Expert: Ronald Levy, M.D. - 2/9/2010

Question
QUESTION: I wrote to you about two years ago after I had a traumatic colonoscopy experience with the drug Versed.  My issue was that the amnesia the drug causes was never explained.  I had told my doctor I wanted to be awake for the procedure, and he had told me I would be able to "watch the screen," but never explained I would have no memory of it.  Even worse, I had no memory of a full two hours after the 10-minute procedure, and a very sketchy memory for an hour after that (when I was supposedly awake and acting completely "normal").
This was PROFOUNDLY disturbing to me, and I had insomnia, nightmares, and depression for months afterward.  I know from reading all your answers to others who detest this drug as much as I do, that you do not really understand why this would upset us. Regardless of how you personally feel about Versed, shouldn't all doctors be honest about it ? As doctors you do not realize the absolute trust we patients put in you, and when we feel that trust has been betrayed, it is every bit as harmful as if we had experienced physical harm under your care.

ANSWER: I can't speak for all doctors, but I do inform all my patients about the effects of the Versed. I usually say something along the lines of "...you won't remember going to the OR and probably won't even remember this conversation we are having...". Most patients are happy with this but if they have any further questions or concerns, I am more than happy to answer them. Our goal is to make you comfortable and if a patient doesn't want Versed (and I can't persuade them about the benefits), then I will use alternative therapies.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston

---------- FOLLOW-UP ----------

QUESTION: It is good to know there are doctors such as yourself who do explain it to patients, but the majority do not.  I also hope that when you are telling them they won't remember your conversation, you are pausing to see  their reaction, and not just slipping it into their i.v. at the same time,  before they can respond.
It is also good to know there are "alternative therapies" to Versed. What are they ? ( No one will ever be able to persuade me about "benefits" of this drug, after my experience.)  Thank you for your time.

Answer
I do wait for a response and I don't ever just push drugs (any drugs) without warning. I think it is unfair to say most don't. I think most do but you don't hear about them because no one is complaining. As for alternatives, they are mostly pain relievers as most anxiolytics have amnestic effects that you don't want. So the best we can do for you is to keep you out of pain.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston