i have about 12000 mg of sertraline saved from when i was prescribed it. is it likely i'd actually ctb or am i just gonna fuck up my body/brain even more?
redbathingduck
Student
- Mar 20, 2023
- 145
Sertaline generally has a pretty low toxicity level, so even with a huge dose like that (assuming you can keep it all in) the change of you succumbing to it is very small and most of the time there's not really any complications from it in the long term. There is however a chance you get serotonin syndrome but it's really not something you want to get. There is a possibility of it killing you but it'll most likely just be an awful experience for you if you do end up getting that. I don't recommend trying this method as someone who has also tried it because it'll most likely amount to nothing
Shadowlord900
Seeker of Darkness
- Sep 29, 2022
- 921
That's 12g, that's a pretty good number.
It is possible to CTB on Sertraline from what I've read, and the highest I've read someone ever recovering from a Sertraline overdose is 4000mg or 4g. But the problem with Sertaline like most other antidepressant drug ODs is it's rather unreliable.
So it'll be a gamble you'll be taking, but if you don't have any antiemetics (metoclopramide, domperidone, ondansetron etc.), it's not worth taking that gamble anyways because you'll need an antiemetic to make sure you don't vomit. If you vomit, that'll ruin your chances of CTBing.
It is possible to CTB on Sertraline from what I've read, and the highest I've read someone ever recovering from a Sertraline overdose is 4000mg or 4g. But the problem with Sertaline like most other antidepressant drug ODs is it's rather unreliable.
So it'll be a gamble you'll be taking, but if you don't have any antiemetics (metoclopramide, domperidone, ondansetron etc.), it's not worth taking that gamble anyways because you'll need an antiemetic to make sure you don't vomit. If you vomit, that'll ruin your chances of CTBing.
Tourniquet
Deranged Psychonaut
- Mar 21, 2023
- 11
Taken from quora after a quick search
There is no guarantee of it doing so, as even the ultra-high overdoses of sertraline do not always end in death. However, sertraline is not safe in overdose and there are hundreds of documented cases of death from sertraline overdose. Even more deaths are associated with cocktails of multiple psychotropic drugs which include sertraline, as they have a higher rate of fatal outcomes.
Completely normal doses can cause death, and do so at a higher rate as compared to placebo within the same patient populations when tested in randomized, placebo-controlled clinical trials—sertraline is a fundamentally risky drug, as are all antidepressants. But in both prescribed use and overdoses, sertraline is not deadly in the majority of cases. Serious effects which do not immediately kill someone are generally more concerning, statistically as well as experientially.
Overdoses as low as 1,100mg have been documented as potentially deadly in specific instances, though it is safe to assume that even lower overdose amounts will kill some people. On the other hand, overdoses 10 times that amount have been seen as non-fatal for some persons. The individual, their health, and the situation are all factors which can impact whether or not a certain dose is fatal.
Because SSRIs are such potent drugs and will often act fairly similarly in the superdosing rage, there is not necessarily a huge increase in risk from 8,000mg, which has been documented as survivable, to 20,000mg. Even at lower doses—those far below the 200mg/day considered the maximum approved dosage in many places—the experienced effects and outcomes of use vary significantly across individuals.
There is also the question of whether 20,000mg can be digested, metabolized, and/or distributed in a way that makes sertraline far more dangerous at 20,000mg than when taken in much smaller overdose amounts. Notably, you are probably talking about at least 200 pills unless someone has gotten their hands on a long-term stockpile of a liquid formulation.
In my opinion if one were to CTB using an SSRI of any kind it would be much more effective if combined with an MAOI such as Syrian Rue which is easily attainable and cheap however I will not offer sources as it is against the rules.
Combination of SSRI and MAOI especially in extremely high doses will almost certainly end with death caused by serotonin syndrome, however I must warn you this will most likely be extremely painful and an agonizing way to go.
Taken from erowid.org
What is "serotonin syndrome"?
Q:What is "serotonin syndrome"?
A:Serotonin syndrome is a condition that is typically induced by drug interactions from taking more than one drug that affects the serotonergic systems. These interactions cause too much serotonin to be released or remain in the synapse and cause hyperactivation of serotnergic neurons.
