meto best antiemetic alternatives?

[malevolentdiety]

Hi, I am on quetiapine which seems to not interact well with metoclopramide. ( For the sn method)

What is the next best option and is there any OTC options that are good enough?

Thanks

 

[4.I.2.Must.Die]

Ultimately, there could be a bunch of OTC meds you could use but what matters more is what could interact with Quetiapine, I suggest that or look at Gb threads that specifically detailed regimens, maybe meclizine since both Cheers and Mofreeko used it.

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[penguinl0v3s]

Hi, I am on quetiapine which seems to not interact well with metoclopramide. ( For the sn method)

What is the next best option and is there any OTC options that are good enough?

Thanks

The reason why you can't take metoclopramide with quentapine is because they both act on dopamine receptors as dopamine antagonists, so the concern is that there will be excess dopamine in your system. But if you take them together, nothing terribly bad will happen and the effectiveness of meto will decrease. If it really bothers you then you can stop your Seroquel.

And there are no OTC options. You need a dopamine antagonist, which some antipsychotics are.

 

[malevolentdiety]

The reason why you can't take metoclopramide with quentapine is because they both act on dopamine receptors as dopamine antagonists, so the concern is that there will be excess dopamine in your system. But if you take them together, nothing terribly bad will happen and the effectiveness of meto will decrease. If it really bothers you then you can stop your Seroquel.

And there are no OTC options. You need a dopamine antagonist, which some antipsychotics are.

The thing is is that my doctor might not prescribe it because they will know that I am on quetiapine. Is there another option?

 

[TiredOfAllThis]

Domperidone is OTC in some countries

 

[rozeske]

Is it Quetiapine- 245 nM? Stan's guide suggests no need to take meto if you are on one of the listed medications as they already act as an antiemetic.

Stan's Guide to SN.

Sodium Nitrite (SN) Method Introduction This document has been designed to give a full understanding of SN, what it is, how it works and how to use it. It will use the most simplest way of delivering this information as many members do not have English as their first language. Therefore using...

sanctioned-suicide.net

 

[sanitystruggle]

The reason why you can't take metoclopramide with quentapine is because they both act on dopamine receptors as dopamine antagonists, so the concern is that there will be excess dopamine in your system. But if you take them together, nothing terribly bad will happen and the effectiveness of meto will decrease. If it really bothers you then you can stop your Seroquel.

Other way around: they are both dopamine antagonists, so they reduce (block) dopamine activity. They can both cause Parkinson's like symptoms when taken alone. Combining them increases the risk and can lead to movement disorders like tardive dyskinesia and in severe cases neuroleptic malignant syndrome:

Quetiapine interactions to avoid

Quetiapine (Seroquel) interacts with drugs that prolong the QT interval, blood pressure medications, anticholinergic drugs, grapefruit, and alcohol. Here’s what you should not take with quetiapine to avoid side effects.

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TD can have lasting effects even after stopping the medication and NMS sounds like a painful and unpleasant experience. I wouldn't mix them.

 

[roku6]

Is it Quetiapine- 245 nM? Stan's guide suggests no need to take meto if you are on one of the listed medications as they already act as an antiemetic.

Stan's Guide to SN.

Sodium Nitrite (SN) Method Introduction This document has been designed to give a full understanding of SN, what it is, how it works and how to use it. It will use the most simplest way of delivering this information as many members do not have English as their first language. Therefore using...

sanctioned-suicide.net

I am a bit sceptical about that information.
There is simply not enough data how good are antipsychotics as antiemetic. I read some studies where olanzapine was successfully used on patients in chemotherapy, but I could not find evidence that it is widely used in treatment. Keep in mind even with meto and domperidone the chances of throwing up is high. Domperidone is considered safer but it also has interaction with antipsychotics.

 

[malevolentdiety]

Is it Quetiapine- 245 nM? Stan's guide suggests no need to take meto if you are on one of the listed medications as they already act as an antiemetic.

Stan's Guide to SN.

Sodium Nitrite (SN) Method Introduction This document has been designed to give a full understanding of SN, what it is, how it works and how to use it. It will use the most simplest way of delivering this information as many members do not have English as their first language. Therefore using...

sanctioned-suicide.net

How do I know if it's 245 nm?

 

[penguinl0v3s]

Domperidone is OTC in some countries

Domperidone may actually be better than meto for some people. It's a shame that it's not for sale in the US.

The thing is is that my doctor might not prescribe it because they will know that I am on quetiapine. Is there another option?

Look up D2 antagonists. The higher the affinity the better. You might not need.

Combining them increases the risk and can lead to movement disorders like tardive dyskinesia

The reason why it says that is because combining them increases the dopamine antagonism. But it's notable that these symptoms are additive and not multiplicative. The warning is mainly to prevent careless doctors from therapeutic duplication and accidentally overdosing their patients on dopamine antagonists.

Disappointingly, D2 is the dopamine receptor that is most responsible for TD, and also most important for antivomitting. Which is what makes meto so good. You can't completely win here, you need to take a sufficient dose to reduce your chance of not vomiting, but taking the higher dose will also increase your risk of TD.

If you really are wary of this, I believe @Meditation guide did genetic testing once to see if they would have adverse side effects to metoclopramide.

How do I know if it's 245 nm?

That's a good question. It works well in theory, but idk how good in reality.

I could not find evidence that it is widely used in treatment.

I bet the reason for this is because it also acts on 5HT2A and 5HT1A receptors, which have nothing to do with antiemetics and affect your mood. A high enough dose that would cause good enough antiemetic properties would also cause unwanted side effects. Which is my guess for why metoclopramide is used, because it targets more specifically for D2.

If we think about an analogy that can be understood with better ease, Zoloft/sertraline is classified as an SSRI even though it has some pretty nifty effects on dopamine reuptake and its dopamine properties are stronger than many drugs. This is because even though its ability to bind to dopamine is strong, its ability to bind to serotonin is really really strong. In actual practice, you could not give someone a dose of Zoloft that would have a good amount of dopaminergic effects, without firstly giving them serotonin toxicity.