Expert: Ronald Levy, M.D. - 10/19/2010

Question
Dr. Levy,

I read with interest your answer to a question about anesthesia and Nardil.  However, I find most anesthesiologist in the Baton Rouge area take the simple way out and just tell my wife, who has been on Nardil since 1982, to stop it as she cannot have any type anesthesia, general or sedating.  This drug was a life saver as she was having mild depression and severe panic attacks, bot alleviated with several weeks of initiation of therapy.  several times she has tried on antidepressants, helped a little, so she went back on Nardil.  I would appreciate a good answer as to what is appropriate for any surgery she might need as she has had 4-5 surgical procedures over the years and always had to get off her Nardil for several weeks.  You can reach me on my cell also, if you so desire, .

Thank you in advance,

Douglas

Answer
As I've said in the past, ideally Nardil should be stopped 10-14 days prior to ELECTIVE surgery but if the patient is having emergency surgery (or for some reason cannot discontinue the drug), surgery can proceed understanding the increased risk for complications (specifically hypertensive crisis, hyperthermia, etc).


Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston