Prozac & Zoloft increase bleeding risk at surgery

It’s been suspected for a while that Prozac and its cousins in the SSRI family have a nasty side effect that’s pretty important for people who are having surgery to know about:  there seems to be more bleeding, and a higher chance of postoperative hematomas requiring a second surgery, if you take these medications around the time of surgery.

Initially, the data only pointed towards an increased risk for people having bowel surgery and GI bleeding.  Now, new data suggests the bleeding effect happens in our field, too – with cosmetic breast surgery.

A new study, published in Aesthetic Plastic Surgery this month, looked at patients who underwent cosmetic breast surgery procedures – breast augmentation, breast reduction or mastopexy, and divided them into users of SSRI medications, and non-users.  Of the 2089 patients who didn’t take Prozac, only 1.15% had a bleeding issue.  But in the 196 study patients that did take an SSRI-type medication, 4.59% had a bleeding problem.  This was a statistically significant difference.

So, regardless of age, weight or the type of procedure performed, it turned out that SSRI usage increased the risk for a post-operative hematoma requiring surgical drainage fourfold (4.14 times normal).

So, if you take Prozac, Zoloft, Celexa or Paxil – this is something to consider and to discuss with your surgeon and your prescribing physician, prior to surgery.