Posted by tonyz on April 29, 2010, at 11:51:34
In reply to Re: Opinion on medication change, posted by Phillipa on April 28, 2010, at 22:24:17
I'm not in the medical field and have a limited understanding of how these things work. Maybe blueberry can add some comments - he seems to be very up on this stuff.
50mg is a not a very high dosage of luvox. I would talk to the anesthesiologist and ask what he thinks. I don't know if the problem you had before when you had surgery was just something unique to you or a result of the combination of things that you were taking.
For some people a small dose of remeron 7.5mg will help with sleep but may leave you with a hangover feeling the next day.
From what I understand ativan is the most potent or one of the more potent benzos.
From your prior postings it sounds like you really need the luvox, and it also appears that interferes with the anesthesia. Maybe there is a similar drug that they can switch to (similar to Luvox) that wouldn't interfere with anesthesia. I'm not sure if this is possible. Maybe doing a gradual conversion from one drug to the other and use the ativan of some other benzo or remeron to manage anxiety during the switch. (This may not work based on what's below). I think you really need to engage your pdoc and anesthesiologist on this one..
I'm just throwing out some ideas here, I really don't know that much about this. I hope someone with more experience (hint blueberry) would chime in.
When I was on luvox very briefly, from what I was reading it appeared to have more interactions with other drugs, but I was primarily looking at tricyclics.
It does say if you are planning on having surgery/general anesthesia within the next few months to inform your doctor.
Special Medication Alerts!
If you are on anti-depressants, please advise your doctor. Some monoamine oxidase (MAO) inhibitors (also known as MAOI) intensify the effects of the anesthesia, especially general anesthesia. This could be quite dangerous in the operating room if your doctor is unaware of your medication usage. If you advise your doctor, he or she can make adjustments for your anesthesia or at least will watch for the slightest decrease in heart or breathing rate.
These medications are used for the treatment of depression, obsessive-compulsive disorder, eating disorders, essential hypertension, chronic pain syndromes and migraine headaches: Isocarboxazid, Marplan, phenelzine (Nardil, Nardelzine) tranylcypromine (Parnate, Sicoton), Deprenyl, selegiline hydrochloride, 5 HTP, Amitriptyline, Prozac, Wellbutrin, Buropion, Buropion HCL, Fluoxetin, EFFEXOR® XR, etc.
They work by inhibiting nerve transmissions in brain that may cause depression.
It is reported that drug interactions can occur even weeks after discontinued use of an MAOI. Therefore, in patients undergoing general anesthesia, usage is normally banned for several weeks prior to surgery to avoid possible cardiovascular effects. However, it may be more important and more risky to cease the MAOI than to keep taking it. Discuss this with your surgeon and/or anesthesiologist.
Sorry I couldn't be more helpful
poster:tonyz
thread:945286
URL: http://www.dr-bob.org/babble/20100425/msgs/945560.html