Method Is there a way to do an antiemetic trial run for N?

[cornflowerblue]

Cost isn't a factor.

I am concerned about the extrapyramidal side effects of meto, so I want to determine whether any other antiemetics listed in PPH would be sufficient.

I can't find any information about whether there's a quantity of N that would trigger the vomiting threshold, but wouldn't cause a coma or brain damage if the antiemetic fails to prevent vomiting. Does anyone have a resource with this information?

I am not looking for antiemetic suggestions. The PPH has a list. I'm looking for an answer for the N dosing question.

 

[jake3d]

Domperidone should be almost as good and less harmful on the body than meto.

 

[cornflowerblue]

Domperidone should be almost as good and less harmful on the body than meto.

I have access to PPH and all the info there, but they still say that meto is the best one so I'd like to actually try out something else. I don't want to find out the hard way by waking up from a coma a few days later if the antiemetic doesn't work quite well enough.

Domperidone should be almost as good and less harmful on the body than meto.

I don't mind going through an extra bottle or two of N if it's possible to take 1/5 of a bottle or something just to test the vomiting level. With a full dose, if the antiemetics fail, even if I don't get any brain damage, I'd be asleep for a suspiciously long time and would end up found and hospitalized.

 

[Menschenfeind]

Domperidone should be almost as good and less harmful on the body than meto.

Would dimenhydrinate be useful for this case?

 

[jake3d]

From my understanding no, the antiemetic needs to be a dopamine blocker for it to work.

 

[LogicalConclusion]

Would dimenhydrinate be useful for this case?

I'm no expert on this by any means, but my best guess is a simple no because the other anti-emetics being discussed are usually obtained through prescription while dimenhydrinate is OTC

 

[Rivotrial]

The only side effect I've had from MCP was diarrhea, it mainly causes a faster defecation (in one direction instead of the other ) ;)

Domperidon has a similar mechanism of action , but can't past blood brain barrier - that's why it doesn't cause any neuroleptic side effects.

Granisetron has no significant side effects. But it's a sick one which is used by cancer patients against nausea caused by cytostatic therapy. At least in my country I can't imagine someone would prescribe it to you without having this indication - not sure about US . It's worth a try to combine it with a dopamin blocker above

Then I heard about droperidol , but don't know much about it.

 

[cornflowerblue]

Would dimenhydrinate be useful for this case?

I'm not looking for a list of alternative antiemetics. I already have that from PPH. My question was about N dosing.

The only side effect I've had from MCP was diarrhea, it mainly causes a faster defecation (in one direction instead of the other ) ;)

Domperidon has a similar mechanism of action , but can't past blood brain barrier - that's why it doesn't cause any neuroleptic side effects.

Granisetron has no significant side effects. But it's a sick one which is used by cancer patients against nausea caused by cytostatic therapy. At least in my country I can't imagine someone would prescribe it to you without having this indication - not sure about US . It's worth a try to combine it with a dopamin blocker above

Then I heard about droperidol , but don't know much about it.

I made a comment that explained my specific concerns in more detail. I'm aware there is a range of antiemetics, but my question is about the N dosing for a trial run.

 

[Menschenfeind]

I'm not looking for a list of alternative antiemetics. I already have that from PPH. My question was about N dosing.

It was more like a question than a statement (for my own purpose). I'm sorry if it's a misconception.

 

[cornflowerblue]

It was more like a question than a statement (for my own purpose). I'm sorry if it's a misconception.

No problem. I wasn't sure if people just weren't reading my question, since all of the responses so far were antiemetic suggestions.

For anyone who wants information about antiemetics, read the PPH. There's an entire chapter about the different options.

 

[Menschenfeind]

No problem. I wasn't sure if people just weren't reading my question, since all of the responses so far were antiemetic suggestions.

For anyone who wants information about antiemetics, read the PPH. There's an entire chapter about the different options.

Thanks! I thought I already read parts but I used an outdated PPH version without the table and information.
I don't know if the advertisement shown in the PHH is a valuable information (and compareable with A´s N, which I doubt):

Spoiler: PPH

closeup:

 

[cornflowerblue]

Thanks! I thought I already read parts but I used an outdated PPH version without the table and information.
I don't know if the advertisement shown in the PHH is a valuable information (and compareable with A´s N, which I doubt):

Spoiler: PPH

View attachment 12036

closeup:
View attachment 12037

I have a subscription to the electronic copy, so I'm able to see updates whenever they're posted. The chapter on antiemetics is separate from the ones about Nembutal. It has a list of many options, suggested doses, and a few paragraphs about the way each works and what the effects are.

