Expert: Ronald Levy, M.D. - 12/13/2009

Question
I have panic disorder, and my psychiatrist has had me on xanax for years. I take about 1 mg every 6 hours. Abrupt xanax withdrawal can be problematic, even dangerous (seizures). Its been recommended that I have either general or spinal anesthesia for a prostate problem, but I am concered about the xanax and anesthesia. Skipping one does is probably ok, but several is problematic. One surgeon says its ok to take the xanax the morning of the surgery, and one says not (I have obtained a second opinion). I was told the problem is with the anesthesia. Can you shed any light on this?

Answer
Generally speaking, it is not a problem if you are on long term Xanax to take it the night before surgery. Even if you didn't take it, the medicines we give you in the OR (generally Versed) has the same effect, so seizures is not an issue. In either case, the best person to talk to is your anesthesiologist. He should speak to you at least a day before surgery as part of his routine preop screening. You can ask him what his preference is. Under no circumstance should you stop a medication without your doctor's approval.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston