Can you take anti-emetic + benadryl with SN to avoid EPS?

[can'tdoitanymore]

I am really scared about getting EPS from either meto or prochlorperazine (buccastem). I already have buccastem so would rather take that. I know it has a slightly higher risk of EPS but i figure if I am going to get side effects either may do it and don't want to wait to order meto if I can avoid it.

I had dystonia once from a shot of haldol and it was a horrible experience (my body was twisting to the side, my tongue felt too big for my mouth and I couldn't speak properly along with feeling physically exhausted but not being able to sleep). It went away with oral benadryl and I have since had haldol injected along with benadryl a few times and never had another reaction (I assume because of the benadryl) I know EPS is quite rare but reading the horror stories online and then because I have had a reaction once before I think I may have a higher chance of it happening. However I am almost certain I took phenergan as a child and was fine so maybe my reaction to haldol does not mean all drugs in this category will cause it for me.

I will test it first but whether i do or do not have any side effects am wondering would there be any harm in taking Buccastem or meto stat dose with some benadryl before SN to stop the anti-emetic side effects? It seems to make sense to me as Benadryl is one of the methods used to treat eps/dystonia caused by other medications but haven't seen it mentioned as working with the regimen and benadryl itself has a slight anti-emetic function. If I have to I will try and get domperidone but don't know if I will be able to and again do not want to have to wait weeks if I can avoid it.

 

[jgm63]

Don't know, but would be interested to know answer.
I would have thought it would be okay, but that's purely a guess, so obviously don't rely on that.

There's a drug interaction tracker :

Spoiler: interaction-checker

Drug Interaction Checker – Check for Interactions Between Prescription Medications

Use WebMD’s Drug Interaction Checker tool to find and identify potentially harmful and unsafe combinations of prescription medications by entering two or more drugs in question.

www.webmd.com

screenshot :



but obviously the interaction checker doesn't have SN listed, so probably not much help....

Note : As always, please note that I strongly encourage you to seek help with whatever is troubling you. Things may seem hard, but with the right help they can improve. There are many sources of help if you look and reach out. Please seek assistance in any and every way possible. You alone must decide upon your actions and take full responsibility for them, and you should always favour seeking help and keeping out of harm's way.

 

[APharmaDestroyedLife]

I am really scared about getting EPS from either meto or prochlorperazine (buccastem). I already have buccastem so would rather take that. I know it has a slightly higher risk of EPS but i figure if I am going to get side effects either may do it and don't want to wait to order meto if I can avoid it.

I had dystonia once from a shot of haldol and it was a horrible experience (my body was twisting to the side, my tongue felt too big for my mouth and I couldn't speak properly along with feeling physically exhausted but not being able to sleep).

Sorry to go a little off topic by not giving you advice. The truth is, I have no idea. When you experienced that how long did that last? It sounds horrible.

 

[Girobatol]

I have had meto and never got EPS. Lithium gives me some EPS but not in the level of haldol. I have seen people in the ward all shaking and twisting because of haldol. So meto cant be compared to haldol in trerms of EPS.

 

[Dazedandconfused32]

I have had meto and never got EPS. Lithium gives me some EPS but not in the level of haldol. I have seen people in the ward all shaking and twisting because of haldol. So meto cant be compared to haldol in trerms of EPS.

I've had EPS from Haldol. It was awful and of course they didn't think I'd need Benadryl to combat the possibility of it happening beforehand. Assholes. I remember my legs locking up in such pain and I had rigidity problems throughout my body. I remember sitting there and not even being able to really sit. I felt like I was turning into stone. It hurt. I just started the 48 hour regime and for the past two hours since taking it I've had no problems as of yet. So thankful for this

 

[jgm63]

I've had EPS from Haldol. It was awful and of course they didn't think I'd need Benadryl to combat the possibility of it happening beforehand. Assholes. I remember my legs locking up in such pain and I had rigidity problems throughout my body. I remember sitting there and not even being able to really sit. I felt like I was turning into stone. It hurt. I just started the 48 hour regime and for the past two hours since taking it I've had no problems as of yet. So thankful for this

Do you intend to make a goodbye post ?

