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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by emmanuel98 on May 23, 2011, at 22:34:57
I am in a partial hospitalization program and the nurse practicioner, whom I saw today, said parnate (I take 10mg tid) should not be mixed with novocaine and that, when I go to the dentist next week, I should tell him I take parnate so he can use another numbing substance (such as?).
She also said I should wear a wrist bracelet saying I take parnate because if I ever went into anaphalytic shock and was given epinephrine, it could kill me.
I have been taking parnate for almost three years and it was first prescribed by Harvard docs at McLean. Since then I have been in another Harvard teaching psych ward and my regular p-doc is pretty good and hooked into all these Harvard teaching hospitals in Boston.
This nurse practicioner is the first person ever to mention any of this.
Does she know what she's talking about? Has anyone else heard this about MAOIs and novocaine, epinephrine?
Posted by Phillipa on May 24, 2011, at 0:04:40
In reply to parnate and novocaine, posted by emmanuel98 on May 23, 2011, at 22:34:57
Hi wow can't believe it's been three years how time flies. I get palpitations from novacaine so they have a numbing substance minus the epi xylocaine I guess and no I've not heard this mentioned here. Have you been well as you mention the hospital. Phillipa. Sure hope someone who knows jumps in.
Posted by emmanuel98 on May 24, 2011, at 4:09:43
In reply to Re: parnate and novocaine » emmanuel98, posted by Phillipa on May 24, 2011, at 0:04:40
Looking back at my notes, it's been two years, not three, since I started parnate. The parnate worked like a charm for me at first. Since then, I have had some severe downs, mostly situational. I have been hospitalized twice. The most recent hospitalization I had bi-lateral ECT. What a major and damaging treatment. It left me like a zombie for 6-8 hours afterward. I still (after 3 weeks since ending) am aware of holes in my memory. Yet two weeks after ending, I feel better than I have felt in over two years. The insurance company asked my case manager if I could do maintainence ECT on a monthly basis. The problem with maintainence bi-lateral ECT is that I would need someone to stay with me for several hours after the treatment, since I wake up completly disoriented, not knowing who I am or where I am or what just happened. I don't see how I could do it outpatient.
Posted by Terry8 on May 24, 2011, at 8:37:13
In reply to parnate and novocaine, posted by emmanuel98 on May 23, 2011, at 22:34:57
> Does she know what she's talking about? Has anyone else heard this about MAOIs and novocaine, epinephrine?
Yes. You should tell your dentist you take an MAOI and can't have epinephrine. He or she should know what you're talking about, and will give you an alternative (I think carbocaine or lidocaine without epinephrine?). My experience was that the anesthesia wore off quicker without epinephrine, so you might have to get numbed more than once if it's a long procedure.
The medical bracelet recommendation is more so that emergency workers don't give you Demerol, which can be fatal when mixed with an MAOI. As for an anaphylactic reaction, though, a friend of mine who is a paramedic pointed out that if you're going into anaphylactic shock, they're probably going to give you epinephrine regardless, because you'll die without it. But even just a wallet card behind your license is good; something that, if you are unconscious, will tell medical workers that you take an MAOI, since they interact with so many drugs.
Posted by deepreason on May 24, 2011, at 15:18:00
In reply to Re: parnate and novocaine, posted by Terry8 on May 24, 2011, at 8:37:13
Definitely get a wrist bracelet. I always wear mine. As said above there are various painkillers etc like meperidine that can kill you but it is possible on a lot of the drugs to allow for the MAOI by giving a substantially lower dose. So they can just give you a %age of the normal amount and get the same effect.
Posted by Willful on May 24, 2011, at 16:10:10
In reply to Re: parnate and novocaine, posted by deepreason on May 24, 2011, at 15:18:00
You can get a bracelet or a necklace. I definitely have one, although for quite a while I just had a sticker in my wallet, that you could see immediately on opening it, that stated what's on my necklace. You should have something in case of accident or other medical emergency where you can't tell doctors about the parnate--
My pdoc never mentioned the bracelet, but he definitely mentioned the issues with novocaine. I'm surprised that your pdoc didn't. unless he said something more general and thought you would know.
Willful
Posted by Phillipa on May 24, 2011, at 20:02:30
In reply to Re: parnate and novocaine, posted by emmanuel98 on May 24, 2011, at 4:09:43
Oh wow so sorry and it did work well for you at first. I do wonder why such a powerful med pooped out so to speak. And so sorry for the ECT and memory lapses. And being alone isn't all that safe. Could you arrange it so you are inpatient if decide to do the maintenance ECT? Do you feel you will. Love Phillipa
Posted by floatingbridge on May 27, 2011, at 8:37:39
In reply to parnate and novocaine, posted by emmanuel98 on May 23, 2011, at 22:34:57
Emmanuel, yes, I've heard all the above and agree it's wise to wear something and to tell the dentist.
Want to send you a virtual hug, too. You are going through some tough stuff.
fb
Posted by emmanuel98 on May 27, 2011, at 20:27:16
In reply to Re: parnate and novocaine » emmanuel98, posted by floatingbridge on May 27, 2011, at 8:37:39
Thanks Phillipa and FB for your kind words. The parnate doesn't seem to be holding me. It worked so well when I started it two years ago. It was like a miracle. The ECT doesn't seem to be holding me either, though at least my memory is recovering. I don't know what to do. I do everything. My p-doc wanted me to do DBT so I do a group and see a DBT therapist. I'm not sure how much it helps. I have an appointment with the DBT therapist next week and my p-doc wants to join us to develop a care plan for me and keep me alive and out of the hospital. My moods are so unstable. AAPs stabilized them, but made me so fat. I have finally lost 45 pounds of weight they put on me. Other mood stabilizers like lamictal and lithium have no effect. I don't know anymore. I'm trying to not give up, but I don't know.
Posted by floatingbridge on May 27, 2011, at 21:11:47
In reply to Re: parnate and novocaine, posted by emmanuel98 on May 27, 2011, at 20:27:16
emmanuel, I imagine rTMS has been brought up?
Have you contemplated a jump to another maoi? Nardil?
I'm sure you and your doc have looked at lots of things. Sometimes dbt seems so mechanical, I know that's odd to say, and it certainly is only my opinion--but I
really clicked with a dbt therapist once. Maybe help will come to you when you least hope for it and in an unexpected
way.You've been through and achieved so much. You will get through this. I am sorry it so tough right now.
Will you post when you feel up to it? So many folks care about you here.
Posted by Phillipa on May 27, 2011, at 23:54:18
In reply to Re: parnate and novocaine, posted by emmanuel98 on May 27, 2011, at 20:27:16
Emmanuel I have some Facebook friends one was on all the maoi's and also had ECT and believe it or not today he is fully functional and working again after many years and his med is now prozac. So things do change. Might be time to try a switch back? You never know. Keep posting I do think it helps to also post to try and help others also. You will live I know it and feel it. Love Phillipa
Posted by floatingbridge on June 2, 2011, at 17:20:35
In reply to parnate and novocaine, posted by emmanuel98 on May 23, 2011, at 22:34:57
emmanuel,
Thinking about you. Wondering how you're doing.
Sending a hand to hold your way.
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This is the end of the thread.
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