Guide to Tricyclic Antidepressants (TCAs) Amitriptyline, Doxepin...

[Kera]

Translation from German
Ways to a dignified self-determined death
German edition 2012 of the WOZZ Foundat

Tricyclic antidepressants

In this chapter we discuss drugs from the group of tricyclic antidepressants that can be used in humane euthanasia. There are other antidepressants such as B. the group of SSRIs (like Prozac), which are sometimes fatal in high doses, but we come to the conclusion.
The toxicological literature indicates that their lethal effects are uncertain.

There are eight tricyclic antidepressants, in alphabetical order:
– Amitriptyline*: 10, 25, 50 and 75 mg tablets
– Clomipramine*: 10, 25 and 75 mg tablets
– Desipramine: Dragee a 25 mg
– Dosulepin: 25 mg capsules, 75 mg dragee
– Doxepin: capsules of 10, 25, 50, 75 and 100 mg
– Imipramine*: 10 and 25 mg tablets
– Nortriptyline*: 10, 25 and 50 mg tablets
– Trimipramine: 25 mg tablets

The four drugs marked with * are regularly prescribed by doctors in many countries.

Cause of death
Death occurs from cardiac arrhythmia, possibly in combination with respiratory arrest.

Availability of medication
For persistent depressive symptoms, doctors often first prescribe an antidepressant from a different group: SSRI antidepressants (such as Prozac or Seroxat). The indications for their use are:
rapid tiredness, depression, insomnia, listlessness or loss of appetite. If there is no improvement, if the symptoms worsen or if unpleasant side effects occur with the SSRI antidepressants, the doctor usually prescribes an antidepressant from the group of tricyclic antidepressants, in particular amitriptyline, clomipramine or nortriptyline. Amitriptyline is also prescribed for insomnia and chronic pain. Although these antidepressants are only available by prescription, they are relatively easy to obtain, including over the internet.

Lethal dose
For all tricyclic antidepressants we recommend a dose of 6 g. For a long and deep sleep, the combination with benzodiazepine is necessary (see below). Tricyclic antidepressants slow down the digestive process and thus their own absorption. Death should normally occur 12 to 24 hours after ingestion of these deadly drugs. However, one should know that dying sometimes takes 24 to 48 hours.
In order for self-determined dying to succeed, it is essential that no life-saving measures are initiated in the first 48 hours.

Tolerance and weaning
Tricyclic antidepressants do not induce tolerance. If taken before a planned death, there is no need to stop taking and go through a withdrawal period.

Necessary sleeping pills
Antidepressants do not induce deep and prolonged sleep. The combination with benzodiazepines is necessary to ensure that the symptoms of intoxication preceding death are suppressed and not experienced. Symptoms include epileptic seizures and elevated temperature.
We therefore recommend taking at least one long-acting benzodiazepine at the recommended dosage with these antidepressants. The addition of a fast-acting benzodiazepine is possible, but not necessary. We would like to point out that prior weaning is essential for the use of benzodiazepines.

Taking the medication
Sometimes a lot of pills have to be taken. 6 g of antidepressant would be 240 tablets of 25 mg. It is therefore advisable to grind them finely and mix them with vanilla sauce or yoghurt.
Sometimes capsules or dragees are prescribed. The former can be opened and their contents scattered. Dragees must not be crushed or opened, they must be swallowed whole with yoghurt or pudding. All antidepressants should be taken together with (very) long-acting benzodiazepines. When taking a fast-acting benzodiazepine at the same time, there is a risk of falling asleep while taking the drug. For this reason, the fast-acting benzodiazepine should be taken last, after all antidepressants and the long-acting benzodiazepines have been taken.
As previously described for other drugs, taking antiemetics within 24 hours of accelerated death is essential.

Documented cases
Only one self-determined death has been reported to w o z z involving the ingestion of 4g of amitriptyline and only 120mg of flurazepam. Although other cases are known in which less than 6 g was fatal, the authors recommend the use of 6 g to be on the safe side.
In this case, the low dose of 120 mg flurazepam was probably compensated by the calming effect of amitriptyline.
With the other antidepressants mentioned, an insufficient dose of sleeping pills can cause the person to consciously experience the symptoms of intoxication, which is undesirable for anyone.

Summary
It has been toxicologically proven that tricyclic antidepressants are lethal at a dose of 6 g. For a humane death they should go with us at least 500 mg of a long-acting benzodiazepine are taken.
In many countries, tricyclic antidepressants are not difficult to obtain. You can order them online, or you can often get them without a prescription from pharmacies in southern and eastern European countries.


This translation of the book is not intended to encourage you to commit suicide and use this method. The reader acts at his own risk.

 

[Kera]

Attention

Dragee must not be ground or crushed, as their coating protects the gastric mucosa. If this coating is no longer intact, the tablet will already dissolve in the stomach and not in the small intestine. The active ingredient would be destroyed in the stomach and thus become ineffective.

