Yeah they blow ass.
Just woke up. Although without problem. *more pill-swallowing*
One ironic-annoying thing is the antiseizure med I use for prevention and that I get an extra additional script now (after some pressing and having to see more than one doctor to get it, stupidly, on their part I mean, the ones that would not comply and expected me to have to use my preventative med to relieve, leaving me low every time I had to respond. The docs before expected me simply to go without or do nothing and suffer the fucking seizures) is a pretty potent sedative too. And its of intermediate duration of action, about 5-6 hours or so.
Although not actually licensed here for seizure control, I find its what works, and it does, pretty well and whats more it works really well for responding to them in particular because it works REALLY quickly. If you've ever drunk strong alcoholic spirit, you'll notice how it comes on minutes after swallowing it, and is absorbed fast as hell? this stuff is the same in that respect, soon as it gets inside one, it starts acting, and its very, very lipophilic and rapidly absorbed, takes about as long as is needed for the gelcaps to break open for it to work, which if I have a seizure is just what I want, to give it the equivalent of a double-barreled shotgun, both barrels to the face at point blank range with solid slug round, and this med, chlormethiazole is pretty much just that, a 10-bore shotgun, both barrels in the face and a big mess left of whatever its fired at, in not very much time whatsoever.
And whilst other sedative-hypnotic type meds are used (like valium/diazepam, its pretty much world standard, as according to WHO-essential medications list for any country as part of the fundamental set needed for a functioning health system for that reason) this one isn't licensed for seizure control here, but unlike benzos, although with a physical dependency either would produce the withdrawals from hell, and dangerous ones at that, fatal in severe cases, chlormethiazole, I've found is oddly un-prone to producing a physical dependency.
I've used it for years, daily, several times a day, day in-day out and there are no withdrawals at all, no physical habituation has resulted from its use for seizure control (and even taking more on top of that when counting what I now have as a response-pack of extras) and I can go several days, more than long enough to flush any hanging about in body fat (and I've got next to nothing in that department, I'm built like a length of wire with the insulation stripped off it and if anything just a spray-coat of epoxy on the outside for insulation) and still no problems directly resulting from the drug itself.
From lacking it, potentially in that I'd not have the seizure coverage its there to provide, but no actual withdrawals stemming from abruptly stopping it. Any benzo like diazepam/valium and I'd end up in hospital if I did that long enough to flush much of it out of me. And it'd be a living hell at that. Really quite surprised me, considering they both work as GABAa receptor positive allosteric modulators, but in the case of chlormethiazole the binding site is different (GABAa has many, many many subtypes sensitive to different things at different areas, with binding sites for various different benzodiazepines, the Z-drugs like zolpidem/ambien and its weird ass relatives, the GABA binding site itself, targeted by the ph-so-weird stuff muscimol, from those famous red capped Amanita muscaria with the white warts on the cap and the little gnomes with their fishing rods sat on top, and weird dissociative-trance inducing-hallucinogenic effects in larger amounts after being cured to render it safe to consume and remove a neurotoxin, and in lesser amounts both a restorative herbal medicine with many uses and also in sub-clinical/psychotropic effects, again after being cured, a rather special little seasoning/spice that works wonders with red meat dishes,
and the receptor complex, consisting of 5 sections, as a heteropentameric protein that forms a central ion channel (conducting chloride) out of a selection of an alpha subunit, a beta subunit (this being the minimum in the throw-together of subunits that make up a human GABAa receptor sensitive to GABA [the neurotransmitter gamma-aminobutyric acid, inhibitory in nature], GABA itself binding at the interface between alpha and beta, and the typical, most common type containing two alphas, two betas and a gamma, benzodiazepines binding at the interface between the beta2 and an alpha subunit, with their being alpha-types 1 through 6; beta having three subtypes 1-3, three types of gamma subunit, a delta, an epsilon, a pi and a rho-subtype (Rho-subunits are odd, in that they form a distinctly different type of GABAa receptor not always termed such, are found mainly in the retina of the eye and they assemble into functional GABAa-rho homomeric channels that are insensitive to many classic ligands used to define GABAa receptors, so are sometimes known as GABAc receptors (GABAb is different from either GABAa types of any isoform, or GABAa-RHO/GABAc, whatever you call the bugger, in that GABAb is a metabotropic, GABA-sensitive inhibitory receptor [typical agonists are baclofen, phenibut and the drug GHB, used both recreationally and for treating narcolepsy], metabotropic receptors relying on the activation of intracellular messenger cascades to produce their effects, and thus are slower to respond than the other primary receptor type, the ionotropic receptor, which form ion channels and as such directly couple to the modulation of ion-flux and produce faster, shorter responses whilst metabotropic types produce slower to initiate but longer responses), the GABAa receptor and GABAa-Rho (aka GABAc) are both ionotropic receptors)
