Author Topic: Did you take your meds today?  (Read 147438 times)

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Offline Lestat

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Re: Did you take your meds today?
« Reply #6270 on: August 21, 2016, 01:55:26 AM »
Not yet. Well, sort of.

Took a dose of what USED to be morphine, but that was turned into alpha-chloromorphide. Run out of chlormethiazole as I had to take an extra one the other day after having a seizure, and the myoclonus wouldn't stop, nor would the atonic 'drop attack' thing. Lucky I was on the sofa at the time, but I could barely move a muscle. EVENTUALLY managed to grab my bottle of chlormethiazole caps and take one, that brought me out of it pretty quick.

Lucky for me, I have some vitamin B1 pills, and I am currently working on turning those into more chlormethiazole to replace the one I used.,
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Offline renaeden

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Re: Did you take your meds today?
« Reply #6271 on: August 21, 2016, 05:33:41 AM »
If I am quite honest I am most surprised, nay, shocked, and appalled that it is still in use. All the APs are somewhat iffy, but haldol is specifically toxic in a malignant kind of way, not merely nasty but actual poison IMO. It has a toxic metabolite, HPP that gets metabolised by MAO-b (sorry but the MAOI you take is specific to the type A isoform) to a charged metabolite, HPP+ once uptaken by DAT into dopaminergic neurones, and thence goes about killing them. Can't leave the cell because its charged, so it gets stuck there frying the neurones. Nasty shit. Loperamide, the antidiarrhea drug does something similar, only the nasty metabolite, LPP/LPP+ is restricted to the periphery because p-glycoprotein, a multi-drug efflux pump localized to the blood-brain barrier craps it out again as fast as it can enter. In infants or baby swine whos BBB has not developed yet, loperamide is pretty toxic.
Would you happen to know of a substitute for haloperidol?
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Offline Queen Victoria

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Re: Did you take your meds today?
« Reply #6272 on: August 21, 2016, 09:10:46 AM »
+
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Offline Lestat

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Re: Did you take your meds today?
« Reply #6273 on: August 21, 2016, 01:08:28 PM »
Well what kind of an neuroleptic effects profile are you wishing to achieve? there are many, many alternatives.

Sedating? activating? describe what your after and what your on (all of it, so I can check interactions) via PM if you wish privacy. I'll then check the BNF and crossreference interactions.
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Offline renaeden

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Re: Did you take your meds today?
« Reply #6274 on: August 21, 2016, 07:11:12 PM »
Well, haloperidol is to ease tics. I'd like something else to do the same. Which means it will probably be seating. Are there activating antipsychotics? I take haloperidol, moclobemide and lithium at night and moclobemide, lithium (yeah they are split doses) dexamphetamine and benztropine in the morning.

Olanzapine, quetiapine and risperidone are a no-go. I don't want to get any fatter. I also can't have ziprasidone as I have heart trouble on that.
« Last Edit: August 21, 2016, 07:12:51 PM by renaeden »
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Offline Lestat

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Re: Did you take your meds today?
« Reply #6275 on: August 21, 2016, 07:40:37 PM »
Yes I was aware of the issues with geodon. Stuff has a black-box warning about long QT.

A good activating AP would be amisulpiride, its quite unique amongst the APs in that it has proglutamatergic effects via its GHB receptor agonism (yes, the same GHB as in, the stuff that is produced via base-mediated saponification and decyclization of gamma-butyrolactone) and is used under the name xyrem for narcolepsy. God, that was fucked up shit....used to do WAY too much of it back in the day, in my teens. Thinkng about that really brings back memories, of my very first synthesis in organic chem. It was GHB, for a very first o-chem project, thats what I chose, ring-opening of y-butyrolactone using caustic soda, to give GHB, its a simple mix in equimolar proportions, heat if needs be, and then evaporate on foil-lined baking trays (so as not to get the trays crusted with GHB and so as not to have to clean them much) and get product. Went like a charm first time, which helped boost my confidence that I could indeed get something done, and something I knew I could, even with at the time, minimal skills, teaching myself as I went on, succeed in doing. A positive result for a very, very first foray into organic work, well lets just say some encouragement and a success for the first time helps a lot in teaching someone they can succeed if effort is put in:)

Currently I'm busy working on making a batch of chlormethiazole, the anti-seizure drug I take (although its an off-label use, it bloody well works better than anything else I've ever tried), also a sedative-hypnotic, a barbiturate-site ligand and pretty effective in that too. Got the vitamin B1 filtering at the moment, then comes a chlorination with SOCl2, and subsequent cleavage to chlormethiazole using bisulfite or metabisulfite.