 

[Dazedandconfused32]

Do you intend to make a goodbye post ?

I'm not sure, I'm kind of shy but I more than likely will, yes

 

[jgm63]

I'm not sure, I'm kind of shy but I more than likely will, yes

No pressure to do so, entirely your choice....
Otherwise I would have wished you a safe journey here instead....

 

[Dazedandconfused32]

No pressure to do so, entirely your choice....
Otherwise I would have wished you a safe journey here instead....

Awe thank you :) I'm going to try. I guess I just don't feel important enough to even say goodbye or even be missed. It's a weird place to be for sure. But anyways, thank you again.

 

[Jean4]

https://sanctioned-suicide.net/threads/stans-guide-to-sn.27535/

 

[APharmaDestroyedLife]

Awe thank you :) I'm going to try. I guess I just don't feel important enough to even say goodbye or even be missed. It's a weird place to be for sure. But anyways, thank you again.

Everyone on this planet is equally important , it is the failure of others and society that has made you feel that way.

I'm sorry this life was so hard on you and for whatever circumstances brought you to this point. Whatever you decide , to go or not, to post or not , you know you have all our support and we will be here if you need us.

 

[can'tdoitanymore]

I have had meto and never got EPS. Lithium gives me some EPS but not in the level of haldol. I have seen people in the ward all shaking and twisting because of haldol. So meto cant be compared to haldol in trerms of EPS.

I feel so much better knowing it might be ok. There's still a risk but I thought it was almost guaranteed I would get EPS.

I've had EPS from Haldol. It was awful and of course they didn't think I'd need Benadryl to combat the possibility of it happening beforehand. Assholes. I remember my legs locking up in such pain and I had rigidity problems throughout my body. I remember sitting there and not even being able to really sit. I felt like I was turning into stone. It hurt. I just started the 48 hour regime and for the past two hours since taking it I've had no problems as of yet. So thankful for this

I feel so much relief now. I thought I was going to have to rule out SN because of the haldol experience. Thanks for letting me know your experience and yes it hurt so bad right! Please update if everything goes smoothly with the meto or you develop EPS.

Don't know, but would be interested to know answer.
I would have thought it would be okay, but that's purely a guess, so obviously don't rely on that.

There's a drug interaction tracker :

Spoiler: interaction-checker

Drug Interaction Checker – Check for Interactions Between Prescription Medications

Use WebMD’s Drug Interaction Checker tool to find and identify potentially harmful and unsafe combinations of prescription medications by entering two or more drugs in question.

www.webmd.com

screenshot :

View attachment 21048

but obviously the interaction checker doesn't have SN listed, so probably not much help....

Note : As always, please note that I strongly encourage you to seek help with whatever is troubling you. Things may seem hard, but with the right help they can improve. There are many sources of help if you look and reach out. Please seek assistance in any and every way possible. You alone must decide upon your actions and take full responsibility for them, and you should always favour seeking help and keeping out of harm's way.

I think I looked it up and the interaction was just increased sedation which would actually be a benefit.

Sorry to go a little off topic by not giving you advice. The truth is, I have no idea. When you experienced that how long did that last? It sounds horrible.

It didn't start till the next morning. The exhaustion kicked in immediately but that always happens with haldol for everyone. I went to urgent care and they didn't know how to treat it so gave me a steroid injection and ativan injection which did nothing. By the late afternoon my psych dr finally called and told me to take the benadrly and it went away within about half an hour if I remember correctly.

 

[jgm63]

@Dazedandconfused32 Please keep us updated with everything.....

And remember to make a goodbye post if you are proceeding.

We care about you

 

[Dazedandconfused32]

@Dazedandconfused32 Please keep us updated with everything.....

