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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by shar on August 6, 2002, at 12:10:29
I'm due for some major dentistry if I can get the money together. The dentist does longer sessions (maybe one or two) instead of multiple shorter sessions. This is fine with me, because I am PHOBIC about dentistry.
However, I am concerned about Halcion with Wellbutrin, Klonopin, Vistaril and what interactions there might be.
I only take Wellbu (250 mg) and klonopin (1 mg at night, occasionally .5 during day if I'm having a rage reaction from Effexor withdrawal). The Vistaril (hydroxyzine pamoate) is very occasional.
The Halcion (he didn't give dosage, I'll have to tell him I'd probably take triple what the normal person would) would just be for two appointments. One prep appointment, and one finish up appointment about 2 weeks later.
Any ideas, or info on possible effects?
Thanks,
Shar
Posted by Christina on August 6, 2002, at 13:00:28
In reply to My dentist wants to use Halcion; concerned, posted by shar on August 6, 2002, at 12:10:29
I don't have any knowledge of interactions, but taking Halcion for dental work sounds like a great idea to me.
I am also dreading some up-coming dentist work, and I need something stronger than simple novocaine.I take Wellbutrin and Adderall, so I'll be interested to learn of any side-effects.
Posted by velaguff on August 6, 2002, at 13:15:13
In reply to My dentist wants to use Halcion; concerned, posted by shar on August 6, 2002, at 12:10:29
I'd be concerned, too, I don't know if dentists really know all that much about drug interactions. Suggest you ask your MD, and also your pharmacist. They shouldn't mind if you ask. That's what they get the big bucks for.
Posted by Shawn. T. on August 6, 2002, at 21:02:02
In reply to My dentist wants to use Halcion; concerned, posted by shar on August 6, 2002, at 12:10:29
Klonopin and Halcion are both benzodiazepines, so taking them both at the same time would have synergistic effects. Taking Klonopin on the day of the appointment would probably not be a good idea; ask a pharmacist to be sure. Wellbutrin can decrease the sedative effects of Halcion, so that is something to consider. It probably wouldn't hurt discussing all of this with a pharmacist. I'm not at all crazy about Halcion myself (bad experience), but I hear that George W. Bush once took it to help him sleep.
Shawn
Posted by susan C on August 7, 2002, at 10:15:12
In reply to Re: My dentist wants to use Halcion; concerned, posted by Shawn. T. on August 6, 2002, at 21:02:02
Hi, I have taken it several times to help with long appointments. It made me not care and just on the verge of sleep. The assistant called my pdoc to check with any conflicts with other medications I take. I take ambien for sleep and depakote for bp2. Basically he warned the dentist that I will metabolize it quickly, so no to be surprised if it wears off faster than usual. Which it did.
I do not have a problem going to the dentist, but I do have a problem with pain. I now tell the dentist and staff that, even though they try to be conservative with their use of medication, (which I appreciate) to give me the most right away.
mouse with almost a full set of gold molars
Posted by Jerrympls on August 7, 2002, at 20:21:52
In reply to Re: My dentist wants to use Halcion; concerned, posted by susan C on August 7, 2002, at 10:15:12
Interesting. I've never heard of using Halcion during dental procedures. My first reaction is that it's very unusual. I know for surgical procedures, common practice is to give a dose of Versed (benzo) to help calm any anxiety. So - what purpose does the halcion serve - I mean, is it used to put the patient asleep while doing the dental work? or to only achieve a hypnotic state of some sort so the patient doesn't feel pain? Why would a dr. use a med liek halcion instead of gas or putting you out completely? I would chose either of those before taking halcion - because for me halcion has hardly any effect . I'd want to me OUT cold if the doc's gonna do an extended session of drilling, pulling, etc. And if the doc is using it strictly to calm anxieties during procedures, halcion - from my knowledge - wouldn't be anywhere near the best choice of med.
Hmm......perhaps I'm just in the dark. Is this really a common thing?
Jerry
Posted by oracle on August 7, 2002, at 21:28:04
In reply to Your DENTIST wants to use HALCION? Wha??, posted by Jerrympls on August 7, 2002, at 20:21:52
> Interesting. I've never heard of using Halcion during dental procedures. My first reaction is that it's very unusual.
Halcion is short acting & a dentist appt is ~ a hour long.
I know for surgical procedures, common practice is to give a dose of Versed (benzo) to help calm any anxiety. So - what purpose does the halcion serve - I mean, is it used to put the patient asleep while doing the dental work?
Makes the patient comfortable.
Why would a dr. use a med liek halcion instead of gas or putting you out completely?
"Putting you under" carries a significant risk, even IV sedation.