And two of the most well known GABAa positive allosteric modulators (an allosteric modulator, from the greek 'allos' (other) and I don't know the root word in greek but 'steric' means 'space', so 'other/alternate space' essentially, is a site other than that which the main neurotransmitter binds in a receptor complex, that when a modulator is present, which can be either negative or positive, the former lessening the effect of the binding of the neurotransmitter or exogenous drug, and the latter increasing it, the term for sites binding the neurotransmitter associated with the receptor type, I.e GABA in GABA receptors, glutamate for glutamate receptors, acetylcholine in muscarinic and nicotinic acetylcholine receptors, or butyrylcholine, is an orthosteric receptor) are benzodiazepines, like valium/diazepam, temazepam, lorazepam/ativan, clonazepam/klonopin, alprazolam/xanax and many, many others, like the nitrazepam (mogadon, or moggies for short) that I have a script for and use occasionally, mostly for those days I seem seizure-prone and that that day is one I have to continually be on my guard against and have to fight off seizures, originally given it for anxiety, but whilst they REALLY should never have let a med like that just be forgotten about and put on repeat scripts indefinitely save only for epilepsy treatment in certain cases, never for sleep or anxiety as I was, I haven't said anything because its also an anticonvulsant and also has a very long duration of action, but I never use it more than a small handful of days in a row, before dropping the dose for one day then stopping and leaving it as long as practical before its used again. And because some people find benzos very abusable, many also finding them addictive psychologically and that physical addiction to them is hideous, at its most pleasant, people who have experienced both say universally they'd take heavy-duty cold-turkey heroin withdrawal over even moderate benzo WD many times over, its that bad. I've experienced it mildly when treated with a short duration one once, and ended up having a seizure in a GPs office because of it, and christ was the taper even, fucking awful to go through and that was only from low dose ativan/lorazepam) they are typically, with the exclusion of people who either won't be intended to stop the drug because of epilepsy and its being used for maintainance, or on long, slow tapers, are intended only to have the benzo they get for either occasional use, when they can't cope with panic attacks etc. or for short-term (a couple of weeks tops) treatment of insomnia when it gets crippling in severity.
I got given the nitrazepam for anxiety after a wrongful arrest, and illegal search warrant and raid executed on my home, with a lot of some really fucked up abuse by the filth, as well as outright thefts (such as for example, whilst claiming to be looking for chemicals of a couple of specific types, neither of which being a crime to have in the first place, such things as precious gemstones were stolen from me, not listed as seized, just taken, made to 'disappear', after being tortured by them (I am not joking, I mean it literally and I am deadly fucking serious, that is exactly what they did whilst they had me in custody in their pig shop)
Got given it whilst they tried to break me with the threat of action (I was never even charged, they just held it over me for months, whilst having precisely no evidence of anything whatsoever) and worse, by my GP for anxiety, and whilst I planned to just go in as and when I needed it, shortly before not having any left, so I'd always have some for when I really did need one, instead I got, to stop me going in so regularly for an appointment, just given a twice-daily script on repeat.
The cause for my needing some is long gone, but the script remains regardless. But I'm saying nothing, because to get any on request, because people can abuse them etc. is very difficult and many if not most doctors will tell a patient to piss off without even thinking about why they need them or for how long, many just say 'I don't prescribe those drugs to patients', because of a personal dislike for their use at all, which IMO is negligent too, but so was leaving me on the repeat, with instructions to take them twice a day. If I HAD taken them as prescribed, I'd be physically dependent without a shadow of a doubt, and within a few weeks at the longest.