And remember to make a goodbye post if you are proceeding.

We care about you

Thank you for your kind words. So far it's been okay. I'd definitely recommend taking Benadryl if not for a precautionary measure. I started to feel it a little bit in my mouth. Like tight jaw and constantly feeling the need to move it so I took some Benadryl and it subsided. I'm on my second day so I can't complain. A little sleepy this morning which can be a struggle if you have to work and run errands like I do but a coffee fixed that right up as well. It's nowhere near what I felt with Haldol. Not even 1%. I'll keep y'all posted and of course work on a goodbye thread for tomorrow.

 

[k75]

I have a question. Everyone is scared of EPS from Meto. I understand. I've had a light case of it before that fortunately went away. But... What does it matter in this context? Unless you're planning on being alive later, which you aren't. I don't get it.

 

[Dazedandconfused32]

I have a question. Everyone is scared of EPS from Meto. I understand. I've had a light case of it before that fortunately went away. But... What does it matter in this context? Unless you're planning on being alive later, which you aren't. I don't get it.

I agree 100%

 

[Ghosted]

Because we don't want to suffer as we die.

 

[jgm63]

I have a question. Everyone is scared of EPS from Meto. I understand. I've had a light case of it before that fortunately went away. But... What does it matter in this context? Unless you're planning on being alive later, which you aren't. I don't get it.

In some cases, EPS symptoms can be severe, and may be extremely distressing. This could seriously interfere with your ability to go through with your attempt. Or it could make what should have been peaceful into a harrowing experience.

I explain this in my N guide :

Spoiler: n-protocol-regime-regimen-notes

https://sanctioned-suicide.net/threads/n-protocol-regime-regimen-notes.27092/

Note : As always, please note that I strongly encourage you to seek help with whatever is troubling you. With the right help things can improve. There are many sources of help if you look and reach out. Please seek assistance in any and every way possible. You alone must decide upon your actions and take full responsibility for them, and you should always favour seeking help and keeping out of harm's way.

 

[noctiva]

EPS are a possible side effect of metoclopramide, but it has been reported in only 1 in 500 people taking it, which is a very low chance (0.2% of people taking it). According to the side effects described, they are reversible and not irreversible.
Additionally, these effects occur with long term use of metoclopramide, not short term, as we use them here. According to webmd, 12 weeks should not be exceeded, so our 2 day regimen should be fine.
I think we're a bit panicky here with the side effects for meto. ALL side effects that can happen have to be listed in the pamphlet, even those with very low occurrence. Even other drugs that have caused EPS to a user do not allow for predictions if this drug will cause them as well.
Care needs to be taken for drug interactions, so if you are taking anti psychotic in addition to meto, you might want to check the crossreactivity.

Extrapyramidal Reactions (EPS)
Acute dystonic reactions, the most common type of EPS associated with metoclopramide, occur in approximately 0.2% of patients (1 in 500) treated with 30 to 40 mg of metoclopramide per day. Symptoms include involuntary movements of limbs, facial grimacing, torticollis, oculogyric crisis, rhythmic protrusion of tongue, bulbar type of speech, trismus, opisthotonus (tetanus-like reactions), and, rarely, stridor and dyspnea possibly due to laryngospasm; ordinarily these symptoms are readily reversed by diphenhydramine (see WARNINGS).
Source: https://www.rxlist.com/reglan-side-effects-drug-center.htm

Because of the risk of tardive dyskinesia, do not take this more often, in larger doses, or for longer than directed by your doctor. According to the manufacturer, treatment should not exceed 12 weeks.
Source: https://www.webmd.com/drugs/2/drug-8679/metoclopramide-oral/details

 

[jgm63]

EPS are a possible side effect of metoclopramide, but it has been reported in only 1 in 500 people taking it, which is a very low chance (0.2% of people taking it). According to the side effects described, they are reversible and not irreversible.
Additionally, these effects occur with long term use of metoclopramide, not short term, as we use them here. According to webmd, 12 weeks should not be exceeded, so our 2 day regimen should be fine.
I think we're a bit panicky here with the side effects for meto. ALL side effects that can happen have to be listed in the pamphlet, even those with very low occurrence. Even other drugs that have caused EPS to a user do not allow for predictions if this drug will cause them as well.
Care needs to be taken for drug interactions, so if you are taking anti psychotic in addition to meto, you might want to check the crossreactivity.

