Expert: Ivan Goldberg, M.D. - 3/6/2005

Question
Dear Dr. Goldberg,
I have bi-polar disorder and had back surgery earlier this week.  
Prior to surgery I spoke to the pre-op doctor I visited the day before surgery, several nurses I encountered before surgery, and the anesthetist with my concerns of any anesthetic and/or medications I would be recieving mixing with Depakote.  I was concerned because I have noticed that Depakote seems to intensify the effects of some over the counter medications and alcohol (both of which I have been avoiding).

Would you agree that I was correct with my concern?...  In recovery, after receiving a couple of shots of morphine, my blood pressure dropped very low.  Of course, I do not have the details of what happened, but I do remember hearing a conversation in recovery about possibly trying Narcan (sp?), which I believe is to reverse the action of a drug overdose.
I only ask for future reference and how I may handle this differently should I require surgery again.  
I did notify my psychiatrist of the surgery, but to the best of my knowledge, he did not make contact with my orthopedic surgeon.

I am a 49 years old and have been taking a low dose of Depekote (500mg daily) for about 5 months with excellent results. I contacted you once before commenting on your excellent bi-polar questionnaire when I was first diagnosed and in total denial.  Your response to me was of great help in my acceptance process.
Thank you for your attention to my concern.
Sincerely,
Debbie Bigley  

Answer
Hi, Debby . . .

Many of my patients taking Depakote have had surgery and there have been no complications. None of the anesthesiologists to whom I have spoken remember ever having run into such complications.

If you require surgery, I hope your experience will be as benign as those of my patients.

Best regards . . .

Ivan
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%