Yet the chlormethiazole I take, it too binds the GABAa receptor as an allosteric modulator, like the much more powerful, and more dangerous in overdose by FAR, barbiturates, most of those now having been discontinued, save for surgical anaesthesia induction and the very long acting indeed one phenobarbital, aka phenobarbitone, or for short, just phenobarb or 'pheno' which is used for epilepsy. Those are monsters for withdrawals, and deadly in overdose whilst the benzos, alone without other sedatives or depressants, in even large overdoses tend just to make the person who does so fall asleep for a long, long time, knocked out cold, but once they get it out of their system they come round.
Barbs? (and chlormethiazole, which binds to the barbiturate recognition allosteric site at GABAa too), one OD, even a not very large one, and your likely to end up dead, and lucky if you don't. But they ARE effective, very effective. And yet chlormethiazole has proved both effective, and used, albeit off-license, for my seizure control, to allow me the continual use of it at this dose without any physical habituation or dependency. And as such, for the combination of its being A-extremely effective and reliable, a real heavyweight slugger of a med of its action-type, the kind that can go a full set of rounds in the ring with the medical problem equivalent of mike tyson on steroids and just flick the problem away like an irritating mosquito, and B-extremely fast acting, which I need for this use of course, as well as C-the most welcome complete absence of my having any habituation to it, which actually really shocked me when I found out, after having to go without after having stomach troubles and vomiting some of the capsules up, leaving me short for a few days without any, and yet, as well as when testing it later, voluntarily holding back on it to see if there wasn't a problem and that was a pattern or a one-off for some reason, taking nothing else that would interfere either positively or negatively, it did indeed prove to be without issue.
The degree of safety and stability that gives me in the case of an emergency loss such as through stomach issues and doctors telling me thats not a good enough reason for not having any, because I vomited them up and into the toilet (what am I meant to do? try and fish them out of the puke filled bog? pour chloroform into the toilet, and vacuum-distill out the few hundred mg of chlormethiazole from a bowl full of stomach contents, piss, shit and bogwater? sometimes I think that some doctors need to really not just reexamine their priorities and expectations but to take them and shove them so far up their asshole they choke to death on them. I've not actually had them say so, but they in many cases have behaved like they expect me to go make my own. I could do, and indeed I've done that synthesis. Its easy, thiamine/vitamin B1 is cleaved into a water soluble pyrimidine compound and a poorly or insoluble 4-methylthiazolyl-2-ethan-1-ol using sodium metabisulfite [can be had from a beer or winemakers hobby shop] in water, the solution cooled and filtered, before washing free of residual bisulfite with ice-cold water, the thiazol-2-ethanol derivative is then dried, and in whatever suitable solvent one chooses, methylene chloride works nicely, chlorinated using thionyl chloride, ideally, which is perfect for this synthesis as its breakdown products are gaseous, and then the dichloromethane, chloroform or whatever you used stripped, using a water aspirator vacuum to vacuum-distill the freebase chlormethiazole. The SOCl2 is difficult for many to buy but it can sometimes be had on ebay for those without connections, or in the form of lithium-thionyl chloride batteries, a specialist type of battery, also available on ebay, although the SOCl2 needs distilling, in a very carefully dried environment because its violently water-reactive and decomposes to SO2 and HCl gases, and fumes in air doing the same, although without violence, due to atmospheric water vapor.
So it COULD be done with beer-making preservative, vitamin B1 pills and batteries, with some basic glassware, as well as some dichloromethane and some calcium chloride or other dessicant to put in the drying tubes, gloves, a gas mask with acid gas filter or doing it carefully outside to avoid the SOCl2 fumes and the HCl and SO2 given off when it hydrolyses. But should a fucking medical patient be expected to both fund the entire thing themself, AND go buy the batteries or preferably, lab grade thionyl chloride, a load of vitamin B1, the winemakers-preservative (metabisulfite), the solvent, the glassware if they don't have it already and teach themselves from scratch how to do a vacuum distillation if they don't already know how?
