Discussion Metoclopromide akathisia

[Topaz111]

I've used metoclopromide before.
I took 10mg 3x a day for GERD.
A couple times I took two doses too close together (6 hours apart instead of 8) and experienced mild akathisia symptoms. I had to constantly move my legs, it was like RLS while being awake, I couldn't stop.
Thankfully it went away, but I really worry.. if I already experienced such effects from taking 2 pills 6 hours apart, how much worse will the involuntary movements be when I take 3 pills at once? I worry I will get severe involuntary movements, tremors, restlessness, then panic and stop the attempt and even possibly have permanent akathisia.
I also get horrible drowsiness and depression/anxiety from meto too so I am reconsidering this..
I can handle a single dose, I used to take it occasionally for nausea too and while the side effects are miserable, even just 10mg was highly effective for nausea for me.
Idk, it's sorta silly I am more afraid of how my body will react to 3x10mg of meto than how it will react to SN.. possibly because once I take the SN there is nothing else I have to do and just need to lay down and stay calm

 

[Endisclose]

I've used metoclopromide before.
I took 10mg 3x a day for GERD.
A couple times I took two doses too close together (6 hours apart instead of 8) and experienced mild akathisia symptoms. I had to constantly move my legs, it was like RLS while being awake, I couldn't stop.
Thankfully it went away, but I really worry.. if I already experienced such effects from taking 2 pills 6 hours apart, how much worse will the involuntary movements be when I take 3 pills at once? I worry I will get severe involuntary movements, tremors, restlessness, then panic and stop the attempt and even possibly have permanent akathisia.
I also get horrible drowsiness and depression/anxiety from meto too so I am reconsidering this..
I can handle a single dose, I used to take it occasionally for nausea too and while the side effects are miserable, even just 10mg was highly effective for nausea for me.
Idk, it's sorta silly I am more afraid of how my body will react to 3x10mg of meto than how it will react to SN.. possibly because once I take the SN there is nothing else I have to do and just need to lay down and stay calm

How long after the second pill did you experience the akathisia?

 

[Macedonian1987]

I've used metoclopromide before.
I took 10mg 3x a day for GERD.
A couple times I took two doses too close together (6 hours apart instead of 8) and experienced mild akathisia symptoms. I had to constantly move my legs, it was like RLS while being awake, I couldn't stop.
Thankfully it went away, but I really worry.. if I already experienced such effects from taking 2 pills 6 hours apart, how much worse will the involuntary movements be when I take 3 pills at once? I worry I will get severe involuntary movements, tremors, restlessness, then panic and stop the attempt and even possibly have permanent akathisia.
I also get horrible drowsiness and depression/anxiety from meto too so I am reconsidering this..
I can handle a single dose, I used to take it occasionally for nausea too and while the side effects are miserable, even just 10mg was highly effective for nausea for me.
Idk, it's sorta silly I am more afraid of how my body will react to 3x10mg of meto than how it will react to SN.. possibly because once I take the SN there is nothing else I have to do and just need to lay down and stay calm

That's why it is recommended to take hefty dose of benzos just 15-20 minutes before taking the 30mg of meto. The benzos will negate much of these side effects. Just don't take too much benzos as you may fall a sleep mid-protocol.

 

[Aflame5926]

How long after the second pill did you experience the akathisia?

what is akathisia exactly? is it a side effect of meto??

 

[Topaz111]

How long after the second pill did you experience the akathisia?

Sadly I don't remember, it was the same day, it wasn't as soon as I took it, it must have been at least 30 mins? Or longer

what is akathisia exactly? is it a side effect of meto??

It is a really bad side effect of meto, not everyone gets it though of course. Restlessness, repetitive movements, inability to sit still.

 

[Suizident]

What are you planning to do with Meto? Take SN?

In that case, shouldn't the side effects of Meto be the least of your worries?

 

[Topaz111]

What are you planning to do with Meto? Take SN?

In that case, shouldn't the side effects of Meto be the least of your worries?

I am planning to take SN, but I am geniuenly more afraid of 3xmeto. Perhaps it's because I already experienced a touch of what it feels like and that's why. Also I have propranolol so that should ease the unpleasant heartbeat symptoms. I will feel the effects of SN far shorter than I will feel the meto too.
Idk, anxiety is not always the most logical thing ever

 

[dirkw83]

Honestly I really doubt you had akathisia, it's a very severe feeling of unrest from within. You probably had your nerves affected by it and temporarily suffered some increased nervousness or something. I'm not a doctor but I know that akathisia mainly stems from prolonged exposure to first gen antipsychotics, benzos can also trigger it. Anyway I'm not trying to dismiss your concerns, mainly just sharing my point of view on it.

 

[Topaz111]

Honestly I really doubt you had akathisia, it's a very severe feeling of unrest from within. You probably had your nerves affected by it and temporarily suffered some increased nervousness or something. I'm not a doctor but I know that akathisia mainly stems from prolonged exposure to first gen antipsychotics, benzos can also trigger it. Anyway I'm not trying to dismiss your concerns, mainly just sharing my point of view on it.

