Questions about the drugs used in the Stan's guide to SN

[do0mer]

Hello,
I have a few questions about the SN method. First of all, are there any alternatives to antiemetics listed in the stans guide? I don't have access to any of the listed drugs (as they are either unavailable or prescription only), and I'd prefer to avoid lying to a doctor. Can I also not take any antiemetics if I don't find any to kill myself? The guide also recommends taking antacids, but I'm not exactly sure why, as further down the author states that NOT taking the drug will result in more SN reaching the bloodstream. Isn't that the whole point? Hope someone will clarify what the point of taking antacids is. Thanks in advance.

 

[andreamysk]

Hello,
I have a few questions about the SN method. First of all, are there any alternatives to antiemetics listed in the stans guide? I don't have access to any of the listed drugs (as they are either unavailable or prescription only), and I'd prefer to avoid lying to a doctor. Can I also not take any antiemetics if I don't find any to kill myself? The guide also recommends taking antacids, but I'm not exactly sure why, as further down the author states that NOT taking the drug will result in more SN reaching the bloodstream. Isn't that the whole point? Hope someone will clarify what the point of taking antacids is. Thanks in advance.

Hi,
regarding antacids, I quote a passage by @cowboypants that I thought was acceptable:

-------------
ANTACIDS AND ACID REDUCERS

Antacids work on the acids already present in the stomach. Whereas acid reducers inhibit the stomach from producing more acids. If there is a build up of acid in the stomach, then it often comes up.

Antacids are not recommended for now as it's speculated to slow down absorption.
For the heartburn, he mentions to take either an H2 Antagonist or Proton pump inhibitors (PPI). Out of the two, it's known that PPI are superior (Omeprazole/ Esomeptizole 80mg)
-------------

Regarding alternative AEs, I read this excerpt from https://web.archive.org/web/20210912075803/https://suicide.wiki/index.php?title=Sodium_Nitrite (not updated to the latest evidence, but at least offers some indications):
------------------
If you are on any of the following antipsychotics, you don't need to take any antiemetic, because they already function as an antiemetic. The dose needed will depend on whether you take it regularly, the dose you're prescribed, and your weight. (Seeman, 2006), (Kusumi, Boku and Takahashi, 2014), and (Li, L. Snyder and E. Vanover, 2016) reported affinity values (Ki) at the D2 receptors of antipsychotics. The lower the numbers next to the drugs, the more powerful antiemetic the substance is.
Receptor Binding Affinity of Dopamine Blockers

Drug class	D2 antagonism
Antiemetics	Domperidone (0.3–3.4 nM), Clebopride (2 nM), Metoclopramide (9.18 nM), Bromopride (14 nM), Alizapride (200 nM)
1st generation antipsychotics	Benperidol (0.027 nM), Spiperone (0.053 nM), Droperidol (0.25 nM), Trifuperidol (0.4 nM), Haloperidol (2.0 nM), Chlorpromazine (2.6 nM), Bromperidol (2.1 nM), Prochlorperazine (6–8 nM), Levosulpiride (27–134 nM), Pipamperone (120 nM)
2nd generation antipsychotics	Lurasidone (1.0 nM), Sestindole (2.7 nM), Paliperidone (2.8 nM), Risperidone (4.9 nM), Olanzapine (21 nM), Clozapine (144 nM), Quetiapine (245 nM)
Benzamide	Tiapride (320 nM)

------------------------
Regarding Metoclopramide, check that in your country there is not actually an over-the-counter version of the drug, with half the active ingredient compared to the standard version (10 mg). In that case - although I am not absolutely sure - you would still have something at your disposal.

 

[DOHARDTHINGS24]

Hi,
regarding antacids, I quote a passage by @cowboypants that I thought was acceptable:

-------------
ANTACIDS AND ACID REDUCERS

Antacids work on the acids already present in the stomach. Whereas acid reducers inhibit the stomach from producing more acids. If there is a build up of acid in the stomach, then it often comes up.