One thing that is important to keep in mind is that it is a "syndrome" and not a well defined problem with a known cause. It is simply a name given to a cluster of symptoms which are believed to be related through a common mechanism. Serotonin Syndrome is a diagnosis given when there are symptoms which match the profile, the patient has taken a serotonergic drug, and there are no other diagnoses that fit better. Serotonin Syndrome is often accompanied by or leads to a hypertensive crisis which can be very dangerous.
Serotonin Syndrome is a potentially fatal condition, with symptoms and complications of euphoria, drowsiness, sustained rapid eye movement, overreaction of the reflexes, rapid muscle contraction and relaxation in the ankle causing abnormal movements of the foot, clumsiness, restlessness, feeling drunk and dizzy, muscle contraction and relaxation in the jaw, sweating, intoxication, muscle twitching, rigidity, high body temperature, frequent mental status changes (including confusion and hypomania - a "happy drunk" state), shivering, diarrhea, loss of consciousness and death. (The Serotonin Syndrome, AM J PSYCHIATRY, June 1991, from http://members.aol.com/atracyphd/syndrome.htm).
Serotonin syndrome first began to be identified as more antipsychotic and antidepressant medicines began being prescribed. These medications often affect serotonin systems and the combination of these drugs was noted as dangerous (back in the 60s). It has recently become an issue with recreational drug users, particularly poly-drug users and abusers or people who use recreational drugs who are also on psychiatric medication such as MAOIs, tricyclic antidepressants, or SSRIs. As with any drug, legally prescribed or otherwise, one should always be aware of possible side effects and dangerous drug interactions.
Additional information can be found at:
aloha
psilo
The description in Bernstein's "Drug Therapy" of Serotonin Syndrome includes "confusion and disorientation.. a variety of autonomic, hypothalamic regulatory and neuromuscular signs and symptoms resembling Neuroleptic malignant syndrome..." That had been my observation, but I'd never seen that in print before. "Muscular rididity, dyspnea, sialorrhea, high fever, leukocytosis and CPK elevations are typical.. shivering, myoclonus, hyperreflexia and ataxia.." He mentions tachycardia and "labile blood pressure" but not specifically hypertension. I'm sure that it can occur as part of the syndrome.
The much more common reaction would be the hypertensive crisis (very high blood pressure) which can be manifested by headaches, bloody nose, and possible stroke. His treatments for the hypertension include rest, quiet, benzos, as well as the Phentolamine IV when necessary. He also mentions IV Beta blockers (like Inderal). He goes on to say that Thorazine can work but has the risk of resulting hypotensive reactions, so he avoids it. He seemed to like the Nifedipine taken sublinqually (10 mg capsule punctured and placed under the tongue, or just chewing the capsule).
Again the above is treatment for the more common hypertensive crisis. For the much rarer Serotonin Syndrome he suggests "careful patient monotoring, supportive measures, perhaps periactin (an serotonin antagonist) or methysergide, nefidipine if there is HBP and a short quick benzo as well as cooling if hyperthermia and hospital care as necessary and indicated.
Anon Doc
Frederick Bois-Mariage writes:
Although Serotonin Syndrome is commonly thought to be diagnosis for cardiovascular hypertension, Cardiovascular parameters are not considered relevant indicators for the serotonin syndrome (e.g. Sternbach 1991) and are not used for its scoring (see Hegerl et al. [1998] and Kaneda et al. [2001] for instance).
As Sternbach (1991: 706) recalled, historically the serotonin syndrome was first described in humans as a non specific pattern of adverse reactions that "differed from typical hypertensive crisis, as there was rarely marked elevation of blood pressure, headache, or a cerebrovascular accident."
Today, its main scored physiological indicators are fever (hyperthermia), hyperreflexia, muscular jerks (myoclonus), tremor, sweating, and diarrhea. The rare toxic forms can have fatal outcomes linked to a severe hyperthermia: coma, blood coagulation, and hepatic damage.
Serotonin Syndrome should not be invoked to explain anything about "cardiovascular effects".
Frederick Bois-Mariage
References:
Hegerl, U. et al (1998) "The serotonin syndrome scale: first results on validity". _Eur. Arch. Psychiatry Clin. Neurosci._, 248:96-103.
