Help SN: Transdermal Scopolamine as anti-emetic

[zevon]

I'd say I'm fairly well versed in conducting my own research however I don't think I've seen anyone mention or ask any questions pertaining to the use of transdermal Scopolamine (aka "scope patches" as my doctors call them) with the SN method.

(For anyone who has seen my Pegasos thread: I haven't been rejected but their response time has dramatically slowed and I simply don't think I'll be able to make it while they take their time, sadly. So I'm preparing for SN as my dreaded last resort.)

I have a mast cell disease as well as very, very severe gastroparesis/GI dysmotility and react to what seems like everything now. I've already been hospitalized due to side effects from compazine/prochlorperazine (dystonia/akathisia) and experience the same from reglan and promethazine, etc. I have to use the patches because everything just sits in my stomach for days or weeks.

I will likely do the stat dose after a three day fast to ensure my stomach is as empty as.possible. I was thinking of doing it today but thought I'd solicit the opinions of anyone here who knows if Scopolamine is a suitable substitute for the anti-emetic.
All of those other psych meds and anti-emetics are.out of the question. I'm also allergic to diphenhydramine, meclizine, etc.
I also have clonazepam and benzos have an anti-emetic effect, though I've been on them for so long who really knows at this point how much of that particular drug feature still applies to me.

I have plenty of propranolol and other BP meds, along with Ivabradine which I'm thinking of slipping for a few days because it helps keep my heart rate stable without tanking my BP even lower. I will likely use Rx muscle relaxers because I am allergic to NSAIDs such as acetaminophen,ibuprofen, ketorolac etc.

I have a consult with a doctor who may give me a GJ tube (the kind that allows for gastric draining and feeding via the small intestines/jejunum). I think sometimes this is also called a PEG tube...? I wonder if I end up getting the order for that....could I just "feed" myself the stat dose of SN straight into my small intestine via the feeding tube?

Anyone who read this far: thank you for your time, curiosity, concern and thoughts if you have any to share.

Apologies for any typos etc. My fingers dislocate when I type.

 

[Aap]

Three day fast? That's pointless and likely counterproductive. Scopolamine is mentioned fairly frequently; it seems like you haven't used the search. Scopolamine is better for motion induced nausea (and is likely the best medication available for such). It won't function as well as zofran or meto, but it is certainly better than nothing. In any event, antiemetics are not essential.

 

[zevon]

Three day fast? That's pointless and likely counterproductive. Scopolamine is mentioned fairly frequently; it seems like you haven't used the search. Scopolamine is better for motion induced nausea (and is likely the best medication available for such). It won't function as well as zofran or meto, but it is certainly better than nothing. In any event, antiemetics are not essential.

I have extremely severe gastroparesis so...yes, at least a 3 day fast is needed to ensure my stomach is as empty as possible. I would have to cease eating for at least 21 days to ensure complete emptiness however.

Thanks for your reply.

 

[anonThrush]

Per Stan's SN guide, antiemetics are only helpful if they're dopamine blockers. It's not fully understood how Scopolamine works, but it seems to be interacting with the histamine and acetylcholine neurotransmitters instead of dopamine. So unfortunately if seems unlikely that your patches will be very helpful.

 

[zevon]

Per Stan's SN guide, antiemetics are only helpful if they're dopamine blockers. It's not fully understood how Scopolamine works, but it seems to be interacting wit the histamine and acetylcholine neurotransmitters instead of dopamine. So unfortunately if seems unlikely that your patches will be very helpful.

Thank you so much. This is the reply I really needed but due to cognitive issues I suffer with from some of my conditions, and also as an injury from ECT treatments, I was having great difficulty referencing or wording exactly the type of information I was looking for.

I'm just gonna end up blowing my brains out. I feel like I'm back to square one. It seems like the only method that would work for me is via IV but I can't even get an email reply back from Pegasos after filling out the whole application and being ready to pay the deposit :/

 

[anonThrush]

I'm so sorry that you don't have any easy options.

Some people on the forum were able to get a prescription for the right kind of antiemetic by saying they were getting migraines, maybe that's an option for you too? Another option would be to just not take an antiemetic. Most people use one, but other people on the forum ctb without it, and one of the nice things about SN is that if it doesn't work, you should just wake up afterwards without any permanent damage to your body.

 

[the_final_countdown]

Your story is sad...I'm sorry you're in so much pain friend.

 

[whitefeather]

I'd say I'm fairly well versed in conducting my own research however I don't think I've seen anyone mention or ask any questions pertaining to the use of transdermal Scopolamine (aka "scope patches" as my doctors call them) with the SN method.

(For anyone who has seen my Pegasos thread: I haven't been rejected but their response time has dramatically slowed and I simply don't think I'll be able to make it while they take their time, sadly. So I'm preparing for SN as my dreaded last resort.)

I have a mast cell disease as well as very, very severe gastroparesis/GI dysmotility and react to what seems like everything now. I've already been hospitalized due to side effects from compazine/prochlorperazine (dystonia/akathisia) and experience the same from reglan and promethazine, etc. I have to use the patches because everything just sits in my stomach for days or weeks.

I will likely do the stat dose after a three day fast to ensure my stomach is as empty as.possible. I was thinking of doing it today but thought I'd solicit the opinions of anyone here who knows if Scopolamine is a suitable substitute for the anti-emetic.
All of those other psych meds and anti-emetics are.out of the question. I'm also allergic to diphenhydramine, meclizine, etc.
I also have clonazepam and benzos have an anti-emetic effect, though I've been on them for so long who really knows at this point how much of that particular drug feature still applies to me.

