I have been on T since Jan 2008. I am looking into having a hestorectomy, but also want to have both top and bottom surgery as well.
Specific_Questions: I am on psychratric medications. Seroquel, Methylphenidate ER, Methylphenidate, and Lexapro. Would these medications be a complication?
Thank you for your interest in what we do.
Hysterectomy is performed by others, but if you have this done, please go for a laparoscopically assisted vaginal hysterectomy and simultaneous oophorectomy (removal of ovaries) as well. 2 letters of therapy clearance should be obtained prior to this irreversible surgery.
We operate on patients taking your medications all the time, and this is not a contraindication. A letter of clearance from your psychiatrist will be requested, and also we do advise your taking any AM medication on the morning of surgery with a sip of water.
A word about methylphenidate…
Methylphenidate should not be prescribed concomitantly with tricyclic antidepressants, such as desipramine, or monoamine oxidase inhibitors, such as phenelzine or tranylcypromine, as methylphenidate may dangerously increase plasma concentrations, leading to potential toxic reactions (mainly, cardiovascular effects). Methylphenidate should not be prescribed to patients who suffer from severe arrhythmia, hypertension or liver damage. It shouldn’t be prescribed to patients who demonstrate drug-seeking behaviour, pronounced agitation or nervousness. Care should be taken while prescribing methylphenidate to children with a family history of Paroxysmal Supraventricular Tachycardia (PSVT).
Special precaution is recommended in individuals with epilepsy with additional caution in individuals with uncontrolled epilepsy due to the potential for methylphenidate to lower the seizure threshold.
All the best,
Harold M. Reed, M.D.