 5.
- Another study discusses the adverse reactions to bupropion (Wellbutrin), but it does not provide information on the interaction between Wellbutrin and surgical procedures like abdominoplasty and liposuction 6.
Surgical Procedures and Complications
- Abdominoplasty is associated with a higher complication rate compared to other aesthetic procedures, and combined procedures can significantly increase complication rates 3.
- Local complications, such as seroma, hematoma, and infection, are more common than systemic complications after abdominoplasty 4.
- The use of bupivacaine and epinephrine in cosmetic surgery, such as liposuction and abdominoplasty, has been shown to be safe and effective 2.
Medication Management and Surgery
- Clinicians must consider the risk-to-benefit ratio of discontinuing medications like SSRIs before an elective operative procedure, as discontinuing may result in discontinuation syndrome or relapse of depression, while continuing may expose patients to bleeding risks 5.