Perioperative implications of common and newer psychotropic medications used in clinical practice

Best Pract Res Clin Anaesthesiol. 2018 Jun;32(2):187-202. doi: 10.1016/j.bpa.2018.06.002. Epub 2018 Jul 2.

Abstract

Psychotropic medications are widely prescribed by clinicians as both primary therapy for a variety of psychiatric and neurodegenerative diseases and as adjunctive analgesics for use in the perioperative period. It is critical to understand various modes of action, drug-drug interactions, side effects, and clinical implications. Health care providers must understand how these medications interact with anesthetics, as well as other drugs used in perioperative care. We review relevant psychiatric and neurodegenerative diseases, psychotropic medications used to treat them, and how these medications interact with anesthetics and drugs used in perioperative care. We will also discuss emerging psychotropic drugs and the challenges they may create during the perioperative period. Future direction of investigation into the role of these drugs during the perioperative period and implications is also discussed.

Keywords: Alzheimer's; Parkinson's; antipsychotics; depression; perioperative care; psychotropic medications; psychotropics.

Publication types

  • Review

MeSH terms

  • Analgesics / administration & dosage*
  • Analgesics / metabolism
  • Anesthetics / administration & dosage*
  • Anesthetics / metabolism
  • Drug Interactions / physiology
  • Humans
  • Parkinson Disease / drug therapy
  • Parkinson Disease / metabolism
  • Parkinson Disease / surgery
  • Perioperative Care / methods*
  • Perioperative Care / trends
  • Psychotropic Drugs / administration & dosage*
  • Psychotropic Drugs / metabolism

Substances

  • Analgesics
  • Anesthetics
  • Psychotropic Drugs