Extrapyramidal Reactions (EPS)
Acute dystonic reactions, the most common type of EPS associated with metoclopramide, occur in approximately 0.2% of patients (1 in 500) treated with 30 to 40 mg of metoclopramide per day. Symptoms include involuntary movements of limbs, facial grimacing, torticollis, oculogyric crisis, rhythmic protrusion of tongue, bulbar type of speech, trismus, opisthotonus (tetanus-like reactions), and, rarely, stridor and dyspnea possibly due to laryngospasm; ordinarily these symptoms are readily reversed by diphenhydramine (see WARNINGS).
Source: https://www.rxlist.com/reglan-side-effects-drug-center.htm

Because of the risk of tardive dyskinesia, do not take this more often, in larger doses, or for longer than directed by your doctor. According to the manufacturer, treatment should not exceed 12 weeks.
Source: https://www.webmd.com/drugs/2/drug-8679/metoclopramide-oral/details

I would say there's a few different factors to this....
The symptoms are likely not "all or nothing" - there would be differing degrees of symptoms.
The "1 in 500" figure might apply to the "more severe" symptoms, but the milder symptoms might be more common, but agreed, still fairly uncommon.

But the main factor is that people have a tendency to worry....
Which is understandable.
Telling people to "stop worrying" is unlikely to be effective.
So it's good to share information, and share solutions/workarounds.
This helps put people's mind at rest, which you can't put a price on....

 

[noctiva]

But the main factor is that people have a tendency to worry....
Which is understandable.
Telling people to "stop worrying" is unlikely to be effective.
So it's good to share information, and share solutions/workarounds.
This helps put people's mind at rest, which you can't put a price on....

It's good to think things through, to be fully informed. But there is a difference between researching the problems and just worrying/ panicking based on reading threads found here on the forum on potential meto side effects.
Realistically speaking, EPS is insanely rare and reversible, yet every thread discusses it as if taking meto leads to a high chance of irreversible EPS which is simply not true and borders on fear mongering, inducing panic down the line leading to the next meto thread.
Hence I added again the sources on metoclopramide as they are described in the patients pamphlets and doctors handbooks. We do need to be realistic here and face the facts as they are reported, not propagate the fear that we will end up with irreversible EPS even if we take meto for up to 48 h at the recommend dose.

 

[jgm63]

It's good to think things through, to be fully informed. But there is a difference between researching the problems and just worrying/ panicking based on reading threads found here on the forum on potential meto side effects.
Realistically speaking, EPS is insanely rare and reversible, yet every thread discusses it as if taking meto leads to a high chance of irreversible EPS which is simply not true and borders on fear mongering, inducing panic down the line leading to the next meto thread.
Hence I added again the sources on metoclopramide as they are described in the patients pamphlets and doctors handbooks. We do need to be realistic here and face the facts as they are reported, not propagate the fear that we will end up with irreversible EPS even if we take meto for up to 48 h at the recommend dose.

"EPS is insanely rare" I think a lot of study would be needed to confidently make such a statement.
As stated, the symptoms are likely not "all or nothing" but rather differing degrees. The less severe symptoms might not be as rare as you think, but might still cause distress to someone. Sure, it's nice and easy to just say "meh, stop worrying so much", but is that acting responsibly ? I don't think so, but that's just my view.

"every thread discusses it as if taking meto leads to a high chance of irreversible EPS" I think that's an exaggeration ("I've told you a million times not to exaggerate !")