 

[Soul]

@cornflowerblue, might it be possible to work out what dose would achieve your aim by looking at information on injections? For example:

Nembutal Dosage Guide - Drugs.com

Detailed dosage guidelines and administration information for Nembutal (pentobarbital sodium). Includes dose adjustments, warnings and precautions.

www.drugs.com

 

[cornflowerblue]

@cornflowerblue, might it be possible to work out what dose would achieve your aim by looking at information on injections? For example:

Nembutal Dosage Guide - Drugs.com

Detailed dosage guidelines and administration information for Nembutal (pentobarbital sodium). Includes dose adjustments, warnings and precautions.

www.drugs.com

The answer might be there, but I don't have the medical knowledge to even know what calculations to do. Maybe somebody here will be able to help based on that link.

 

[Soul]

The answer might be there, but I don't have the medical knowledge to even know what calculations to do. Maybe somebody here will be able to help based on that link.

I hope someone can help.

Meanwhile I'm interested to see it can be given as an intramuscular injection. The "usual dose" listed for that is higher than the IV dose, but for people who don't want to drink it and can't set up an IV that might be good news.

Here's some more input that might help you work out a dosage:

Suicide - Wikibooks, open books for an open world

en.m.wikibooks.org

 

[bilamajina]

@cornflowerblue, I also have concerns about extrapyramidal symptoms of meto, which is holding me back. I already have involuntary spasms/movements, and I don't know if taking meto may make them worse. I'm just looking for a solution were I not successful I won't screw up my body any more than it is already. My doctor doesn't know what is causing them but won't refer me to a specialist because they are mild in nature, and I can hardly ask him "will meto make them worse?"

One reason barbiturates were removed from the retail market was because people accidentally overdosed on them, i.e. dose effect was unpredictable for the person in question - so I doubt you are going to find any reliable information on a dose that will trigger your vomiting threshold, but won't cause coma or brain damage - sorry.

There is more info on meto here:
https://www.pdr.net/drug-summary/Metoclopramide-Oral-Solution-metoclopramide-2732.5843

Is there a specific reason why you are worried about extrapyramidal symptoms ?

 

[cornflowerblue]

Is there a specific reason why you are worried about extrapyramidal symptoms ?

I can tolerate the symptoms if I absolutely must, but I'd prefer to have a fully peaceful exit. I want to be able to relax and go to sleep, not sit around feeling anxious and experiencing EPS until the N kicks in.

 

[bilamajina]

@cornflowerblue, I understand your fear of EPS given a single 10mg dose can trigger this effect. I'm afraid of taking a test dose as I know EPS is sometimes irreversible. Just wanna go peacefully, and not be ruled by fear.

 

[jake3d]

Take half a pill for a test then. From my understanding, the risk of EPS from meto is high only when it is taken for more than a month. Kinda like benzos take 3-4 weeks to cause physical dependence and withdrawal symptoms upon discontinuation.

 

[cornflowerblue]

Take half a pill for a test then. From my understanding, the risk of EPS from meto is high only when it is taken for more than a month. Kinda like benzos take 3-4 weeks to cause physical dependence and withdrawal symptoms upon discontinuation.

Metoclopramide and extrapyramidal symptoms: a case report - PubMed

Metoclopramide is a useful medication in the anesthesia provider's armamentarium. Its primary indication in the preoperative phase is to reduce gastric contents and increase lower esophageal sphincter tone for pharmacologic pulmonary aspiration prophylaxis. Metoclopramide can precipitate...

www.ncbi.nlm.nih.gov

"Tardive dyskinesia and Parkinsonism is generally seen after long-term use, whereas dystonia and akathisia can occur after a single dose of metoclopramide."

Take half a pill for a test then. From my understanding, the risk of EPS from meto is high only when it is taken for more than a month. Kinda like benzos take 3-4 weeks to cause physical dependence and withdrawal symptoms upon discontinuation.