I have plenty of propranolol and other BP meds, along with Ivabradine which I'm thinking of slipping for a few days because it helps keep my heart rate stable without tanking my BP even lower. I will likely use Rx muscle relaxers because I am allergic to NSAIDs such as acetaminophen,ibuprofen, ketorolac etc.

I have a consult with a doctor who may give me a GJ tube (the kind that allows for gastric draining and feeding via the small intestines/jejunum). I think sometimes this is also called a PEG tube...? I wonder if I end up getting the order for that....could I just "feed" myself the stat dose of SN straight into my small intestine via the feeding tube?

Anyone who read this far: thank you for your time, curiosity, concern and thoughts if you have any to share.

Apologies for any typos etc. My fingers dislocate when I type.

 

[ZardozOmega]

There was a dude here recommending this. I'm skeptical, since anticholinergics are not mentioned in the PPH, and scopolamine will slow down stomach emptying.

 

[DetachedDreamer97]

Hello...

Yeah, sorry @ZardozOmega... I think I might've gotten carried away with recommending scopolamine.
I'll say only use that as a last resort, considering yeah, you got gastropariesis, so that will further worsen absorption as scopolamine slows GI motility. If you can, you should try inhousepharmacy to get metoclopramide delivered.

That said, I only say scopolamine is useful as dopamine and acetylcholine go hand in hand as high dopamine in the CTZ causes the release of Ach in the vomiting centre, which leads to throwing up. That and scopolamine competitively binds to serotonin receptors.

 

[ZardozOmega]

Hello...

Yeah, sorry @ZardozOmega... I think I might've gotten carried away with recommending scopolamine.
I'll say only use that as a last resort, considering yeah, you got gastropariesis, so that will further worsen absorption as scopolamine slows GI motility. If you can, you should try inhousepharmacy to get metoclopramide delivered.

That said, I only say scopolamine is useful as dopamine and acetylcholine go hand in hand as high dopamine in the CTZ causes the release of Ach in the vomiting centre, which leads to throwing up. That and scopolamine competitively binds to serotonin receptors.

maybe if you use scopolamine patches a few minutes after drinking sn it could work

 

[DetachedDreamer97]

maybe if you use scopolamine patches a few minutes after drinking sn it could work

Nah, I don't think that would work, especially not with patches. For one, scopolamine is used to prevent nausea, and I'm not sure on it being capable of relieving nausea and vomiting once it starts.
Another thing is that, maybe patches would, but that takes 4 hours for it to kick in, which would be long after OP would either die or vomit it up.

 

[zevon]

maybe if you use scopolamine patches a few minutes after drinking sn it could work

I also have a ton of promethazine left but I react poorly to it. I guess the physical effects I anticipate with the SN method are nothing I haven't already experienced as part of my conditions and/or medication side effects.

I may be getting a feeding tube that will put everything straight in my small intestine, with another tube to drain whatever gastric juices my stomach may still be producing (basically none at this point). I wonder if anyone has injected the SN "solution" straight into their tube like this? I'll have to do a search....thinking "out loud" a bit here, don't mind me.

I'd really rather just go to Pegasos, but who knows how long all of that will take despite me being read to pay the deposit and scheduling fees right now as I'm typing this. Been scrimping and saving for it....I deserve some damn dignity! Don't we all!

Your story is sad...I'm sorry you're in so much pain friend.

Thanks for the kind words, my friend!

I have a sense of humor about it now...it's the only way I can deal.

Here's where my username comes from:

maybe if you use scopolamine patches a few minutes after drinking sn it could work

I would definitely need to put the patch on ahead of time. They go behind the ear. Not sure how long absorption takes but likely not fast enough to keep me from yacking. I kind of doubt I will vomit due to my systemic dysmotility but would rather whoever finds me not have to see it. My concern is still for the courtesy of whoever finds me, lol, I have had thousands of kidney stones, had anesthesia not work during surgery.... and survived far too many attempts (I realize now due to my dead stomach not sending anything on to my intestines to be taken up into my bloodstream, etc.). It can't get much worse for me (I mean...it COULD *awkward laugh*) but I can't help my human suit's desire for as painless and peaceful as is possible....

I really appreciate this community. I feel so much love here. Almost like I'm a kid again

I'm so sorry that you don't have any easy options.

Some people on the forum were able to get a prescription for the right kind of antiemetic by saying they were getting migraines, maybe that's an option for you too? Another option would be to just not take an antiemetic. Most people use one, but other people on the forum ctb without it, and one of the nice things about SN is that if it doesn't work, you should just wake up afterwards without any permanent damage to your body.

My docs will pretty much write scripts for anything but pain meds. I just send them to a Canadian pharmacy and hope they don't take months this to arrive in the mail. I will look into the site everyone mentions for domperidone or *shudders* Reglan (horrible reaction) but I know I need something to scream at my stomach/vagal nerve to kick it into dumping mode instead of paralyzed dead mode, if that makes any sense!

I worry a bit about this because I've gotten a DEA "love letter" when something was caught at the border so my home address is burned and I don't know anyone who can, or is willing, to receive anything for me. I hesitate to have a package mailed to an abandoned address because it'd likely be picked up by someone else using it for other purposes. But I digress.

The reason I'm on scope patches at this point is because I react to everything else and transdermal causes me much less grief than swallowing yet another pill full of mysterious and seemingly always changing fillers and excipients.