Kaneda, Y. et al. (2001) "The serotonin syndrome: investigation using the Japanese version of the Serotonin Syndrome Scale". _Psychiatry Res._, 105:135-142.
Sternbach, H. (1991) "The serotonin syndrome". _Am. J. Psychiatry_, 148:705-713.
Gillman KP. Psychotropical.com
There is no guarantee of it doing so, as even the ultra-high overdoses of sertraline do not always end in death. However, sertraline is not safe in overdose and there are hundreds of documented cases of death from sertraline overdose. Even more deaths are associated with cocktails of multiple psychotropic drugs which include sertraline, as they have a higher rate of fatal outcomes.
Completely normal doses can cause death, and do so at a higher rate as compared to placebo within the same patient populations when tested in randomized, placebo-controlled clinical trials—sertraline is a fundamentally risky drug, as are all antidepressants. But in both prescribed use and overdoses, sertraline is not deadly in the majority of cases. Serious effects which do not immediately kill someone are generally more concerning, statistically as well as experientially.
Overdoses as low as 1,100mg have been documented as potentially deadly in specific instances, though it is safe to assume that even lower overdose amounts will kill some people. On the other hand, overdoses 10 times that amount have been seen as non-fatal for some persons. The individual, their health, and the situation are all factors which can impact whether or not a certain dose is fatal.
Because SSRIs are such potent drugs and will often act fairly similarly in the superdosing rage, there is not necessarily a huge increase in risk from 8,000mg, which has been documented as survivable, to 20,000mg. Even at lower doses—those far below the 200mg/day considered the maximum approved dosage in many places—the experienced effects and outcomes of use vary significantly across individuals.
There is also the question of whether 20,000mg can be digested, metabolized, and/or distributed in a way that makes sertraline far more dangerous at 20,000mg than when taken in much smaller overdose amounts. Notably, you are probably talking about at least 200 pills unless someone has gotten their hands on a long-term stockpile of a liquid formulation.
In my opinion if one were to CTB using an SSRI of any kind it would be much more effective if combined with an MAOI such as Syrian Rue which is easily attainable and cheap however I will not offer sources as it is against the rules.
Combination of SSRI and MAOI especially in extremely high doses will almost certainly end with death caused by serotonin syndrome, however I must warn you this will most likely be extremely painful and an agonizing way to go.
Taken from erowid.org
What is "serotonin syndrome"?
Q:What is "serotonin syndrome"?
A:Serotonin syndrome is a condition that is typically induced by drug interactions from taking more than one drug that affects the serotonergic systems. These interactions cause too much serotonin to be released or remain in the synapse and cause hyperactivation of serotnergic neurons.
One thing that is important to keep in mind is that it is a "syndrome" and not a well defined problem with a known cause. It is simply a name given to a cluster of symptoms which are believed to be related through a common mechanism. Serotonin Syndrome is a diagnosis given when there are symptoms which match the profile, the patient has taken a serotonergic drug, and there are no other diagnoses that fit better. Serotonin Syndrome is often accompanied by or leads to a hypertensive crisis which can be very dangerous.
Serotonin Syndrome is a potentially fatal condition, with symptoms and complications of euphoria, drowsiness, sustained rapid eye movement, overreaction of the reflexes, rapid muscle contraction and relaxation in the ankle causing abnormal movements of the foot, clumsiness, restlessness, feeling drunk and dizzy, muscle contraction and relaxation in the jaw, sweating, intoxication, muscle twitching, rigidity, high body temperature, frequent mental status changes (including confusion and hypomania - a "happy drunk" state), shivering, diarrhea, loss of consciousness and death. (The Serotonin Syndrome, AM J PSYCHIATRY, June 1991, from http://members.aol.com/atracyphd/syndrome.htm).
Serotonin syndrome first began to be identified as more antipsychotic and antidepressant medicines began being prescribed. These medications often affect serotonin systems and the combination of these drugs was noted as dangerous (back in the 60s). It has recently become an issue with recreational drug users, particularly poly-drug users and abusers or people who use recreational drugs who are also on psychiatric medication such as MAOIs, tricyclic antidepressants, or SSRIs. As with any drug, legally prescribed or otherwise, one should always be aware of possible side effects and dangerous drug interactions.
