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Old 09-15-2012, 08:29 AM   #1 (permalink)
 
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Talking Parnate and dental anesthesia

I asked this on a Nardil thread since Parnate is also an MAOI, but afraid it might get missed, so my question is:

I'm trying an MAOI (Parnate) for the first time. I also need to get some major dental work done, and now I find out MAOIs present a real problem with dental anesthesia. I know one of the alternatives is to "simply" come off the MAOI for a week before, so I don't want to get too much farther into my trial if I have to do that. (Which would be too bad as I think I'm getting my first positive AD response, ever.) I'm not sure if there are any anesthetic alternatives or strong painkillers the dentist could prescribe that are also an option.

I've searched the net and this forum for old threads, but can't seem to find any detailed information on the subject.
If anyone out there has run into this themselves or knows anything about this problem, it would be greatly appreciated...
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Old 09-15-2012, 02:59 PM   #2 (permalink)
 
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There are alternatives that Dentists will use if you are on an MAOI. It is not a problem for you to to stay on your medication and get your Dental Surgery done.

Just tell your dentist ahead of time (before you go in for the procedure) that you are taking an MAO Inhibitor. Your Dentist should know what to do. Give the Dentist your prescribing doctor's phone number and tell the dentist to call your doctor if they have any questions. Not a problem.

My cousin is a Dentist and this topic came up during a conversation recently, Dentists are trained about which anesthetics and analgesics to use for a patient taking an MAO Inhibitor.

Good luck at the dentist, be sure to get some decent pain killers on your way out (and a little toothbrush with a sample pack of floss, toothpaste and mouthwash)
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Old 09-15-2012, 04:53 PM   #3 (permalink)
 
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Default Parnate and dental anesthesia

Thank you so much for your thoughtful response. It's good to know your cousin's a dentist, too. I sure hope they can give me some decent painkillers, since Oxy is now illegal in Canada! As I have a chronic pain disorder on top of my anxiety disorder, this makes it all the more scary. But I've done some research into a new dentist I've chosen, so I just have to put my trust (and my teeth) into her hands.

All the best
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Old 09-15-2012, 06:25 PM   #4 (permalink)
 
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Pressor drugs such as norepinephrine, meperidine and epinephrine should be avoided at all costs due to their propensity to screw with blood pressure and the cardiovascular system.

All the traditional meds used for induction of anaesthesia such as Midazolam / propofol are considered 'safe'.

For pain and amnesia morphine, fentanyl are also considered safe.

For anaesthesia maintenance the volatiles sevoflurane, desflurane as well as nitrous oxide are safe.

Muscluar blocking agents are mostly safe, with the exeption of Pancuronium which has the ability to release stored noradrenaline and thus lead to a hypertensive crisis.

For vasoconstriction, Felypressin has been established as safe.

Antichollinergic drugs as well as non steroidal anti inflammatory drugs are fine.

If the anaesthetist is half the doctor he ought to be then this will be a walk in the park. Just make sure you constantly repeat that you are on or coming 'off' of an MAOI (state drug here) to all doctors / nurses you are consciously in contact with. You may even be given a braclet stating a potential med interaction.
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Old 09-15-2012, 08:51 PM   #5 (permalink)
 
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Wow. Are you a doctor or dentist, yourself?? That's some precise and incredibly helpful information.
Thank you, thank you, thank you -- I'm feeling much less panicked about it all now.

Take care of yourself.
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Old 09-16-2012, 03:16 AM   #6 (permalink)
 
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Hah, not currently. However i do share a passion for neurology, anaesthesia and psychiatry.

You have nothing to worry about. Im sure it will go well.
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Clonazepam 2mg prn (once a week)


Previous meds: Amitriptyline 200mg, Dexamphetamine 60mg, Dosulepin 50mg, Lithium 900mg, Lexapro 20mg, Lyrica 100mg, Methylphenidate IR 40MG LA 60mg, Moclobemide 450mg, Prozac 60mg, Saphris 10mg, Seroquel 300mg, Sodium Valproate 1500mg, Thorazine 500mg, Temazepam 20mg, Topamax 100-150mg
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Old 09-16-2012, 06:02 AM   #7 (permalink)
 
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Quote:
Originally Posted by A Sense of Purpose View Post
Hah, not currently. However i do share a passion for neurology, anaesthesia and psychiatry.

You have nothing to worry about. Im sure it will go well.
Also, he has a sense of purpose so we would expect him to also posses a wealth of knowledge.
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