Antacids are not recommended for now as it's speculated to slow down absorption.
For the heartburn, he mentions to take either an H2 Antagonist or Proton pump inhibitors (PPI). Out of the two, it's known that PPI are superior (Omeprazole/ Esomeptizole 80mg)
-------------

Regarding alternative AEs, I read this excerpt from https://web.archive.org/web/20210912075803/https://suicide.wiki/index.php?title=Sodium_Nitrite (not updated to the latest evidence, but at least offers some indications):
------------------
If you are on any of the following antipsychotics, you don't need to take any antiemetic, because they already function as an antiemetic. The dose needed will depend on whether you take it regularly, the dose you're prescribed, and your weight. (Seeman, 2006), (Kusumi, Boku and Takahashi, 2014), and (Li, L. Snyder and E. Vanover, 2016) reported affinity values (Ki) at the D2 receptors of antipsychotics. The lower the numbers next to the drugs, the more powerful antiemetic the substance is.
Receptor Binding Affinity of Dopamine Blockers

Drug class	D2 antagonism
Antiemetics	Domperidone (0.3–3.4 nM), Clebopride (2 nM), Metoclopramide (9.18 nM), Bromopride (14 nM), Alizapride (200 nM)
1st generation antipsychotics	Benperidol (0.027 nM), Spiperone (0.053 nM), Droperidol (0.25 nM), Trifuperidol (0.4 nM), Haloperidol (2.0 nM), Chlorpromazine (2.6 nM), Bromperidol (2.1 nM), Prochlorperazine (6–8 nM), Levosulpiride (27–134 nM), Pipamperone (120 nM)
2nd generation antipsychotics	Lurasidone (1.0 nM), Sestindole (2.7 nM), Paliperidone (2.8 nM), Risperidone (4.9 nM), Olanzapine (21 nM), Clozapine (144 nM), Quetiapine (245 nM)
Benzamide	Tiapride (320 nM)

------------------------
Regarding Metoclopramide, check that in your country there is not actually an over-the-counter version of the drug, with half the active ingredient compared to the standard version (10 mg). In that case - although I am not absolutely sure - you would still have something at your disposal.

Hey
I've seen that table before - any chance you can explain to me - in 2nd gen anti psychotics, next to quetiapine, it says 245nM - what does that mean??? I have no clue. It's a drug I'm on. I had a trial run of a single AE that you recently helped me with - no side effects. No chance to try a second one today though, but was encouraged by zero side effects. Doc that prescribes the quetiapine also prescribed AE - prochlorezapine or whatever - I trust doc that they aren't concerned about mixing the 2. Any help appreciated on the nM bit. Thanks.

 

[andreamysk]

Hey
I've seen that table before - any chance you can explain to me - in 2nd gen anti psychotics, next to quetiapine, it says 245nM - what does that mean??? I have no clue. It's a drug I'm on. I had a trial run of a single AE that you recently helped me with - no side effects. No chance to try a second one today though, but was encouraged by zero side effects. Doc that prescribes the quetiapine also prescribed AE - prochlorezapine or whatever - I trust doc that they aren't concerned about mixing the 2. Any help appreciated on the nM bit. Thanks.

It is believed that the antiemetic effect of these classes of drugs is due to their antagonistic capacity on the D2 dopamine receptors: that value expressed in µM (micrometers) should express the respective affinity values for the D2 receptor (the lower the numbers next to the drugs, the more powerful antiemetic the substance is: that is, it should present a higher concentration).

PS: I have no chemical-pharmaceutical expertise and to answer you I only read some articles on PubMed :-)

 

[Nephy]

So you need a lot of quetiapine ? Damn! Was my choice

 

[andreamysk]

So you need a lot of quetiapine ? Damn! Was my choice

The relationship is not exactly linear (but it does antagonize dopamine D2 receptors a little less than the others). Whatever you are already taking (in your case, I assume, Quetiapine) the guide suggests (for the stat dose) to just triple the dose you are already taking (as well as for the meto which triples the standard dose of 10 mg).

I repeat that I have no chemical-pharmacological expertise and that mine are only suppositions based on what I have read