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  3. ANAESTHESIA AND PSYCHIATRIC DRUGS – PART 2 MOOD STABILISERS AND ANTIPSYCHOTICS ANAESTHESIA TUTORIAL OF THE WEEK 175

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Basic Sciences

Tutorial 175

ANAESTHESIA AND PSYCHIATRIC DRUGS – PART 2 MOOD STABILISERS AND ANTIPSYCHOTICS ANAESTHESIA TUTORIAL OF THE WEEK 175

Dr Helen Bromhead, Consultant Anaesthetist

Royal Hampshire County Hospital, Winchester, UK

Dr Adrian Feeney, Consultant Forensic Psychiatrist

Hampshire Partnership Foundation Trust, UK

Correspondence to hjbromhead@hotmail.com

19/04/2010

Abstract

• Mood stabilisers and antipsychotic drugs should be continued throughout the perioperative period to avoid the risk of relapse.
• Lithium has a low therapeutic index and high incidence of toxicity.
• Patients taking lithium require care with fluids and electrolytes, and avoidance of drugs which may cause renal failure.
• Cardiac risk factors are increased in patients taking long term antipsychotic drugs due to a combination of side effects and high smoking levels in these patients.
• Patients taking long term antipsychotics are at risk of increased complications (including death) during and after surgery.

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