Expert: JM Starkman, MD - 11/21/2009

Question
I recently had a colonoscopy and my doctor told me it would be ok to have the abive drugs while on Nardil 30 mg q day.  The premedication had no effect on me and I was wide awake through the procedure.  The doctor kept increasing versed and fentalyn up to 3X the normal dose and there was no effect at all.  Can Nardil block the effects of these drugs?  This was not an experience I ever want to have again - the pain and discomfort was more than intense!

Answer
I'm sorry you had the problem that you did with this "doctor" (probably a gastroenterologist, not an anesthesiologist).  Many medications do not 'block', but instead "soup up" (the medical term is enzyme induction) one's liver to much more rapidly metabolize drugs than would be normally be expected.  Chronic Nardil therapy has likely done this in your case.

In the future, always have an anesthesiologist giving the anesthesia.  We don't do colonoscopies---because we're not gastroenterologists having exhaustively studied digestive diseases.  We don't do face lifts because we're not cosmetic surgeons, etc.  Amazing that these physicians, who have no formal training in the administration of anesthetics regularly make poor and, in your case, outdated anesthetic decisions.  Most non-anesthesiologists learn about the administration of local and sedative anesthetics from others in THEIR field leading to plenty of old or innaccurate info.  Dentists seem to do a much better job at providing correct and modern choices than most other non-anesthesiologists.

Versed and its amnesia tendencies can "hang around" a long time.  Give yourself a full week before you do anything of a physical nature or legal importance.