It's excellent that you are sharing valuable information, so thanks very much.
It's also great that you are not a worrier.
The fact remains, for better or worse, a lot of people do worry a lot, and just telling them not to doesn't work.
So instead we share info and share solutions/workarounds, which puts people's minds at rest....

 

[k75]

Just for the record, I wasn't trying to downplay anything or judge anyone with my original question. I'm well aware of EPS dangers and all that. I take Meto and have taken some other meds in the past that had that as a side effect. I've briefly suffered symptoms myself ( not related to Meto).

It just seems to me that overall, the worry about it seems to get magnified in people's heads or treated as something that is guaranteed to happen with Meto. And while it can happen, I believe it's not so likely with the short amount of time we take it. And if it does, we probably aren't going to be living with it for very long, if at all.

I don't know. It's kind of like the SN boogeyman. But the fear without understanding is leading to people wanting to do trial runs of their Meto, which I see as the real danger because that's even more of the drug that you're taking, which increases your exposure and risk.

It's just a silly situation overall to me. And something I would only be seriously concerned with if I planned on being alive to suffer the consequences.

 

[jgm63]

Just for the record, I wasn't trying to downplay anything or judge anyone with my original question. I'm well aware of EPS dangers and all that. I take Meto and have taken some other meds in the past that had that as a side effect. I've briefly suffered symptoms myself ( not related to Meto).

It just seems to me that overall, the worry about it seems to get magnified in people's heads or treated as something that is guaranteed to happen with Meto. And while it can happen, I believe it's not so likely with the short amount of time we take it. And if it does, we probably aren't going to be living with it for very long, if at all.

I don't know. It's kind of like the SN boogeyman. But the fear without understanding is leading to people wanting to do trial runs of their Meto, which I see as the real danger because that's even more of the drug that you're taking, which increases your exposure and risk.

It's just a silly situation overall to me. And something I would only be seriously concerned with if I planned on being alive to suffer the consequences.

I realise you only have the best intentions.
That fact you had symptoms might show it may not be as rare as people think. Your symptoms might be mild. Some people's symptoms might be slightly less mild. But a key factor is some people might handle it better than others. Mild EPS might cause some people of a weaker constitution to panic, which could interfere badly with their attempt...
It's true that people might over magnify it in their mind. Fully agree.
But just knowing that doesn't resolve the issue for them.
Providing workarounds (careful meto testing in advance, plus Diphenhydramine as a backup for those who feel the need) helps them worry less.

There are some cases, although rare, where EPS can be severe enough to significantly interfere with or prevent, an attempt.
That was the initial point I was making when I first replied to your post.
When someone happens to be one of those cases, then these discussions certainly won't be pointless to them.....

 

[k75]

I realise you only have the best intentions.
That fact you had symptoms might show it may not be as rare as people think. Your symptoms might be mild. Some people's symptoms might be slightly less mild. But a key factor is some people might handle it better than others. Mild EPS might cause some people of a weaker constitution to panic, which could interfere badly with their attempt...
It's true that people might over magnify it in their mind. Fully agree.
But just knowing that doesn't resolve the issue for them.
Providing workarounds (careful meto testing in advance, plus Diphenhydramine as a backup for those who feel the need) helps them worry less.

There are some cases, although rare, where EPS can be severe enough to significantly interfere with or prevent, an attempt.
That was the initial point I was making when I first replied to your post.
When someone happens to be one of those cases, then these discussions certainly won't be pointless to them.....

I don't think it's super rare, but it's still uncommon.
I've never experienced these symptoms with Meto, and I've had to take it for up to a few weeks on several occasions over the past 5 years. A few weeks ago I got three large doses by IV in a couple of hours. No side effects.
When I did experience the symptoms it was from Vraylar, which is totally different and I had to discontinue, which made the symptoms completely go away.

