{"id":10294,"date":"2026-06-16T07:09:40","date_gmt":"2026-06-16T07:09:40","guid":{"rendered":"https:\/\/kliniekhetbolwerk.nl\/antidepressants-and-an-eyelid-correction-ssris-snris-and-mao-inhibitors\/"},"modified":"2026-07-12T15:24:27","modified_gmt":"2026-07-12T15:24:27","slug":"antidepressants-and-an-eyelid-correction-ssris-snris-and-mao-inhibitors","status":"publish","type":"post","link":"https:\/\/kliniekhetbolwerk.nl\/en\/antidepressants-and-an-eyelid-correction-ssris-snris-and-mao-inhibitors\/","title":{"rendered":"Antidepressants and an eyelid correction: SSRIs, SNRIs and MAO inhibitors"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"10294\" class=\"elementor elementor-10294 elementor-9621\" data-elementor-post-type=\"post\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6e1d1e28 e-flex e-con-boxed e-con e-parent\" data-id=\"6e1d1e28\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-3edca1ea elementor-widget elementor-widget-text-editor\" data-id=\"3edca1ea\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Are you using antidepressants? For most people this is not a problem around an eyelid correction. Still, there are two points of attention that we would like to share with you: a possibly increased bleeding risk with SSRIs and SNRIs, and an important interaction with (the rarely used) MAO inhibitors.  <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-aa53687 elementor-widget elementor-widget-heading\" data-id=\"aa53687\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Which medication does this concern?\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-bcece18 elementor-widget elementor-widget-text-editor\" data-id=\"bcece18\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<ul><li>SSRIs: sertraline, paroxetine (Seroxat), fluoxetine (Prozac), citalopram, escitalopram<\/li><li>SNRIs: venlafaxine (Efexor), duloxetine<\/li><li>Tricyclic antidepressants: amitriptyline, nortriptyline<\/li><li>MAO inhibitors (rare): phenelzine, tranylcypromine, and selegiline, which is used for Parkinson&#8217;s<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-da40fd3 elementor-widget elementor-widget-heading\" data-id=\"da40fd3\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Why is this relevant?\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-75e2201 elementor-widget elementor-widget-text-editor\" data-id=\"75e2201\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>SSRIs and SNRIs reduce the storage of serotonin in blood platelets, which can affect platelet function. Research shows that the use of SSRIs can increase the risk of bleeding complications during and after an operation [1,2,3]. <\/p><p>This does not mean that you have to stop your antidepressants: the risk of relapse, withdrawal symptoms or a return of depressive complaints when stopping is generally considered greater than the (small) increased bleeding risk. The decision to stop is therefore rarely made, and certainly not without consultation with the prescribing doctor [1]. <\/p><p>MAO inhibitors are a separate category: these products can have an interaction with certain substances, including adrenaline (epinephrine), which is sometimes added to local anaesthetic. Modern insights show that local anaesthesia with careful dosing and monitoring is often still possible with MAO inhibitors, but this requires extra attention [4]. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6b91416 elementor-widget elementor-widget-heading\" data-id=\"6b91416\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Points of attention<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-bb93e3d elementor-widget elementor-widget-text-editor\" data-id=\"bb93e3d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<ul><li>SSRIs and SNRIs can slightly increase the bleeding risk, especially in combination with blood thinners or NSAIDs [1,2,3]<\/li><li>Never stop antidepressants on your own initiative before a procedure<\/li><li>Are you using an MAO inhibitor? Always report this; this is rare, but requires an adjusted anaesthetic [4] <\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f5f25c1 elementor-widget elementor-widget-heading\" data-id=\"f5f25c1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Our protocol at Kliniek het Bolwerk<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1f6c04f elementor-widget elementor-widget-heading\" data-id=\"1f6c04f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">1. Extensive medical history<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-db7e16e elementor-widget elementor-widget-text-editor\" data-id=\"db7e16e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>We ask about your antidepressants, including the name of the product and any combination with other medication such as blood thinners or NSAIDs.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-75bbea3 elementor-widget elementor-widget-heading\" data-id=\"75bbea3\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">2. Continuing medication<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c32fbae elementor-widget elementor-widget-text-editor\" data-id=\"c32fbae\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>SSRIs, SNRIs and other antidepressants are, as a rule, simply continued [1].<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-629de7f elementor-widget elementor-widget-heading\" data-id=\"629de7f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">3. Adjusted anaesthetic with MAO inhibitors<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6c70c7f elementor-widget elementor-widget-text-editor\" data-id=\"6c70c7f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>In the case of use of an MAO inhibitor, we adjust the anaesthetic: careful, measured administration and monitoring during the procedure [4].