Thats the opposite way round to how its usually done, its usually cleavage first then chlorination with thionyl chloride, but this SHOULD I hope, simplify workup.

I'll look up APs in the BNF ren and see what comes up.
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Offline renaeden

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Re: Did you take your meds today?
« Reply #6276 on: August 22, 2016, 06:53:48 AM »
Many thanks, Lestat, for your suggestion so far. :)
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Offline odeon

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Re: Did you take your meds today?
« Reply #6277 on: August 22, 2016, 10:59:57 AM »
I did.
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Offline Queen Victoria

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Re: Did you take your meds today?
« Reply #6278 on: August 22, 2016, 04:25:30 PM »
Damn it, no.
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Offline Lestat

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Re: Did you take your meds today?
« Reply #6279 on: August 24, 2016, 09:59:41 AM »
Ren...also, btw, question? must it be an AP or would you try alternatives? none of those drugs are great for the brain and its tissue.

And do you know if there is any specific and definable biological, physiological cause of the tics? The more I know the better any chance of my being capable of assistance:)

What I'd be inclined most to do, is to try and drop the AP, without actually not collecting the scripts for it, that way everything is, and remains, at your discretion entirely, and not your doctor's choosing, that way he may not choose an outcome or method of reaching a given outcome that you are not prepared to tolerate.

If it doesn't work out, then re-add the stuff at whatever dose you originally started on, as long as it is not greater than what you are on now.  Since you only take 5 mil, a very small dose compared to what might be used to turn schizophrenics from psychotics into vegetables or to incapacitate an acutely violent fruitbin in a psych ward when the crowd of burly men and/or skinhead women with voices that sound like a loud-hailer chewing powdered bullets and glass shards who make the butch-est bulldyke lesbians look like willowy, uber-feminine supermodel girls with an anorexia problem so severe they eat only once every other decade (:(:(:(:()***and (the straitjacket-bearers) who's one and only contribution to femininity is the lack of possession of a Y-chromosome and not being in fact not biological life at all but in fact, a disguised android controlled by algorithms in lieu of personality sensu stricto.

Then I am of the inclination to think that you could easily drop the haldol entirely at once, or if you don't feel comfortable, then half it for a few days first, and then do so, or even do it by knocking quarters off, taking a few days in between each time if you are extremely sensitive and feel through personal familiarity with how the noxious muc...errr...drug, sorry, ahem:P affects you personally.  Likely as not though you should be able to do it with absolutely minimal side effects.

You may or may not wish to lower (in the short term only) the moclobemide, but it shouldn't be needed, but only in the case of dopaminergic rebound effects from the removal of the haloperidol that are perceived as unpleasant by you. BUT, only if it A-happens and is B-not pleasant. That said, it shouldn't make a difference much, because moclobemide is an inhibitor of the type A isoform of monoamine oxidase, and MAO-a metabolises primarily serotonin and noradrenaline, paying much less attention so to speak, to chewing up dopamine and spitting out the pieces whilst with MAO-b its mostly DA this isoform is interested in munching on.

As for my meds, just took some pantoprazole, a proton-pump inhibitor (decreases stomach acid secretion), along with pramipexole, a dopamine agonist, gabapentin-for neuropathic pain, which does not respond well to opioid painkillers, cimetidine-again for my guts, for acid reflux and I take it for a dual reason: I originally was scripted its close relative, ranitidine but had my doc change the rx to cimetidine, for unlike ranitidine, cimetidine is a reasonably strong substrate&inhibitor of hepatic cytochrome P450-3A4 and CYP-P450-2D6, enzymes that metabolize and destroy morphine and oxycodone, so the cimetidine enables a given dose of either painkiller to both hang around in the body longer, in greater quantities and in essence, work harder, more bang for the same buck. My GP was most surprised to hear me making that suggestion, because he had no idea about the existence of that little trick, he gave me a look of total surprise, and asked me why I was telling him to change from ranitidine to cimetidine, because generally speaking the two drugs are regarded as being functionally identical, and surprise turned to astonishment as I explained to him my reasoning for the change. That was kinda hilarious, but it was good that I was able to educate him and pass on some of my knowledge in a way that could be used to help other patients of his in the future.

