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I share your intuition about benzos, wish I could ask the PPH author(s) what their thoughts were as to those large benzo doses, maybe there's something we're missing. What are your thoughts on propranolol and cimetidine? What if someone with gastric issues like acid reflux/GERD were to consider SN, would cimetidine then seem important?
I could speculate that it's to do with making sure one is completely out of it but I don't know beyond that.

Propranolol could definitely prove to be useful against tachycardia which is the compensatory mechanism that occurs due to the increased blood flow. I think it's viable if you can get it, there was talk of potentiating sn with it a few years back but recent changes left out prop as part of the regimen, although I don't think it should be since it doesn't seem to interfere with the process to such a degree that does warrant it being left out.

What if someone with gastric issues like acid reflux/GERD were to consider SN, would cimetidine then seem important?
Hmm, honestly if someone does have any of those issues then I suppose if they do want to still use sn then I'd say that it becomes rather important although only the individual knows to the extent of how beneficial something like Cimetidine can be. Otherwise if they opt out of sn then it makes sense why they would.
 
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