<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-226fbef elementor-widget elementor-widget-heading\" data-id=\"226fbef\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">4. Extra attention with combination with blood thinners<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6be734d elementor-widget elementor-widget-text-editor\" data-id=\"6be734d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Are you using an SSRI or SNRI together with blood thinners or platelet inhibitors? Then we take extra account of this with the surgical technique [3]. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-bfdcb71 e-con-full e-flex e-con e-child\" data-id=\"bfdcb71\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1fce09b elementor-widget elementor-widget-text-editor\" data-id=\"1fce09b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><i><span style=\"font-weight: 400;\">Important: never stop antidepressants on your own initiative. Are you using an MAO inhibitor (such as phenelzine, tranylcypromine or selegiline)? Always report this; this is an important point of attention for the anaesthetic.  <\/span><\/i><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1587f2c elementor-widget elementor-widget-heading\" data-id=\"1587f2c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">When do we advise against the procedure (for the time being)?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-73ca29a elementor-widget elementor-widget-text-editor\" data-id=\"73ca29a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<ul><li>Not on the basis of SSRI or SNRI use alone<\/li><li>In the case of a combination of an SSRI\/SNRI with blood thinners and other bleeding risks, without consultation [3]<\/li><li>If the prescribing doctor advises against the procedure at this time<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-435c0d7 elementor-widget elementor-widget-heading\" data-id=\"435c0d7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Our advice\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c758f5a elementor-widget elementor-widget-text-editor\" data-id=\"c758f5a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Are you using antidepressants? Mention this on your medication list during the intake consultation at Kliniek het Bolwerk. Are you using an MAO inhibitor? Then report this in particular, so that we can adjust the anaesthetic accordingly.  <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-61bfeb9 elementor-widget elementor-widget-heading\" data-id=\"61bfeb9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Literature references<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d3978ea elementor-widget elementor-widget-text-editor\" data-id=\"d3978ea\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>The publications below form the medical-scientific basis of this article:<\/p><ol><li>Selective Serotonin Reuptake Inhibitors and Operative Bleeding Risk: A Review of the Literature. PubMed. 2016. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/27684291\/\" target=\"_blank\" rel=\"noopener\">https:\/\/pubmed.ncbi.nlm.nih.gov\/27684291\/<\/a>   <\/li><li>Serotonin reuptake inhibitors and bleeding risks related to elderly submitted to major orthopedic surgery. PMC. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6777648\/\" target=\"_blank\" rel=\"noopener\">https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6777648\/<\/a> <\/li><li>Use of serotonin reuptake inhibitor antidepressants and the risk of bleeding complications in patients on anticoagulant or antiplatelet agents: a systematic review and meta-analysis. Annals of Medicine (PMC). 2021. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC8725830\/\" target=\"_blank\" rel=\"noopener\">https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC8725830\/<\/a>  <\/li><li>MAO Inhibitors: Anesthetic Interactions. OpenAnesthesia.  2026.  <a href=\"https:\/\/www.openanesthesia.org\/keywords\/mao-inhibitors-anesthetic-interactions\/\" target=\"_blank\" rel=\"noopener\">https:\/\/www.openanesthesia.org\/keywords\/mao-inhibitors-anesthetic-interactions\/<\/a><\/li><\/ol>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Are you using antidepressants? For most people this is not a problem around an eyelid correction. Still, there are two points of attention that we would like to share with you: a possibly increased bleeding risk with SSRIs and SNRIs, and an important interaction with (the rarely used) MAO inhibitors. Which medication does this concern? [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":9798,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[92],"tags":[],"class_list":["post-10294","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-eyelid-surgery"],"acf":[],"_links":{"self":[{"href":"https:\/\/kliniekhetbolwerk.nl\/en\/wp-json\/wp\/v2\/posts\/10294","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kliniekhetbolwerk.nl\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kliniekhetbolwerk.nl\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kliniekhetbolwerk.nl\/en\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/kliniekhetbolwerk.nl\/en\/wp-json\/wp\/v2\/comments?post=10294"}],"version-history":[{"count":1,"href":"https:\/\/kliniekhetbolwerk.nl\/en\/wp-json\/wp\/v2\/posts\/10294\/revisions"}],"predecessor-version":[{"id":10295,"href":"https:\/\/kliniekhetbolwerk.nl\/en\/wp-json\/wp\/v2\/posts\/10294\/revisions\/10295"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/kliniekhetbolwerk.nl\/en\/wp-json\/wp\/v2\/media\/9798"}],"wp:attachment":[{"href":"https:\/\/kliniekhetbolwerk.nl\/en\/wp-json\/wp\/v2\/media?parent=10294"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kliniekhetbolwerk.nl\/en\/wp-json\/wp\/v2\/categories?post=10294"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kliniekhetbolwerk.nl\/en\/wp-json\/wp\/v2\/tags?post=10294"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}