I think that is asking quite a lot too much of any patient, just because they have stomach problems and need 6 to 9 capsules of an essential medication to prevent them having a seizure to cover them from a friday afternoon to the coming monday morning, no? and some doctors wonder why I get snarky with them??
Ironically the main doctor, my personal one at that clinic, is the one who knows most about my abilities as a chemist, and he is the one who will not fail to help me in such a situation! the other one who knows I'm a chemist, she has helped me at times and others not, without much if any difference between situations, seemingly depends wholly on how she feels that particular moment, maybe so little as if she had her morning cup of coffee hot enough or enough milk on her fucking breakfast cereal.
And others, who've outright screwed me, and whilst not knowing I actually did indeed have the skills and chemicals and equipment to do exactly that, doubtless thinking I was just being snarky when I ASKED them 'what?!? do you actually expect me to go home, take out laboratory equipment and dangerous, corrosive, acid-fuming, violently water reactive and above all EXPENSIVE chemicals, at a time I am particularly seizure-liable, and instead of your printing off a prescription for just enough of what keeps me safe and healthy to last until this coming monday [asked on a friday, late, so literally two and 1/3rd of a days essential pills for that one single medication], and produce it myself?'
They just looked at me funny like I was taking the piss. Until I said something like 'so I'm to go home, seizure prone, take out my expensive and delicate glassware, extract vitamin B1 from pills I barely have the money to buy, crack it into pyrimidine crap and 4-methylthiazole-2-ethanol, then chlorinate this, whilst, I'll remind you, I am trying to fight off having a fucking seizure, and vacuum-distill the product, find some sort of herbal rubbish from a health food store that comes in gelcaps, pack my own gelcaps of the finished medicine and swallow them???'
Responded to by 'I can't answer that/won't answer that', when they realized that it wasn't snark, but I was actually asking a question of them. Albeit a serious question in snark's clothing. With a hefty serving of snark-tar sauce to go along with it. But they did realize after I actually snarked out the outline of the procedure itself that I actually WAS going to that dr appointment in the hope I could instead, go a few minutes out of my way to a pharmacy and hand over a fucking prescription form to stay whole and healthy, not have to spend the rest of the day and into the night working on making my own just for the 'privilege' of not having a twatting well seizure....
I'll admit one thing though, the look on the face of the incompetent and tightfisted, miserable prick of a doctor that did that to me, when they realized that I wasn't ONLY taking the piss, but if they refused me, thats exactly what they were forcing me into doing, that was priceless. One of said doctors was a black, and christ, they might as well have been an eskimo at the end of that appointment, they'd practically turned pale enough to see it. Any paler and I'd have drowned them in bleach to make them a paler shade of 'your saying your going to WHAT?....'
'does it SOUND like I am joking?, and thanks a mother fucking bunch for wasting my time and forcing me to waste valuable chemicals and putting my health at risk, god damned fuckin' bitch'
*and black doctor transitions to one so ghostly 'just-swallowed-a-dog-turd' pale, that adolf hitler would have put them in a breeding program and started putting his 'aryans' in death camps for not being white enough*
Times like that, as far as I'm concerned, any on the job stress and grief a doctor gets from me, if they do that to me, they are bringing it down on their own heads, I'm merely the shelf with the big heavy priceless ming china vase full of red hot bricks on it that they tip over and make drop on their own head, metaphorically speaking. I might clothe the bollocking from hell in verbal form and choose the languages some of the more offensive things are said in whilst walking out, but in reality, the rightful fury and anger was already there loaded into the shell casings, it just needed a doctor to be a suitable asshole to load them into the right caliber of patient-cannon, and them to put the barrel in their mouth and shit on the trigger.
When somebody ACTS like a bastard, and shits on somebody from on high, chances are that somebody is going to acknowledge the fact and TREAT them as a bastard, and shit on them in return.
(metaphorically, I mean. I've never actually pulled my Y-fronts down, stood on a GP's desk and crapped on their knees)
Not yet, anyway.