The risk vs benifit is too great. Gas does not calm you down.
Many dentists offer a benzo to their diffiuclt patients. I always
take an Atavin before seeing the demtist.
Posted by utopizen on August 8, 2002, at 10:09:06
In reply to Your DENTIST wants to use HALCION? Wha??, posted by Jerrympls on August 7, 2002, at 20:21:52
I had a surgery on my broken arm, asked to be put under.
the hospital has 2 anestheisologists during the surgery for me the whole time. I vomitted while being under, and they were able to quickly numb the esophogas to help me breathe after it.
Point to story: don't trust dentists to put you under. They don't have the same resources a surgergical hospital has, and you could very well die (as I would have if I did not have intervention from an anesthesiologist).
Posted by oracle on August 8, 2002, at 10:42:48
In reply to Re: Your DENTIST wants to use HALCION? Wha??, posted by utopizen on August 8, 2002, at 10:09:06
> I had a surgery on my broken arm, asked to be put under.
>
> the hospital has 2 anestheisologists during the surgery for me the whole time. I vomitted while being under, and they were able to quickly numb the esophogas to help me breathe after it.
>
> Point to story: don't trust dentists to put you under. They don't have the same resources a surgergical hospital has, and you could very well die (as I would have if I did not have intervention from an anesthesiologist).What does Halcion have to do with is ? Not following here.
Posted by MattDDS on August 8, 2002, at 12:29:19
In reply to My dentist wants to use Halcion; concerned, posted by shar on August 6, 2002, at 12:10:29
Hey Everyone,
I'm a 3rd year dental student, and using benzos for long dental procedures is pretty common.
Oral (conscious) sedation with triazolam (Halcion) is used quite often because:1. Some believe Halcion has the side effect of amnesia somewhat more often than other benzos.
This side effect becomes useful in the dental setting, seeing as how most patients prefer NOT
to remember the experience. This is called retrograde amnesia, and the degree to which
people experience this varies.2. It has a short half-life. This allows patients to drive home afterward without being
impaired.I think the bad rap Halcion has gotten in the press is unwarranted. Pharmacologically, it
is not a whole lot different than any other benzo, except for the short half-life.Other strategies include conscious sedation with nitrous oxide or IM midazolam (Versed). In
cases where the patient is extremely phobic, general anesthesia can be used. However, this
would likely be done in a hospital setting. I also emphasize that using general anesthesia is
very rare for general resorative dentistry. On the other hand, it is used regularly in oral
surgery (e.g. 'wisdom tooth' extractions).
I would not be concerned about your dentist using this strategy, and this actually represents
the standard of care for anxious patients.Hope this helps.
Matt
Posted by shar on August 8, 2002, at 22:33:27
In reply to Re: My dentist wants to use Halcion; concerned » shar, posted by MattDDS on August 8, 2002, at 12:29:19
I am glad to hear that this is not an unusual approach, because I'd never heard of it before. I've had conscious (IV) sedation before, and that went very well (once for wisdom teeth and once was for oral surgery). My dentist doesn't think IV is called for here, because what he's doing is not all that invasive (or whatever you would call surgery) it is just gonna take a long time. I'll be having nitrous also, and novocaine, of course.
I did not know if the Halcion might interact badly with the Wellbutrin/Klonopin that I take now, but from what I've been able to see on the internet, that doesn't seem like it will be a problem.
The good part will undoubtedly be the extra relaxation/anti-anxiety effect, as long as I don't metabolize it like a wasp. Even then, I'll still have the nitrous and will be able to communicate with the doc.
Matt, since you may one day treat a phobic person like me, I will tell you that a lot of my anxiety and tension comes from having very sensitive teeth (since babyhood). So, while the involved tooth area may be numb, anything hitting any of my other teeth (water from rinsing, water from a drill, spurts of air, etc.) is VERY uncomfortable (painful). I get very antsy when I see them pull out the little water squirter thingy because I know it will hurt like the dickens on my 'awake' teeth.
Thanks to all for your responses.
Shar
Posted by coral on August 11, 2002, at 12:58:28
In reply to Re: Halcion---Thanks, All, posted by shar on August 8, 2002, at 22:33:27
Dearest Shar,
(((((((((((Shar))))))))))) I know what dental work does to you . . . Hope all goes well.
I saw a bumper sticker the other day that read: RELEASE THE FAIRIES and I instantly thought of the tooth fairy. May the tooth fairy sit on your shoulder, hold your hand and keep you free from pain and anxiety!
xoxoxox
Coral
Posted by shar on August 11, 2002, at 23:39:25
In reply to to Shar, posted by coral on August 11, 2002, at 12:58:28
This is the end of the thread.
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