Q:  Dentistry & Pain Meds

my husband is bipolar I with agoraphobia and panic and anxiety attacks.  he also has very long and dramatic manic states.  its not uncommon for him to stay up 3 to 5 days at a time with no sleep.  well, now he has a tooth ache.  what can the dentist give him?  can the lithium, seroquel, librax, kolonapin, and soma he is on be causing mouth/tooth pain?  he has never had a drug problem, so i know he isnt just wanting pain killers....  what can the dentist safely give him for pain and to numb his jaw to pull the tooth?


Dear Anne -- 
Hopefully by the time you read this, that tooth pain (maybe the tooth itself!) is long gone. Generally it's okay to use pain medications with the stuff we use, including the medications you named -- with the possible exception of the soma, which would somewhat be replaced in function by the pain medication, temporarily.  

Since the general worry would be "one more sedating medication on top of a bunch of medications that cause sedation", there should be caution taken about excess sedation when the pain medication is added, including a plan for which of his medications to turn down if sedation is a problem (like potentially enough to cause a fall; and no driving while on the cocktail). This would include one or both of the "benzodiazepines" (librax and klonopin), at least to be turned down (can't stop them both entirely or there would be a risk of "benzodiazepine withdrawal" even with the rest of the medications around). 

Dr. Phelps

Published September, 2005