He was like 'how on EARTH did you know THAT; *I* had no idea you could even DO that!!!; and then went on to first fill the prescription asked for, and then change my regular repeats so cimetidine would be on them in the future from then on and ranitidine would be replaced. It works nicely, actually, makes my morphine (and to a lesser extent, oxy) both last a fair bit longer and take considerably greater effect, cracking the whip and yelling 'get the fuck back to work, bitches, who said you could rest you pair of lazy maggots! *THWACK!*:D

Quite a funny appointment, and from then on, its definitely done the job, not only for my stomach, for which ranitidine worked, but to drive my painkillers like a pair of slaves in the poppy-plantation like an overseer with his whip.:autism:

And should I indulge in drinking and eating those perennial favourite treats of mine, tinned grapefruit segments in grapefruit juice, and cartons of  grapefruit juice with the pulp and the bits left in the juice, those contain flavonoids, terpenoids and such that serve as not just an overseer and his whip, but an entire squad of particularly foul-tempered, brutally sadistic overseers with not just whips but electrified cattle-zapper shock prods, whipping zapping, shocking, jolting and tanning the backsides of the poppy-plantation slave-workers and giving mr.morphia and mr.oxy not a minute of rest, so that the plantation owner (me, in other words) can sit up on the porch of his cabin with his feet up on his  soft, comfy leather sofa with a cold glass of ale and a smoke, and rest all day, aside from when he needs either drop a log, piss, put food in his mouth, hike through the woods, or of course, and this is when rest is as scarce a commodity as its ever going to get, head on into his pride-and-joy, namely, his lab in order to work upon whatsoever of his personal projects as the mood may take him in any given moment:autism:
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Offline odeon

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Re: Did you take your meds today?
« Reply #6280 on: August 24, 2016, 12:08:45 PM »
Thankfully, yes.
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Offline Queen Victoria

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Re: Did you take your meds today?
« Reply #6281 on: August 24, 2016, 02:48:01 PM »
+
A good monarch is a treasure. A good politician is an oxymoron.

My brain is both uninhibited and uninhabited.

:qv:

Offline renaeden

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Re: Did you take your meds today?
« Reply #6282 on: August 24, 2016, 10:57:10 PM »
Ren...also, btw, question? must it be an AP or would you try alternatives? none of those drugs are great for the brain and its tissue.

And do you know if there is any specific and definable biological, physiological cause of the tics? The more I know the better any chance of my being capable of assistance:)

What I'd be inclined most to do, is to try and drop the AP, without actually not collecting the scripts for it, that way everything is, and remains, at your discretion entirely, and not your doctor's choosing, that way he may not choose an outcome or method of reaching a given outcome that you are not prepared to tolerate.
Since I'm mainly looking for something to help tics, I am not that fussed about it being an antipsychotic. Though they are what is prescribed for tics. I have seen a few people on tv with pretty bad tics and wonder what they take - if anything - for them. They all have Tourettes though, I don't have that.

I don't know the cause of my tics. My first one was when I was 5. Squinting my eyes shut all the time. Since I had just had eye surgery, it was blamed on that. I was simply told off for others I had and I learnt to hide them.

I have had one where I tense all my neck, back and side muscles all the time. For years. That's what I first told my psychiatrist about because it kept me awake at night, really annoying. So I went on a low dose of haloperidol and it worked well. 3mg I think. Then in 2014 I got a breathing tic which stopped me from breathing out properly so the haloperidol was raised to 5mg. It worked. I haven't had that problem since then. This is the second time I've been on haloperidol. The first time I came off it was to try ziprasidone, which also worked. I ended up having a manic episode when I first went on that. It lasted 3 weeks. I had an awesome time. It was around Christmas and for the first time I enjoyed being around my family and going Christmas shopping. Then, mid-January I was back to being flat me again. Oh well.

I think I was on ziprasidone for 2 years. I was on quite a high dose of it. My psych didn't say anything about getting an ECG  to check how my heart was doing on it. That happened in hospital and they were quite alarmed about it.

When I first came of haloperidol to go on ziprasidone, I felt sick for a week. Very unpleasant.
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Offline odeon

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Re: Did you take your meds today?
« Reply #6283 on: August 25, 2016, 12:23:01 AM »
About to.

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Offline "couldbecousin"

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Re: Did you take your meds today?
« Reply #6284 on: August 25, 2016, 08:26:43 AM »
  Yes I did.  It's going to be a pleasant day at home.  8)
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