Ironically, it's the testing of the meto that is causing the most risk. You can't really test for EPS, because either you get it or you don't, and just because you didn't get it this time doesn't mean next time you won't. For Meto, it might be cumulative.

The only thing you can test for is if it helps with your nausea, and that's only if you're in danger of puking at the time. And the people around here I see trying to test it are not. Things like that should probably not be encouraged.

 

[jgm63]

I don't think it's super rare, but it's still uncommon.
I've never experienced these symptoms with Meto, and I've had to take it for up to a few weeks on several occasions over the past 5 years. A few weeks ago I got three large doses by IV in a couple of hours. No side effects.
When I did experience the symptoms it was from Vraylar, which is totally different and I had to discontinue, which made the symptoms completely go away.

Ironically, it's the testing of the meto that is causing the most risk. You can't really test for EPS, because either you get it or you don't, and just because you didn't get it this time doesn't mean next time you won't. For Meto, it might be cumulative.

The only thing you can test for is if it helps with your nausea, and that's only if you're in danger of puking at the time. And the people around here I see trying to test it are not. Things like that should probably not be encouraged.

Testing with meto is thought to be a good idea because if you're going to get EPS symptoms then it's surely better to take a small amount, eg 10mg, and get milder symptoms than get more severe symptoms from a higher amount, eg a 30mg stat dose. (I'd be surprised if the effect was completely all-or-nothing).

In most cases, it's all about "peace of mind" and feeling rehearsed/ready, which is a very important thing to most people.

When I wrote my N guide, I stated "Most people don't get EPS". So I'm not trying to cause unnecessary worry, but some people do tend to worry, which I fully understand.

"it's the testing of the meto that is causing the most risk" Personally I don't agree with this. When you test with meto, you would try to do it several days or more in advance of an actual attempt, giving plenty of time for it to clear out of the body (I believe the half life is around 6 hours). I'm sure you're right that if you don't get symptoms on one occasion, you still might on another occasion. Nobody said the testing is 100%, but it's maybe 75% (guess), which is way better than nothing.

If the EPS stuff seems over-the-top to you, then that's awesome. You do you.
I'm sure there are plenty of people that agree with you, which is great also.

But I'm also pretty sure that a lot of people get peace of mind from staying informed, knowing what the workarounds are, and having the possibility of testing in advance with a small dose.
So it's good (in my view) to put the info out there, document the workarounds, etc, and let each person make their own minds up....

 

[k75]

So it's good (in my view) to put the info out there, document the workarounds, etc, and let each person make their own minds up....

Agreed. Which is exactly what all this back and forth among the last three of us in this thread has done a good job of. Each person has a responsibility to figure out their own comfort level based on available facts.

But I also really do think the EPS issue is becoming more like a game of side-effect telephone around here. One person gets scared and then everybody's terrified and a lot of people don't even know why or how or what. And in the end, it's kind of like being worried that you might die if you take too much SN. ;)

 

[jgm63]

Agreed. Which is exactly what all this back and forth among the last three of us in this thread has done a good job of. Each person has a responsibility to figure out their own comfort level based on available facts.

But I also really do think the EPS issue is becoming more like a game of side-effect telephone around here. One person gets scared and then everybody's terrified and a lot of people don't even know why or how or what. And in the end, it's kind of like being worried that you might die if you take too much SN. ;)

Sure. Although rare, some EPS symptoms could *prevent* people from dying since the severity can interfere with the attempt, so that's what some people may worry about. Or they may want a peaceful passing in the presence of a loved one, to not cause any distress to that loved one, etc.

Many people probably just don't want to take any chances they can possibly avoid (however small), especially if they only get occasional chances at being alone to make an attempt.

I do think sometimes people are limited in their ability to think outside their own situations, and consider people in different circumstances. Many different types of people in many types of circumstances may wish to CTB, and to some of them, peace of mind is everything. So I sometimes feel these "why do people worry so much" type posts are not fully on point.