 

[Xta4Love]

I used nortrilen in combination with benzo's and alcohol. It is a peacefull way to go
Unfortunetelly I lived with roommates at the time and paramedics were called after 8 hours (more or less)
I woke up in emergrncy. Didnt know where I was and why strangers were touching me and poking into me with needles. I got upset angry so they tied me down. Spend two days in intensive care and off to psych ward.
Dont do this method if you are going to get found within 48 hrs

But it is a good method. Would do it again if I could. But it took very long to collect the nortrilen

 

[Kera]

I used nortrilen in combination with benzo's and alcohol. It is a peacefull way to go
Unfortunetelly I lived with roommates at the time and paramedics were called after 8 hours (more or less)
I woke up in emergrncy. Didnt know where I was and why strangers were touching me and poking into me with needles. I got upset angry so they tied me down. Spend two days in intensive care and off to psych ward.
Dont do this method if you are going to get found within 48 hrs

But it is a good method. Would do it again if I could. But it took very long to collect the nortrilen

Thank you so much for sharing your experience with us. Really bad what you have experienced. I find it especially bad when they tie you up like a criminal There I would just scream the whole time. But then you are drugged with means. You are so powerless!!! Just awful!

I had translated the guide once for others. Maybe it is helpful for someone!!! Glad to hear it's a good method with TZA :)

I myself would take Ami in combination with Propranolol. Only Ami takes too long for me too. And 6g is the minimum dose from heitige point of view. Even if Ami has the highest toxicity among TZA.

 

[Kera]

Here is a small compilation from a pharmacy magazine.

What we should know about the use of tablets, which we mainly use here.

It is recommended to prefer tablets over coated tablets and sustained release tablets. Capsules can be opened, etc.:

Facts about pills

Tablets, capsules and dragees are the most common solid dosage forms of medicines.
In this form, the active ingredient can be easily dosed, is easy to transport and has a long shelf life.
Size and weight can vary widely, from 0.1 grams to 1.3 grams.
Capsules or film-like coatings protect the active ingredient from external influences such as light, oxygen or gastric acid.
Tablets are usually machine made from a powder. This is compressed with high pressure.
They may contain binders, fillers, disintegrants, or colorants.
Tablets are not pills. These are softer and used to be made by hand ("pill rollers"). Due to better hygiene and safer release of active ingredients from tablets, pills have almost completely disappeared. However, the term pill has stuck and is sometimes used interchangeably with tablets (as in contraceptive medication).

types of tablets

Hard capsules
This dosage form consists of two gelatin halves and usually contains

powder
granules
Pellets
or oily liquids

The pharmacist can also fill them up on site and put them together if the doctor's prescription requires it.

Anyone who has trouble swallowing the capsule could pull the capsule halves apart relatively easily and access the contents. "However, whether the content alone has the same effect as the whole capsule or whether it is even harmful without the capsule shell can vary from preparation to preparation. The patient should best ask the pharmacist about this," advises Dr. Wolfgang Kircher from Peißenberg, former member of the Medicines Commission of German Pharmacists.

film-coated tablets and dragées
Some tablets are coated with a film that protects them from light. In addition, tablets with a film are usually easier to swallow than those without. Dragees are coated with a protective layer of sugar for similar reasons

Extended-Release Tablets
Sustained-release tablets are intended to release their active ingredient with a time delay as they migrate through the intestine . They are appropriate when a constant level of active ingredient is desired. There are several possibilities for that. Among other things, the manufacturers use indigestible carriers from whose pores the active ingredient only gradually escapes. The carrier substance is then excreted apparently unchanged, which can confuse uninformed patients. "The carrier can also be very hard, so don't bite the prolonged-release tablets," warns Kircher. Time and time again, patients would break a tooth when trying to chew .

Enteric coated tablets
With some active ingredients such as diclofenac, the tablets have to be coated with a layer that keeps gastric acid out. This works very well with soft capsules, for example. Sometimes, however, hard capsules also get such a protective cover, for example typhoid vaccine. "So that the tablets pass through the stomach quickly, they should be swallowed on an empty stomach with plenty of tap water, i.e. generally in the morning at least half an hour before breakfast," says Kircher. The reason is the sphincter muscle at the end of the stomach, which only releases tablets into the small intestine when there are no leftovers in the stomach.

Tips to make pills easier to swallow:

Take tablets and capsules in your mouth with a large gulp of water and do not tilt your head back, but pull your chin to your chest. This reduces the risk of the preparations remaining in the mouth when the water has drained away when you try to swallow them.
Crumble dividable tablets and mix into viscous foods such as applesauce or mashed potatoes to swallow. For children, it can also be jello, ice cream or nut nougat cream.

Can coated tablets be crushed?