Additional information can be found at:
Erowid MAOI Vault : Summary of Interactions
How do MAOIs and SSRIs interact with other drugs and with each other?
www.erowid.org
Erowid MAOI Vault : Info on Hallucinogens with Antidepressants, by Kit Bonson
Information on MAOIs (monoamine oxidase inhibitors). The Interactions between Hallucinogens and Antidepressants
www.erowid.org
aloha
psilo
The description in Bernstein's "Drug Therapy" of Serotonin Syndrome includes "confusion and disorientation.. a variety of autonomic, hypothalamic regulatory and neuromuscular signs and symptoms resembling Neuroleptic malignant syndrome..." That had been my observation, but I'd never seen that in print before. "Muscular rididity, dyspnea, sialorrhea, high fever, leukocytosis and CPK elevations are typical.. shivering, myoclonus, hyperreflexia and ataxia.." He mentions tachycardia and "labile blood pressure" but not specifically hypertension. I'm sure that it can occur as part of the syndrome.
The much more common reaction would be the hypertensive crisis (very high blood pressure) which can be manifested by headaches, bloody nose, and possible stroke. His treatments for the hypertension include rest, quiet, benzos, as well as the Phentolamine IV when necessary. He also mentions IV Beta blockers (like Inderal). He goes on to say that Thorazine can work but has the risk of resulting hypotensive reactions, so he avoids it. He seemed to like the Nifedipine taken sublinqually (10 mg capsule punctured and placed under the tongue, or just chewing the capsule).
Again the above is treatment for the more common hypertensive crisis. For the much rarer Serotonin Syndrome he suggests "careful patient monotoring, supportive measures, perhaps periactin (an serotonin antagonist) or methysergide, nefidipine if there is HBP and a short quick benzo as well as cooling if hyperthermia and hospital care as necessary and indicated.
Anon Doc
Frederick Bois-Mariage writes:
Although Serotonin Syndrome is commonly thought to be diagnosis for cardiovascular hypertension, Cardiovascular parameters are not considered relevant indicators for the serotonin syndrome (e.g. Sternbach 1991) and are not used for its scoring (see Hegerl et al. [1998] and Kaneda et al. [2001] for instance).
As Sternbach (1991: 706) recalled, historically the serotonin syndrome was first described in humans as a non specific pattern of adverse reactions that "differed from typical hypertensive crisis, as there was rarely marked elevation of blood pressure, headache, or a cerebrovascular accident."
Today, its main scored physiological indicators are fever (hyperthermia), hyperreflexia, muscular jerks (myoclonus), tremor, sweating, and diarrhea. The rare toxic forms can have fatal outcomes linked to a severe hyperthermia: coma, blood coagulation, and hepatic damage.
Serotonin Syndrome should not be invoked to explain anything about "cardiovascular effects".
Frederick Bois-Mariage
References:
Hegerl, U. et al (1998) "The serotonin syndrome scale: first results on validity". _Eur. Arch. Psychiatry Clin. Neurosci._, 248:96-103.
Kaneda, Y. et al. (2001) "The serotonin syndrome: investigation using the Japanese version of the Serotonin Syndrome Scale". _Psychiatry Res._, 105:135-142.
Sternbach, H. (1991) "The serotonin syndrome". _Am. J. Psychiatry_, 148:705-713.
Gillman KP. Psychotropical.com
redbathingduck
Student
- Mar 20, 2023
- 145
There's very little information I could find on people actually succeeding in their CTB attempt with Sertraline, but I've read of a woman in her 50s taking 8000 mg and making it out perfectly fine after a week. She did get treated in a hospital of course but yeah it's just really not a reliable substance for overdosing, it's usually one of the first antidepressants doctors/psychiatrists subscribe because of the low risk of it all too. 12g is indeed a lot but I don't think it's worth the risk here especially not without an antiemetic.
Shadowlord900
Seeker of Darkness
- Sep 29, 2022
- 921
Ah, thank you for that. Admittedly I only researched up on it for a few mins and found 4000mg to be the highest surviving overdose. But if you've found someone surviving as high as 8000mg, then yeah 12000mg starting to sound like a bigger risk now.
ty all of you! probably gonna pick something more concrete then, don't wanna risk just getting serotonin syndrome :/
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