autumnal
Enlightened
- Feb 4, 2020
- 1,950
"Like all antipsychotic drugs, sulpiride is thought to work by blocking dopamine receptors in the brain, and works by exerting antipsychotic action, antiemetic actions and an effect on gastrin secretion.[my emphasis]
(REF, under dropdown 'Why is this medication prescribed?')
This study found similar antiemetic effects between meto and sulpiride at doses of 10mg and 50mg respectively every eight hours. So that dosage might be a useful stepping-off point. Incidentally, that study used sulpiride as a one-off (or three-off!) to provide antiemetic effects, which differentiate it from say quetiapine where it is (believed) necessary to take it regularly to build up levels and antiemetic effects.
Note also in that study, their meto regimen is 10mg every eight hours a maximum of three times (10mg x 3 = 30mg per day total). We also know that a working stat dose of meto is 30mg as a one-off. Whether this similarly means that their use of a sulpiride regimen (50mg x 3 = 150mg per day total) also suggests a stat dose of 150mg as a one-off might have similar effects would require the expertise of someone more knowledgeable than me. @Aap perhaps?
Notabadguy
Mage
- Feb 7, 2020
- 576
PN and PPH advise to use Meto. You can buy it through an online pharmacy.
Last edited:
autumnal
Enlightened
- Feb 4, 2020
- 1,950
Yes true, that's a given. But Stan's Guide expands on this and recommends both other viable antiemetics, and certain antipsychotics that also have antiemetic effects.
autumnal
Enlightened
- Feb 4, 2020
- 1,950
https://sanctioned-suicide.net/attachments/autumnal-rtfm-resources-only-extended-information-png.34278/
I thought you might be a new member to ask that, but it seems you've been here nearly two years. I'd be very surprised if you hadn't already come across the Resource Compilation. It's a thread which is pinned at the top of the Suicide Discussion forum. The Resource Compilation is a convenient drawing together of the most useful forum threads and external resources relating to each of the main suicide methods. In it is a link to Stan's Guide to SN. Stan's Guide is the most definitive and comprehensive resource about the SN method on the entire forum, written by an experienced forum member who has since passed away. The guide is also frequently mentioned and referenced in discussion here.
Please tell me you have at least read the Peaceful Pill Handbook (PPH) chapter on SN?
ohhgeeitsme
Wizard
- Feb 5, 2020
- 694
Can someone explain to me why it is has to be a dopamine blocker? Everyone says that, but I don't believe I've actually seen a reason why that is. I can't take dopamine blockers because I have akathisia, but I do have ondansetron. Others have said this wouldn't work, but why is that if it also prevents nausea and vomiting? I'm sure there is a reason, I just haven't seen it stated anywhere.
autumnal
Enlightened
- Feb 4, 2020
- 1,950
Essentially, vomiting from different sources of nausea trigger different areas in the brain.
https://sanctioned-suicide.net/attachments/vomiting-centres-png.12442/
(Illustration thanks to @Quarky00)
- Toxins in the stomach (such as SN) trigger the chemoreceptor trigger zone (CTZ), and are countered using dopamine antagonists.
- Whereas vomiting from chemotherapy or surgery is triggered via the nucleus tractus solitarius, and can be countered by 5HT3-antagonists (like ondansetron).
ohhgeeitsme
Wizard
- Feb 5, 2020
- 694
Essentially, vomiting from different sources of nausea trigger different areas in the brain.
https://sanctioned-suicide.net/attachments/vomiting-centres-png.12442/(Illustration thanks to @Quarky00)
I am not in any way an expert, but it may be worth looking into whether the antiemetic benefits of a single stat dose of meto in your SN protocol may outweigh the potential for worsening your akathisia symptoms during the period of time you remain conscious. You might gain some insight into this by trialling a single stat dose of meto in a practice run without taking SN, to gauge the severity and duration of any possible adverse effects.
- Toxins in the stomach (such as SN) trigger the chemoreceptor trigger zone (CTZ), and are countered using dopamine antagonists.
- Whereas vomiting from chemotherapy or surgery is triggered via the nucleus tractus solitarius, and can be countered by 5HT3-antagonists (like ondansetron).
However, be warned that both considering such a trial, and your ultimate decision regarding meto would ideally involve input from members with far more medical knowledge than I posses.
Thank you. I'm not personally willing to risk it. The chances are far too high for me, but I appreciate it.
Essentially, vomiting from different sources of nausea trigger different areas in the brain.
https://sanctioned-suicide.net/attachments/vomiting-centres-png.12442/(Illustration thanks to @Quarky00)
I am not in any way an expert, but it may be worth looking into whether the antiemetic benefits of a single stat dose of meto in your SN protocol may outweigh the potential for worsening your akathisia symptoms during the period of time you remain conscious. You might gain some insight into this by trialling a single stat dose of meto in a practice run without taking SN, to gauge the severity and duration of any possible adverse effects.
- Toxins in the stomach (such as SN) trigger the chemoreceptor trigger zone (CTZ), and are countered using dopamine antagonists.
- Whereas vomiting from chemotherapy or surgery is triggered via the nucleus tractus solitarius, and can be countered by 5HT3-antagonists (like ondansetron).
However, be warned that both considering such a trial, and your ultimate decision regarding meto would ideally involve input from members with far more medical knowledge than I posses.
It does say 5HT3-antagonists work for that too on the left one, though.
autumnal
Enlightened
- Feb 4, 2020
- 1,950
Yes true. Perhaps they are listed in order of effectiveness, or perhaps there is another explanation more complex than captured in the diagram. This is about as far as my knowledge in this specific area goes, unfortunately.
Perhaps @Quarky00 or @Aap can advise?
Quarky00
Enlightened
- Dec 17, 2019
- 1,956
Please read FAQ. Because D is systematic and prokinetic and goes to brain stem .5HT3 is not prokinetic , it will reduce vomiting signal but still cause expelling of toxins .
| Will any antiemetic work? | NO. Guide provides 6 AEs – only use those.
|
| Other AEs? | DO NOT use –
|
| Why not Dramamine? | Histmine is responsible for body movements (Vestibular nucleus) , treats motion sickness
|
| Why not Ondansetron? |
|
| In simple words? | Need broad systematic AE targeting both CTZ (brain) and stomach plus prokinetic. |
| How vomiting works | Complex interactions:
|
| Strong effects without Meto? | Ondansetron and Domperidone target peripheral receptors, not the brain (less side effects): Domperidone (Dopamine, less EPS) + Ondansetron (5HT3, less EPS) = Metoclopramide (Dopamine+5HT3 , Brain/EPS) |
This is serious toxic that will activate all systems . Expelling poisions may close digestion valves . Prokinetic is important . Ondansteron works on specific limited cases . That said people used SN fataly without AEs.
While zofran is not pro kinetic, I can say that it, by a HUGE margin, is he antiemetic of choice for surgical, chemotherapeutic, and drug induced vomiting in the US, while Reglan is an order of magnitudes or three behind application in the US, though Perhaps not rest of world. It is also viewed as extremely safe given the ubiquity of usage. The fact it works is the reason it is included in the PPH.
It is effective, period. I generally just don't comment on it, as it is so dogmatically accepted here that it isnt effective. There is a notion that zofran is not "systemic" and therefore not effective. This is flatly wrong and ignores the causes of vomiting. The stomach has no "toxin" receptors. Most vomiting is mediated by the brain. Now, zofran is not prokinetic, which is a benefit in the case of SN.
Honestly, why BOTH are not taken (overlapping and complimentary sites of actions and effects) is beyond me. It is obvious Meto can't stop all of the SN induced vomiting; why not add an additional agent that works at slightly different areas?
It is effective, period. I generally just don't comment on it, as it is so dogmatically accepted here that it isnt effective. There is a notion that zofran is not "systemic" and therefore not effective. This is flatly wrong and ignores the causes of vomiting. The stomach has no "toxin" receptors. Most vomiting is mediated by the brain. Now, zofran is not prokinetic, which is a benefit in the case of SN.
Honestly, why BOTH are not taken (overlapping and complimentary sites of actions and effects) is beyond me. It is obvious Meto can't stop all of the SN induced vomiting; why not add an additional agent that works at slightly different areas?
Last edited:
Quarky00
Enlightened
- Dec 17, 2019
- 1,956
You are here a month, these claims about AE protocol post surgery and CINV had been discussed 3-4 months ago, so I'm not going to repeat myself.
