• Blas Catalani, Craig S Hamilton, Edwin W Herron, Richard D Urman, Charles J Fox, and Alan David Kaye.
• Department of Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, LA, USA. Electronic address: bcatal@lsuhsc.edu.
• Best Pract Res Clin Anaesthesiol. 2014 Jun 1; 28 (2): 167-81.

AbstractThe use of antidepressants, anxiolytics, mood stabilizers, anticonvulsants, and major tranquilizers introduces neurochemical, behavioral, cognitive, and emotional factors that increase the complexity of medical and surgical tasks. Increasingly, various classes of psychotropic medications are being prescribed in the perioperative setting for their analgesic properties in patients with or without a psychiatric diagnosis. In many cases, the precise mechanisms of action and dose-response relationships by which these agents mediate analgesia are largely unclear. An appreciation of the side effects and adverse-effect profiles of such medications and familiarity with the clinically relevant drug interactions that may occur in the perioperative setting are imperative to ensure the best possible outcome in dealing with patients on these medications. This review focuses on various classes of psychotropic agents, which are addressed individually, with particular focus on their analgesic properties. The latest published research is summarized, deficiencies in our current collective knowledge are discussed, and evidence-based recommendations are made for clinical practice.Copyright © 2014 Elsevier Ltd. All rights reserved.

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