The coating protects the active pharmaceutical ingredient from external effects, such as reactions with atmospheric oxygen, water or wear and tear during storage.
The coating can also be constructed in such a way that the coated tablet is enteric-coated. An active ingredient that is supposed to develop its effect only in the small intestine is thus protected from undesired decomposition by gastric acid. The tablet coating then dissolves in the intestine.

Taking medication before or after eating?

Some medicines should not be taken on an empty stomach, because otherwise they are less well tolerated and attack the mucous membranes. Other substances are better absorbed when dissolved in fatty foods.

Best with just water

Pharmacist Kircher advocates swallowing tablets with water only. "Both juices, cola, coffee and black tea may react with the ingredients," says the expert. In addition, the patient should drink plenty of water, at least 150 milliliters, preferably more: "In studies on the effectiveness of the medication, the test participants even had to drink 240 milliliters of water with the tablets." Otherwise, you may experience more side effects. Or the drug has a delayed effect because it does not pass through the stomach fast enough.

Be careful with milk products or fruit juices, they can influence the effects and side effects of some medicines and should therefore not be taken together with tablets.

 

[AnonymousL]

I used nortrilen in combination with benzo's and alcohol. It is a peacefull way to go
Unfortunetelly I lived with roommates at the time and paramedics were called after 8 hours (more or less)
I woke up in emergrncy. Didnt know where I was and why strangers were touching me and poking into me with needles. I got upset angry so they tied me down. Spend two days in intensive care and off to psych ward.
Dont do this method if you are going to get found within 48 hrs

But it is a good method. Would do it again if I could. But it took very long to collect the nortrilen

So if I am correct
When using this method you need to be alone for 48 hours and In these 48 hours you are 'asleep' ?

 

[reborn87]

I used nortrilen in combination with benzo's and alcohol. It is a peacefull way to go
Unfortunetelly I lived with roommates at the time and paramedics were called after 8 hours (more or less)
I woke up in emergrncy. Didnt know where I was and why strangers were touching me and poking into me with needles. I got upset angry so they tied me down. Spend two days in intensive care and off to psych ward.
Dont do this method if you are going to get found within 48 hrs

But it is a good method. Would do it again if I could. But it took very long to collect the nortrilen

How much alcohol did you take? Abd any anti vomiting otc pill? How many mg of anti vomit pill?

 

[Xta4Love]

How much alcohol did you take? Abd any anti vomiting otc pill? How many mg of anti vomit pill?

No anti vormit pills at all. It is amazing i did not vormit.
I think I drank half a bottle. It's hard to tell. I passed out really FAST

 

[reborn87]

No anti vormit pills at all. It is amazing i did not vormit.
I think I drank half a bottle. It's hard to tell. I passed out really FAST

How many mg did you take? Is it in same class as amitriptyline? An anticyclic antidepressant?

Which benzo did you take and how much alcohol?

Is Xanax ok ?

 

[divinemistress36]

48 hours damn

 

[Xta4Love]

How many mg did you take? Is it in same class as amitriptyline? An anticyclic antidepressant?

Which benzo did you take and how much alcohol?

Is Xanax ok ?

How many mg did you take? Is it in same class as amitriptyline? An anticyclic antidepressant?

Which benzo did you take and how much alcohol?

Is Xanax ok ?

I took near 1 gram. It is an incredible amount of pills.

I used ozazepam and diazepam. Oxazepam and xanax are similair. But you need a lonf

How many mg did you take? Is it in same class as amitriptyline? An anticyclic antidepressant?

Which benzo did you take and how much alcohol?

Is Xanax ok ?

I took 1 gram but you need 2 gram. It's over 100 pills. I would advice you to look up the peacefull handbook. This method is described. I failed so I cant advice you any further.
Most important: this method takes a long time to die from. You need 48 hours of privacy. Or you will end up tied to a hospital bed like I did.

 

[reborn87]

I took near 1 gram. It is an incredible amount of pills.

I used ozazepam and diazepam. Oxazepam and xanax are similair. But you need a lonf

I took 1 gram but you need 2 gram. It's over 100 pills. I would advice you to look up the peacefull handbook. This method is described. I failed so I cant advice you any further.
Most important: this method takes a long time to die from. You need 48 hours of privacy. Or you will end up tied to a hospital bed like I did.

Is 50 mg of Xanax OK and 40 mg of Valium?

Attention

Dragee must not be ground or crushed, as their coating protects the gastric mucosa. If this coating is no longer intact, the tablet will already dissolve in the stomach and not in the small intestine. The active ingredient would be destroyed in the stomach and thus become ineffective.

Is this dagree ? It's in USA 50 mg amitriptyline it has red coating.

 

[Xta4Love]

Is 50 mg of Xanax OK and 40 mg of Valium?

Is this dagree ? It's in USA 50 mg amitriptyline it has red coating.

Please go to the peacefull pill handbook. Im not a doctor.