Amitriptyline and numbing..

[Nicci]

Please can you tell me what my options are for numbing if I'm on amitriptyline?

Ive been getting anesthetic without adrenaline for some years after I felt ill after injections..

I can't even remember what I felt tbh, racing heart maybe? It was so long ago. I just remember treatment stopped after he checked my heart rate.. I remember I felt out of it/extremely faint.


What affect does amitriptyline have on dental anesthetic, generally speaking?

Just worried as I have a tooth with a possible RCT needed, yet I felt the drilling during the deep filling on that tooth.. So I'm extremely uncomfortable having my nerves drilled out given that I felt pain with just a filling.. Plus given the time it takes to wear off on me (usually within 40 minutes) it's making it likely it will have worn off before she finishes the rct..
I appreciate it can be topped up, but the pain before came out of nowhere, it was just suddenly extremely painful.

I don't know what to do, try anesthetic with adrenaline and risk those effects, or risk pain with non adrenaline injections...

 

[Gordon]

Same as somebody who isn't on amitriptyline

If the adrenaline is accidentally injected into a vein then it can produce the symptoms you mention. It's usually a one off but some people seem to be unlucky and have it happen a few times, apart from being scary, it's pretty harmless. (I'd be a bit worried if the patient was somebody with unstable angina or recovering from a heart attack but then they wouldn't be getting treated in my normal clinic anyway )

There's plenty of local anaesthetic drugs available without adrenaline so if somebody tells me they don't want it I'm happy to go along with them.

It's something you should discuss with your dentist and agree what local anaesthetic you want to go with, there's plenty of choice out there.

As with all drugs, there are pros and cons, trouble is, dentists are so used to just bunging in good old 2% lignocaine with 1:80k adrenaline because that works for nearly everybody nearly all the time!