I could deal with mild symptoms if I had no other choice, but then I'd likely also experience anxiety and be acutely aware that I'm going to CTB, and then spiral into worrying it won't work. Ideally I want to feel absolutely normal right up until the last moments.

@cornflowerblue, I understand your fear of EPS given a single 10mg dose can trigger this effect. I'm afraid of taking a test dose as I know EPS is sometimes irreversible. Just wanna go peacefully, and not be ruled by fear.

I can't say for sure, but I don't think a single dose would cause irreversible EPS. I can't find any studies on google saying that's a risk, anyway.

 

[Camille Lejeune]

Meto is the best. This EPS risk sucks and there is nothing we can do about it. I've just admitted it.

 

[angie]

Metoclopramide and extrapyramidal symptoms: a case report - PubMed

Metoclopramide is a useful medication in the anesthesia provider's armamentarium. Its primary indication in the preoperative phase is to reduce gastric contents and increase lower esophageal sphincter tone for pharmacologic pulmonary aspiration prophylaxis. Metoclopramide can precipitate...

www.ncbi.nlm.nih.gov

"Tardive dyskinesia and Parkinsonism is generally seen after long-term use, whereas dystonia and akathisia can occur after a single dose of metoclopramide."

I could deal with mild symptoms if I had no other choice, but then I'd likely also experience anxiety and be acutely aware that I'm going to CTB, and then spiral into worrying it won't work. Ideally I want to feel absolutely normal right up until the last moments.

I can't say for sure, but I don't think a single dose would cause irreversible EPS. I can't find any studies on google saying that's a risk, anyway.

How much metoclopramide do you intend taking whats your regime before N

 

[cornflowerblue]

How much metoclopramide do you intend taking whats your regime before N

I plan to follow the PPH recommendations.

 

[angie]

I plan to follow the PPH recommendations.

Which is how much ?is it the stat dose your taking ? or a few days dosage ? as the stat dose apparently changed from 60mg to 30mg someone said there had been an update to it .

 

[cornflowerblue]

Which is how much ?is it the stat dose your taking ? or a few days dosage ? as the stat dose apparently changed from 60mg to 30mg someone said there had been an update to it .

What difference does this make? I don't want to disclose more about my situation than is absolutely necessary.

I have access to medical journals to read publications about EPS incidence depending on dosing regimen, but that won't answer the question I posted about.

 

[Camille Lejeune]

Which is how much ?is it the stat dose your taking ? or a few days dosage ? as the stat dose apparently changed from 60mg to 30mg someone said there had been an update to it .

60 mg sounds crazy excessive to me! You're not supposed to take more than 30mg/day. I'm planning to take only 20 + maybe 1 domperidone, but I'm not sure yet. I'm scared to take more.

 

[angie]

What difference does this make? I don't want to disclose more about my situation than is absolutely necessary.

I have access to medical journals to read publications about EPS incidence depending on dosing regimen, but that won't answer the question I posted about.

It did used to say 60mg in Ppeh but people have said its changed to 30mg i was only asking about how much you were taking case like me you were unaware it had been changed .sorry if i offended you . I dont know what what info journals you have ?

60 mg sounds crazy excessive to me! You're not supposed to take more than 30mg/day. I'm planning to take only 20 + maybe 1 domperidone, but I'm not sure yet. I'm scared to take more.

I dont know why it has been changed maybe because 60mg was excessive it does seem like a lot .i will probably go for 30mg if any i think .

 

[cornflowerblue]

It did used to say 60mg in Ppeh but people have said its changed to 30mg i was only asking about how much you were taking case like me you were unaware it had been changed .sorry if i offended you . I dont know what what info journals you have ?

I dont know why it has been changed maybe because 60mg was excessive it does seem like a lot .i will probably go for 30mg if any i think .

I wasn't offended, don't worry! I subscribe to the e-handbook so I always have the latest version.

I can access most medical journals through the databases at my public library. So far I haven't run into one I couldn't read.

 

[oopswronglife]

From my understanding no, the antiemetic needs to be a dopamine blocker for it to work.

What is your source for this and do you know why other antiemetics wouldn't work for this?

 

[jake3d]

^^
Dr. Admiraal's book. Nitschke knows less about this than Dr. Admiraal who was an anesthesiologist his entire life.