What to Do About Herbs and Antidepressant Medications When Considering Plastic Surgery

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The number of people who take daily medication, prescription or supplemental, continues to increase. In otherwise healthy people, who make up the majority of elective plastic surgery patients, the two most common medications are antidepressants and herbal supplements. It is quite common to see patients taking both. As it appears that the popularity of these drugs and herbs will continue to grow, it is important that all patients considering cosmetic plastic surgery be aware of their potentially harmful effects.

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Most antidepressants, such as Effexor and Wellbutrin for example, work by inhibiting serotonin and norepinephrine uptake into the nerve ends. By keeping these excitatory neurotransmitters circulating in one's system, one is keep 'stimulated' with a resultant elevated mood. Such drug effects may pose potential problems with anesthesia particularly causing high blood pressure and other cardiac effects.

Herbs are extracts from any seed-bearing plant and, while there are hundreds of herbs, the most common one's taken are Garlic, Gingko, Ginseng, Ginger, St. John's Wort, Valerian, Echinacea, Kava, and Ephedra. The effects of these herbs are all quite different but many of them have potential issues with bleeding and cardiovascular effects as well as numerous drug interactions with anesthetic drugs.

Dietary supplements of fish oil and glucosamine are incredibly common and they have a real potential to interfere with clotting, increasing the risk of bleeding right after surgery.

In the January 2009 issue of Plastic and Reconstructive Surgery, Drs. Chin et al from Manhattan Eye, Ear, and Throat Hospital and NYU, looked at all of these drugs. They review their mechanisms of actions and what potential problems they may cause during and after surgery. While there are no uniform guidelines for what to do with these drugs, the recommended guidelines is for one to stop all non-essential drugs (herbs and supplements) two weeks before surgery. One should consult with their psychiatrist or their prescribing physicians in regards to antidepressant medications but, if possible, they should be stopped two weeks before surgery as well.

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