Psychotropic treatment in patients undergoing gynaecological procedures

Abstract

Background: Around 27% of the adult population in Europe has at some point suffered from a mental disorder in the past year. Patients with psychiatric illness have different needs and require specific medication review prior to surgery in view of the risks from anesthesia, the direct and indirect effects of psychotropics, risk of withdrawal symptoms, and risk of psychiatric recurrence or relapse. Gynaecological patients, particularly those going through the menopausal transition phase have an associated risk of psychiatric conditions especially mood disorders.

This audit is set to determine the link between psychotropic drug use and patients seen at gynaecological pre-operative assessment clinic, the most encountered diagnosis, how this relates to age together with analysis of most common drugs used to treat these patients. --

Methods: Data of 123 patients from 24 weekly pre-operative assessment clinics was collected. The number of patients listed in each clinic was documented together with the patient’s age. Patients on psychotropic medication were analysed to note diagnoses of each case and treatment used. --

Results: 21.1% of patients suffered from a mental health illness requiring psychotropic medication. Their average age was that of 51 years. The most common diagnosis was depression, summing up to 9.8% of all patients, followed by anxiety at 6.5%. --

Conclusion: Depression and anxiety are leading mental health illnesses both in this cohort and the general population. Such patients have lower pain threshold which affects their recovery. Some psychotropics have severe interactions with anaesthetic thus need to be stopped prior to surgery after evaluation of risks such as drug withdrawal and deterioration in mental health.