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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by KAL44 on March 17, 2008, at 21:48:03
I went from Nardil to Parnate recently and now I am going to have hand surgery. They decided on the surgery asap as my joint is really bad. Problem is I will be off of Parnate for only 7 days when I have the surgery. I wonder if this is enough time. I am really scared they will give me something that will kill me. I will be telling them that I will be off of the Parnate only 7 days. It will be day 8 off of Parnate when I do the surgery (next Tuesday). Doctor knows about the meds, but anesthesiology does not know yet.
Posted by SLS on March 18, 2008, at 8:41:13
In reply to RE: surgery and Parnate, posted by KAL44 on March 17, 2008, at 21:48:03
> I went from Nardil to Parnate recently and now I am going to have hand surgery. They decided on the surgery asap as my joint is really bad. Problem is I will be off of Parnate for only 7 days when I have the surgery. I wonder if this is enough time. I am really scared they will give me something that will kill me. I will be telling them that I will be off of the Parnate only 7 days. It will be day 8 off of Parnate when I do the surgery (next Tuesday). Doctor knows about the meds, but anesthesiology does not know yet.
The MAO system recovers much quicker with Parnate than with Nardil. I think 7 days should be enough. Just a guess, though. Unfortunately, the people who would know the most on this subject no longer post here. You should ask the anaesthesiologist to make accomodations for your current medical treatment. It is done. It is most important to stay away from epinephrine.
Are you to be given a local anaesthetic or systemic?
- Scott
Posted by KAL44 on March 18, 2008, at 18:29:26
In reply to RE: surgery and Parnate, posted by SLS on March 18, 2008, at 8:41:13
It will be a general anesthetic. I will be put under as it is long and delicate surgery.
Posted by SLS on March 19, 2008, at 4:55:42
In reply to RE: surgery and Parnate » SLS, posted by KAL44 on March 18, 2008, at 18:29:26
> It will be a general anesthetic. I will be put under as it is long and delicate surgery.
Conventional wisdom is to discontinue an MAOI two weeks prior to general anesthesia. With Parnate, 10 days is probably sufficient. For Nardil, 3 weeks would be advised. However, there really is very little substantive data on these interactions.
http://www.anesthesia-analgesia.org/cgi/reprint/83/3/656.pdf
I can't make a recommendation that you continue Parnate. Although sparse, serious reactions have occurred.
For me, personally, I would fight like hell to continue with Nardil, and leave it to the anesthesiologist to do some homework. Combining
MAOIs with general anesthesia has been done often enough (especially for ECT) that he should have some information about it.
- Scott
Posted by KAL44 on March 19, 2008, at 23:15:28
In reply to RE: surgery and Parnate » KAL44, posted by SLS on March 19, 2008, at 4:55:42
I am now temporarily off all my psychiatric meds and maybe will try something different after the surgery. So far I am doing okay other than dissociating and losing an hour this morning. Don't know what I did or where I was and ended up being 15 minutes late to therapy. Maybe being back on meds will be good. Today was my mother's birthday. She has been dead for 10 years. I think I would like to try different meds. Will talk to T on Friday about this as I won't see him again until after the surgery. It is basal joint (thumb) replacement surgery. I had it on the other hand a year and a half ago and already know it hurts like H. I won't have time to be depressed or emotionally all over the map. I stopped the Abilify too--was only on 5 mg. and will go back to that after Tuesday.
Posted by SLS on March 21, 2008, at 5:52:58
In reply to RE: surgery and Parnate » SLS, posted by KAL44 on March 19, 2008, at 23:15:28
Hi.
Good luck on the surgery.
When you go back to Abilify, I think you should try going up to between 10-20mg. I do better at 20mg than I do at 10mg.
Good luck on your new med combo. It would be nice if you were to post what you are taking once you restart psyche meds.
- Scott
> I am now temporarily off all my psychiatric meds and maybe will try something different after the surgery. So far I am doing okay other than dissociating and losing an hour this morning. Don't know what I did or where I was and ended up being 15 minutes late to therapy. Maybe being back on meds will be good. Today was my mother's birthday. She has been dead for 10 years. I think I would like to try different meds. Will talk to T on Friday about this as I won't see him again until after the surgery. It is basal joint (thumb) replacement surgery. I had it on the other hand a year and a half ago and already know it hurts like H. I won't have time to be depressed or emotionally all over the map. I stopped the Abilify too--was only on 5 mg. and will go back to that after Tuesday.
Posted by KAL44 on March 21, 2008, at 22:18:08
In reply to RE: surgery and Parnate » KAL44, posted by SLS on March 21, 2008, at 5:52:58
Thanks. Yah my T wants me to go up to 10 mg. per day, but I hate the dry mouth. It is so nice now not to have a dry mouth. I tend to be rather resistant to doing what he wants. He says I act like what meds to take are a suggestion, not what is prescribed. LOL. My T is also my pdoc. I will let you know what I take after the surgery. I don't see my T now until next Friday.
Posted by KAL44 on March 29, 2008, at 20:32:37
In reply to RE: surgery and Parnate » SLS, posted by KAL44 on March 21, 2008, at 22:18:08
surgery went well. joked with anesthesiologist and anesthesiology residents and nurses. no problems with parnate as an issue. i only can type with one finger now though and forget caps. started to dissociate in the recovery room undressing for the surgery. reminded me too much of when i got ect--same hospital but different recovery room. therapist/pdoc says he thinks i should go back on parnate. i think he is right. it was working, and now off 2 weeks i am starting to feel like i want to cry all the time for no reason. we will discuss on tuesday, but i agree now that i should. i think i am past needing a narcotic for pain. the abilify is another matter.
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