Likelyhood to develop EPS symptoms from Meto

[enjolras]

https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/017854s058lbl.pdf

Taken straight outta the FDA message







Note the population groups prone to a higher sensitivity.

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

(To be continued ? participate)

 

[Гууу]

I suffered from EPS Haloperidol and Trifluoperazine. It's easy removed by Trihexyphenidyl or smoking tobacco depends on insensitivity. I think, same for meto.

 

[jgm63]

Disclaimer : My opinion only....
Maybe 1 in 500 refers to the more "severe" symptoms.
I think the milder symptoms might be a bit more common than that....
So in general, the frequency will depend on what degree of severity you are discussing.
The lower the severity, the higher the frequency....

In general pre-testing is a good idea, as discussed here :
https://sanctioned-suicide.net/threads/n-protocol-regime-regimen-notes.27092/post-673851

(posted that link quite a few times lately, but it ties in with quite a few threads, so.....)

 

[enjolras]

I got your back covered already for an "extension" of content. No church here :)

I'm not assimilating isolated numbers, staying attracted to deviation !
Only really trying to note redundancies when I search for info (when available), to dissipate certitudes ...and in order to generate tendencies. Think I came across some interesting meaning. (not enough time in a day - stay tuned)

 

[AcornUnderground]

I got this from 30 mg meto daily for 3-4 mos in my early 20s. It was awful. It comes back now with some medications or if I get really stressed out. It was set off by meto. It took many months for me to get it, though.

 

[enjolras]

Thanks for the testimonial ! From my own research, up to this point, some specific population groups are a LOT more at risk to develop EPS, up to a whole lot of greater magnitude, while some other persons will generally be more immunised and protected against EPS by default, namely mid-aged persons, male preferably, free of other medical conditions ...which may be the core of the FDA stats expressing rarity in the OP

I'll post the evidences later, but as a woman in early 20s, it seems you could have been damn under much higher probabilities to develop EPS. That's what I meant by tendencies.
The statistical variance could expand from 0.2% to 25% - immense gap - following the min-max displayed online with redundancy. It'd generally happen more frequently in kids/teenagers (badly), young adults below 30yo, then elderlies, and rather females... or also cumulating diseases, like diabetes or affective disorder, as aggravating factors

I got interested in this, cause that could mean someone testing a light stat dose of Meto safely, might not be a sufficient indication to save testing for a full regimen. Or alternatively, that a person might be taking higher chances to choose a final stat dose at the last minute after a regimen complete (pre-checked for safety, since risk appears correlated to duration and dose exposure especially within 24-48 hours for the symptoms that are not "tardive" by nature) ...if it were to be concerning a 18yo female with schizoaffective disorder or BPD, opposed 45yo sane male. That could lead to further prevention (that's the goal to collect data), not sticking to dumb numbers, but more of adopting a general conduct notice of extra assumptions

 

[jgm63]

One of the reasons I'm cautious regarding the "1 in 500" stat is that I've heard a few people on this site mention EPS, at varying degrees of severity, mostly non-severe, so although I think it's uncommon, I think it's more common than 1 in 500. So like I said, I think maybe the 1 in 500 is for the more severe cases (and they do use the term "acute", so that's perhaps what they are saying).
But just an opinion. No actual data to offer....

But anyhow, in my link above, that post discusses doing a "full test run" of the antiemetic regimen if you want to be more certain....

 

[lovedread]

Apparently, domperidone works well/decently as a replacement for meto with less likelihood of EPS symptoms. I think I'm going to look into that...

 

[Girobatol]

Olanzapine works very good as antiemetic but with very low EPS. Also quetiapine.

 

[laserfocus111]

If you're worried about extrapyrimidal symptoms you might want to take some diphenhydramine 25mg on top of your regimen. Problem solved.

 

[ohhgeeitsme]

If you're worried about extrapyrimidal symptoms you might want to take some diphenhydramine 25mg on top of your regimen. Problem solved.

Diphenhydramine makes mine much worse, even though I always read it's supposed to help. So it's probably uncommon. I just think I'm more easily prone to EPS than most Even before I had any of this, diphenhydramine would make my restless leg syndrome worse.

 

[laserfocus111]

You should try 25mg first.. Its just one tablet and I don't expect any adverse effects besides some drowsiness. The stories about hallucinations you hear about come from way higher doses.

Am in the healthcare biz

Diphenhydramine makes mine much worse, even though I always read it's supposed to help. So it's probably uncommon. I just think I'm more easily prone to EPS than most Even before I had any of this, diphenhydramine would make my restless leg syndrome worse.

 

[ohhgeeitsme]

You should try 25mg first.. Its just one tablet and I don't expect any adverse effects besides some drowsiness. The stories about hallucinations you hear about come from way higher doses.

Am in the healthcare biz

I have a lot A LOT of experience with diphenhydramine, which is why I know it makes it worse for me.

 

[laserfocus111]

I have a lot A LOT of experience with diphenhydramine, which is why I know it makes it worse for me.

I'm sorry I missed out on your restless legs syndrome. If that's the case even a small amount could tip you over.

An alternative could be ondansetron.. Maybe you've already thought of that.

 

[jgm63]

If you're worried about extrapyrimidal symptoms you might want to take some diphenhydramine 25mg on top of your regimen. Problem solved.

For many cases that might be true, but in some rare cases EPS can be severe, and might not be resolved by diphenhydramine, so it's still advisable to do some "pre-testing" to be on the safe side...

As posted above, I have various notes here that may be useful :
https://sanctioned-suicide.net/threads/n-protocol-regime-regimen-notes.27092/post-673851

Diphenhydramine makes mine much worse, even though I always read it's supposed to help. So it's probably uncommon. I just think I'm more easily prone to EPS than most Even before I had any of this, diphenhydramine would make my restless leg syndrome worse.

@faust was saying that propranolol can be very effective :
https://sanctioned-suicide.net/thre...ling-a-druc-overdose-not-sn.36301/post-674990

So perhaps that might be worth looking into....

Or of course, you could perhaps switch to domperidone....