I've written to you on 3 different threads that ctb is not a medical setting, which you keep mentioning. So I disagree with said notions and the blunt manner in which they were deilvered, dismissing everything. American hospitals practices are not to be considered as "truths" -- many of us were hurt by those wonderful 'protocols'. Being prokinetic, release sphincters, is crucial. PPH is also not to be taken as it is. Their SN dosage changed from 10g to 25g in short period. Propranolol 2g. And many more mistakes. The addition of 'alternative AEs' is new. PPH had done a an amazing job and is a overall a reliable source, but they have failed us several times before.
You are also factually wrong. The stomach does have chemoreceptors recognizing harmful substances. It is quite ridiculous to think the brain has 'toxin receptors' while the stomach doesn't. That's how Zorfram works... It works by stomach signaling 5HT3. The vomiting is mediated by brain, but it's initiated by a complex system of vagus nerves in the GI.
The link has been provided and this had been researched here -- "History of Drug Discovery for Treatment of Nausea and Vomiting" -- sadly you did not read nor searched previous discussions, saying that the stomach doesn't recognize toxins...
Again, you are not familiar with the content on this site. Members have suggested many times taking both. Some members ARE already taking both. However the problem for most members is obtaining Meto/Domp. Since it is very effective, overcoming this often negates use of Zofran. But several combinations have been raised and deemed viable.
It is beyond you -- because you lack the aforementioned knowledge and awareness. You had reached a conclusion without reading everything.
------
I'm disheartened by you delivering "medical information" in that manner. It's great to challenge and suggest. But if you want to "contradict" Guide's and Resources, done over long period of time, by a big group of people -- with such high level of confidence -- at least research first. You also like to do a back-and-forth, previously claiming that "morphine causes anxiety" (bringing preoperative practices). You are entitled to your opinions, but they don't hold, argumentative, and despite appearance of knowledge -- poor. I'm not going to do this back and forth with you yet again. It's tiresome. Please learn how to listen, research, and speak, and raise doubts and suggestions in a more respectful way -- rather than throwing short statements
Last edited:
Dammmmnnnnn @Quarky00 that's a very comprehensive viewpoint and I think maybe @Aap is just gonna slowly back away from this.
"Toxin" receptors don't exist. I choose my words carefully; there are specific receptors that bind certain ligands. A one and done generic "toxin" receptor isn't a thing. I did not claim the GI is not involved in emesis. To claim zofran is only active peripherally and not centrally in CTZ is simply not supported. Pull out Goodman and Gillmans. Look at the fda link below.
Calling me ignorant is rich. Unlike others, I do not feel the need to list my accedemic qualifications. I promise I didn't first learn of zofran a month ago. If I've said anything factually incorrect, by all means please point it out. Otherwise, the claim I have no idea of what I speak (I'm ignorant) is exactly what it is, an emotional personal attack.
do you not agree that zofran and reglan would be better than reglan alone? I'm not understanding the name call8ng. No where did I say don't take reglan. I commented because I was asked and generally don't for this very reason and am largely repeating advice in the PPH.
Calling me ignorant is rich. Unlike others, I do not feel the need to list my accedemic qualifications. I promise I didn't first learn of zofran a month ago. If I've said anything factually incorrect, by all means please point it out. Otherwise, the claim I have no idea of what I speak (I'm ignorant) is exactly what it is, an emotional personal attack.
do you not agree that zofran and reglan would be better than reglan alone? I'm not understanding the name call8ng. No where did I say don't take reglan. I commented because I was asked and generally don't for this very reason and am largely repeating advice in the PPH.
Last edited:
Quarky00
Enlightened
- Dec 17, 2019
- 1,956
I did not wish for them to "back away" but get informed and move to productive discussion, rather than stating "flatly wrong" (not productive).
I had little doubt they would be compelled to reply and bring "counter arguments".
For me it's never about being right and wrong, made enough mistakes here and in real life, emotional and factual, which I gladly admit. I don't care about such things.
You did not understand it, despite me saying it's not an insult.
No, my dear friend, you appear smart, and don't need others saying (as you mentioned). I appreciate your contributions. But this is not about credentials, rather being aware to context, to big picture and small details; being aware previous discussions; been aware to this place, to members, to people, and to how we converse. I though about it well before reaching my conclusion. I'm sorry for offending you. It was a fair indictment:
However it's not a pleasant event (for neither parties), so I do apologize.
It's a pattern and I'm not engaging with that. We have lost several dear friends recently and such conversations are of less importance considering imminent death (and us being here together).
Last edited:
