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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by GraceR on June 28, 2004, at 14:27:16
Hello. I'm new to this site.
I am very interested in the 2003 postings I found here about Parnate and anaesthesia.
I have been scheduled for elective surgery for two months. I told my surgeon from the outset that I take Parnate. He was confident that the anaesthesiologists could work around it. I even spoke during pre-op to one of the anaesthesiologists who said essentially the same thing. My prescribing psychiatrist concurred.
Today I went in for the actual surgery. They hooked me up to the IV and even gave me a preliminary pre-op relaxer. But at the last second, another anaesthesiologist raised concerns. Half a dozen of them plus my surgeon and the hospital pharmacist talked and researched and talked for over an hour. Ultimately they told me they weren't comfortable going forward with the five-hour elective procedure.
They apologized at length but said no one there had any direct experience with an MAOI and anaesthesia. They committed to try finding someone with specific experience so that we can re-schedule surgery. Actually going off the Parnate isn't an option for me, but I did commit to ask my psychiatrist about some type of "bridge" anti-depressant that I might be able to take in lieu of Parnate temporarily.
Does anyone here know of anaesthesiologist(s) who have direct, personal experience with MAOI's (particularly Parnate) and general anaesthesia? I live in Georgia but it doesn't matter where the subject matter expert resides. I just need to find one.
Or does anyone have any information about a possible, temporary "Parnate" bridge anti-depressant that wouldn't raise anaesthesia concerns? I would need it to bridge for two to three weeks.
I would very much appreciate any help provided.
Posted by Merci on June 28, 2004, at 20:31:08
In reply to Parnate / MAOI and Anaesthesia / Anethesia, posted by GraceR on June 28, 2004, at 14:27:16
Hi Grace,
I was taking Nardil, another MAOI, when I underwent ECT last year...I don't know if you are familiar with ECT, but anesthesia is given to the patient before each treatment. Anyway, I'd imagine that there are many other ECT patients who are on MAOIs...perhaps there is a hospital near you that administers ECT? The anestheseologists there would likely have experience with Parnate and anesthesia - and if not, they might be able to point you in the right direction.
I hope this helps! Good luck.
Merci
Posted by Questionmark on June 28, 2004, at 23:18:47
In reply to Re: Parnate / MAOI and Anaesthesia / Anethesia, posted by Merci on June 28, 2004, at 20:31:08
i don't know for sure, but i would imagine that nitrous oxide-- esp.ly on top of some high dose benzodiazepine (e.g., lorazepam/Ativan) intake-- would be completely safe.
Posted by King Vultan on June 29, 2004, at 12:16:53
In reply to Parnate / MAOI and Anaesthesia / Anethesia, posted by GraceR on June 28, 2004, at 14:27:16
The problem you run into as far as a bridge antidepressant is that you will find most ADs contraindicated somewhere in the medical literature. That be said, there are some that have proven safe to use with MAOIs, such as trazodone, but it's hard to recommend this as an antidepressant in your situation because it is so sedating and is viewed in some circles as a rather mediocre AD anyway. Remeron is a better AD but is also quite sedating.
One drug that you might want to consider is the stimulant Provigil (modafanil). It is more similar to Parnate than trazodone or Remeron because it is quite activating, and it seems to be one of the best liked drugs by many patients. I highly doubt it would be as effective as Parnate, but it might be good enough to get you by. Its use is discussed in this reference near the end of the article in the section "Avoiding other MAOI-related side effects." It appears to be safe, based on the authors' experience, anyway. If this is something you may actually want to do, I would suggest doing some further research.
http://www.currentpsychiatry.com/2002_06/06_02_maoi.asp
Todd
Posted by jerrympls on June 29, 2004, at 22:35:40
In reply to Parnate / MAOI and Anaesthesia / Anethesia, posted by GraceR on June 28, 2004, at 14:27:16
> Hello. I'm new to this site.
>
> I am very interested in the 2003 postings I found here about Parnate and anaesthesia.
>
> I have been scheduled for elective surgery for two months. I told my surgeon from the outset that I take Parnate. He was confident that the anaesthesiologists could work around it. I even spoke during pre-op to one of the anaesthesiologists who said essentially the same thing. My prescribing psychiatrist concurred.
>
> Today I went in for the actual surgery. They hooked me up to the IV and even gave me a preliminary pre-op relaxer. But at the last second, another anaesthesiologist raised concerns. Half a dozen of them plus my surgeon and the hospital pharmacist talked and researched and talked for over an hour. Ultimately they told me they weren't comfortable going forward with the five-hour elective procedure.
>
> They apologized at length but said no one there had any direct experience with an MAOI and anaesthesia. They committed to try finding someone with specific experience so that we can re-schedule surgery. Actually going off the Parnate isn't an option for me, but I did commit to ask my psychiatrist about some type of "bridge" anti-depressant that I might be able to take in lieu of Parnate temporarily.
>
> Does anyone here know of anaesthesiologist(s) who have direct, personal experience with MAOI's (particularly Parnate) and general anaesthesia? I live in Georgia but it doesn't matter where the subject matter expert resides. I just need to find one.
>
> Or does anyone have any information about a possible, temporary "Parnate" bridge anti-depressant that wouldn't raise anaesthesia concerns? I would need it to bridge for two to three weeks.
>
> I would very much appreciate any help provided.HI
I was on Nardil last August and had surgery that required gnereal anesthesia. I talked to my pdoc and my family doc about it before hand and they had no concerns. The anesthesiologist had no problem with it either. I had no problems what so ever. Not sure if it's because the surgery team had worked with MAOIs before or not.
Good luck
Jerry
Posted by cubbybear on June 30, 2004, at 10:22:26
In reply to Re: Parnate / MAOI and Anaesthesia / Anethesia » GraceR, posted by jerrympls on June 29, 2004, at 22:35:40
> > HI
>
> I was on Nardil last August and had surgery that required gnereal anesthesia. I talked to my pdoc and my family doc about it before hand and they had no concerns. The anesthesiologist had no problem with it either. I had no problems what so ever. Not sure if it's because the surgery team had worked with MAOIs before or not.
>
> Good luck
> JerryHi Jerry,
Could you PLEASE get in touch with your pdoc and/or anaesthesiologist and find out EXACTLY what anaesthesia they gave you (trade names/generic names) ?? There are a number of us here who really want to find out and the available information is so scanty. I myself have been putting off a recommended colonoscopy, which ordinarily requires mild anaesthesia, because of these concerns.It's taken decades for us MAOI users to get more definitive and practical info on the diet restrictions. Now, we have to work on the difficult task of getting a list of "safe" anaesthesia with MAOIs. Since you say you had no adverse effects, you yourself can be a liason in helping us get some answers once and for all. Pls. let us know.
Cubbybear
Posted by jerrympls on June 30, 2004, at 20:47:21
In reply to Re: Parnate / MAOI and Anaesthesia / Anethesia » jerrympls, posted by cubbybear on June 30, 2004, at 10:22:26
> > > HI
> >
> > I was on Nardil last August and had surgery that required gnereal anesthesia. I talked to my pdoc and my family doc about it before hand and they had no concerns. The anesthesiologist had no problem with it either. I had no problems what so ever. Not sure if it's because the surgery team had worked with MAOIs before or not.
> >
> > Good luck
> > Jerry
>
> Hi Jerry,
> Could you PLEASE get in touch with your pdoc and/or anaesthesiologist and find out EXACTLY what anaesthesia they gave you (trade names/generic names) ?? There are a number of us here who really want to find out and the available information is so scanty. I myself have been putting off a recommended colonoscopy, which ordinarily requires mild anaesthesia, because of these concerns.
>
> It's taken decades for us MAOI users to get more definitive and practical info on the diet restrictions. Now, we have to work on the difficult task of getting a list of "safe" anaesthesia with MAOIs. Since you say you had no adverse effects, you yourself can be a liason in helping us get some answers once and for all. Pls. let us know.
> Cubbybear
>
>Hi Cubbybear-
YES- I will do what I can to get this information. I see my doctor tomorrow and she maybe able to print it out for me. I will post it here of course.
Jerry
Posted by jerrympls on June 30, 2004, at 22:18:28
In reply to Re: Parnate / MAOI and Anaesthesia / Anethesia » jerrympls, posted by cubbybear on June 30, 2004, at 10:22:26
> > > HI
> >
> > I was on Nardil last August and had surgery that required gnereal anesthesia. I talked to my pdoc and my family doc about it before hand and they had no concerns. The anesthesiologist had no problem with it either. I had no problems what so ever. Not sure if it's because the surgery team had worked with MAOIs before or not.
> >
> > Good luck
> > Jerry
>
> Hi Jerry,
> Could you PLEASE get in touch with your pdoc and/or anaesthesiologist and find out EXACTLY what anaesthesia they gave you (trade names/generic names) ?? There are a number of us here who really want to find out and the available information is so scanty. I myself have been putting off a recommended colonoscopy, which ordinarily requires mild anaesthesia, because of these concerns.
>
> It's taken decades for us MAOI users to get more definitive and practical info on the diet restrictions. Now, we have to work on the difficult task of getting a list of "safe" anaesthesia with MAOIs. Since you say you had no adverse effects, you yourself can be a liason in helping us get some answers once and for all. Pls. let us know.
> Cubbybear
>
>Cubbybear-
I found the operative report for the surgery I had while on Nardil. As fas as anesthesia, it only says "GENERAL ENDOTRACHEAL ANESTHESIA." I'll try tomorrow to get a more exact report. If you'd like to look at the report, email me and I will send you a "censored" PDF (with the Dr's names blacked out, etc).
Jerry :-)
Posted by cubbybear on July 1, 2004, at 6:20:16
In reply to Re: Parnate / MAOI and Anaesthesia / Anethesia » j » cubbybear, posted by jerrympls on June 30, 2004, at 22:18:28
> I found the operative report for the surgery I had while on Nardil. As fas as anesthesia, it only says "GENERAL ENDOTRACHEAL ANESTHESIA." I'll try tomorrow to get a more exact report. If you'd like to look at the report, email me and I will send you a "censored" PDF (with the Dr's names blacked out, etc).
> jerrympls@mn.rr.com
>
> Jerry :-)Hi Jerry,
Yes, of course, I'd definitely like to see that report. But I had a problem when I clicked on your E-mail address. For some reason the letter I typed wouldn't go out. Pls. explain what to do.
cubbybear
>
This is the end of the thread.
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