ADHD with "anxiety" sub-classification needs Medication suggestion (please)

[mrc109]

ADHD with "anxiety" sub-classification needs Medication suggestion (please)

Before I went to my last dental procedure involving drilling/filling and the unrelated laser removal of a cheek "flap" tissue thing (I bite the inside of my lip a lot) I asked my PCP doctor (internal medicine specialist) for some kind of oral medication as "extra" pain relief "help". He prescribed for me, 0.5 mg alprazolam, taken 1 hour before the "dental procedure".

In the past I have been prescribed halcion (by different doctor) as well. It may have worked better, but it was so long ago, I am unable to compare the relative performance characteristics for these two different types of drugs.

Would anyone care to comment about the particular merits for when to use one drug in difference to the other?

In my situation, I have ADHD, with "anxiety" as a sub-component.

When the drilling begins, it is all I can do to keep myself from stiffening up all over, kind of like "rigor mortise" has begun to set in.

The last time I had work done, I remember thinking, I wish I had taken 1.0 mg alprazolam instead of the 0.5 mg tablet (I never realized until today that alprazolam is not a "pain-killer" like valum, demerol or halcion)!

I remember that I still had that hot, I'm burning up on the inside all over, sickly kind of feeling in my gut thing, that seems to accompany shooting nerve pain in my mouth.

Does this surprise any of you that I would say this? Should I have asked for halcion? I never questioned my PCP's prescribing the alprazolam.

If I become a nervous "wreck" kind of patient, and I also have inordinate amount of drilling "tooth pain" (my tooth actually feels "burning hot", like my nerve is somehow really "on-fire"). And of course the smell of burning tooth decay does not help matters either. I won't even go there for what it is like to have a piece of "flesh" seared off ones inner cheek other than the fact that it hurt like HELL and smelled like it too!

What is the correct kind of pain medication for me (besides a well placed ball-peen hammer blow to my forehead)?

I do remember that the alprazolam did seemed to keep me from sweating as much as I would normally do. Without the alprazolam the back side of me, any part that contacts the chair, my clothing will become "wet" with perspiration.

Since I will be driving, valum is probably out of consideration.

I know my dentist has a choice between using a "long acting" or a "short acting" injectable pain killer (some sort of a "caine" I suppose), is one of these types, "better" than the other for patients like me?

Nitrous is out, it's too expensive, and it doesn't really seem to work for drilling pain on me. Besides, it makes feel "funny" and I become terribly self-conscious being the only "comic relief" in the room.

I have some 5 different "caries" that I need to get taken care of, two pairs on opposite sides of my mouth plus another, anterior and below the pair on the top. This work will be spread over two different "sessions". One session will require numbing on both the upper and lower on one side of my face (I am not looking forward to this event).

Your suggestions for possible "supplementary" pain medications I might want to propose to my doctor would be greatly appreciated. My appointment is three weeks away.

Thank you for your help.

mrc109

 

[comfortdentist]

Re: ADHD with "anxiety" sub-classification needs Medication suggestion (please)

First if halcion was effective before then I see no reason to switch. The problem was that you got your medication from your physician and not your dentist so your physician prescribed a typical anti-anxiety drug. Nothing wrong with that just not usually optimal for dental use. Valium, halcion. alprazolam, ativan, are all in the same class and are NOT pain pills. Demerol, percocet, hydrocodone, oxycodin, meperidine, morphine, codeine are all for pain.

 

[comfortdentist]

Re: ADHD with "anxiety" sub-classification needs Medication suggestion (please)

Your dentist needs to learn how to work with you and I think that you will be fine.

 

[RP]

Re: ADHD with "anxiety" sub-classification needs Medication suggestion (please)

First if halcion was effective before then I see no reason to switch. The problem was that you got your medication from your physician and not your dentist so your physician prescribed a typical anti-anxiety drug. Nothing wrong with that just not usually optimal for dental use. Valium, halcion. alprazolam, ativan, are all in the same class and are NOT pain pills. Demerol, percocet, hydrocodone, oxycodin, meperidine, morphine, codeine are all for pain.

And oh by the way, you shouldn't be driving with any of these in your system, narcotic pain meds or benzodiazepines for anxiety. It sounds like you are really looking for supplemental pain relief and not an anti-anxiety med? A few ibuprofen taken before the appointment would be fine.

However........ There shouldn't be pain with drilling or lazer- tell the dentist you are still feeling it and don't let him work until you are properly numb. If you can then trust that that is the case- the anxiety with the sweating will get better.

rp