The self-reporting of psychiatric medications in patients scheduled for elective surgery

Study Objective: To determine by survey the percentage of patients, over the age of 21 years, reporting for elective surgery who also are taking psychotropic medications.

Design: Institution-approved, anonymous survey.

Setting: Teaching hospital.

Patients: 169 patients who were scheduled for elective surgery.

Interventions: After completion of the preoperative evaluation by members of the anesthesia care team, all patients were given an institution-approved survey of medications they were taking in addition to their nonpsychiatric medications. The survey listed 33 drugs known to affect central nervous system neurotransmitters, and included the most commonly prescribed antidepressants, antipsychotics, benzodiazapines, and lithium. Over-the-counter drugs known to affect mood, such as melatonin, also were included in the survey. Patients were not asked the indications for the medications, and no psychiatric questions were asked of the patients.

Measurements and Main Results: 300 surveys were distributed, and 169 patients completed the survey for a response rate of 53%. Forty-three percent of all patients who completed the survey admitted to taking one or more of the psychotropic medications. Of these patients, 35% were taking antidepressants, 34% were taking benzodiazapines, 19% were taking combination therapies, and 11% took antipsychotics, lithium, or over-the-counter drugs such as melatonin.

Conclusion: The number of patients taking psychotropic medications and who present for elective surgery is high. The anesthetic implications of this drug usage are essentially unknown. Additional study of these medications and their impact on anesthetic care is warranted.