I was on 10mg 3x a day for 10 days, it wasn't just from a one time dose.
Akathisia can be caused by antipsychotics, but metoclopromide is another substance that can cause it albeit it's far more likely if you take it long term, that's why doctors are advised to only perscribe it for a few days.
The pamphlet that comes with the drug says to keep at least 6 hours between doses to avoid an overdose and that if you take more than recommended you may experience extrapiramidal symptoms.
Extrapiramidal symptoms can also occur even at therapeutic doses, even from a single pill if you are unlucky enough.
This is literally info from the manufacturer themselves.
Side effects from meto can be really severe and I think people should always read the paper included with the drug to know the risks, especially since people often don't follow through and they should be aware of the possible effects of the drug if they don't end up commiting with SN.

 

[Aflame5926]

I was on 10mg 3x a day for 10 days, it wasn't just from a one time dose.
Akathisia can be caused by antipsychotics, but metoclopromide is another substance that can cause it albeit it's far more likely if you take it long term, that's why doctors are advised to only perscribe it for a few days.
The pamphlet that comes with the drug says to keep at least 6 hours between doses to avoid an overdose and that if you take more than recommended you may experience extrapiramidal symptoms.
Extrapiramidal symptoms can also occur even at therapeutic doses, even from a single pill if you are unlucky enough.
This is literally info from the manufacturer themselves.
Side effects from meto can be really severe and I think people should always read the paper included with the drug to know the risks, especially since people often don't follow through and they should be aware of the possible effects of the drug if they don't end up commiting with SN.

no doctor or anything but can you maybe supress it with an opiud?

 

[Topaz111]

no doctor or anything but can you maybe supress it with an opiud?

Opioids slow gastric emptying which can be problematic with SN method, also, super hard to obtain legally, especially as a 23year old with mental issues.
I guess I'll just have to take a risk or try hanging again instead

 

[Endisclose]

I was on 10mg 3x a day for 10 days, it wasn't just from a one time dose.

Wait.. so you took it for 10 days? Do you remember on which day you had these symptoms?

As per my research EPS with meto occured mostly with IV administration. I remember reading about 1 case where it occured on the second 10 mg dose with IV. I have read of at least 1 case where it did occur with a pill intake. But don't think there were any details as to how many doses later it happened.

Also from what I've read, the stat dose leaves more meto in the system compared to the 48 hour regimen which I think is more risky in terms of EPS. It usually takes time for the EPS to manifest. I thought 1 hour after the stat dose should a safe enough period.

There have been people who have taken the stat dose of meto without reporting any major symptoms. Possibly body weight might also have something to do with it. The closer one is to one's normal body weight, I think the lesser may be the chance that one experiences EPS. I came across one case of a person on this forum who was underweight about 47 kgs who reportedly experienced mild to moderate EPS symptoms after the stat dose.

As regards the 2nd cup of SN, I think it may only be needed if the vomiting is immediate. Even with a mega dose of benzos, one would remain conscious for at least 5 to 10 mins until it is absorbed by the body. If vomiting is immediate or if it takes place within that period, one can take the 2nd cup. Even if vomiting takes place after say 5 or 10 mins, IMO enough SN should have been absorbed by the body for purpose of CTB.

The standard dose is 25 g. As per reports even 2 g has been fatal. 4 g has a much greater chance. After vomiting, all that needs to remain in the body, has to be around 4 or 5 g. TOD might be a bit longer like if 25 g takes 40 mins maybe 4 g might take 6 times longer? so maybe 240 mins - possibly around 4 hrs?

I think it's just SI related anxiety that causes one to think about failure because of possibly not taking the second cup in case of vomiting. Well what happens if the second cup was vomited? There can always be the apprehension that one won't be there for the third cup or the fourth cup and so on ad infinitum..

If vomiting takes place immediately or within 5 mins it's better to take the 2nd cup. I think it should be fine otherwise. I think one must just keep air sickness bags ready and if it happens beyond the 5 to 10 min period, maybe one should just see if one can take the 2nd cup, if one isn't able to reach for the 2nd cup, one shouldn't panic and just go to sleep. Chances of waking up from that are pretty slim IMO.

 

[Topaz111]

Wait.. so you took it for 10 days? Do you remember on which day you had these symptoms?

As per my research EPS with meto occured mostly with IV administration. I remember reading about 1 case where it occured on the second 10 mg dose with IV. I have read of at least 1 case where it did occur with a pill intake. But don't think there were any details as to how many doses later it happened.

Also from what I've read, the stat dose leaves more meto in the system compared to the 48 hour regimen which I think is more risky in terms of EPS. It usually takes time for the EPS to manifest. I thought 1 hour after the stat dose should a safe enough period.

There have been people who have taken the stat dose of meto without reporting any major symptoms. Possibly body weight might also have something to do with it. The closer one is to one's normal body weight, I think the lesser may be the chance that one experiences EPS. I came across one case of a person on this forum who was underweight about 47 kgs who reportedly experienced mild to moderate EPS symptoms after the stat dose.

As regards the 2nd cup of SN, I think it may only be needed if the vomiting is immediate. Even with a mega dose of benzos, one would remain conscious for at least 5 to 10 mins until it is absorbed by the body. If vomiting is immediate or if it takes place within that period, one can take the 2nd cup. Even if vomiting takes place after say 5 or 10 mins, IMO enough SN should have been absorbed by the body for purpose of CTB.

The standard dose is 25 g. As per reports even 2 g has been fatal. 4 g has a much greater chance. After vomiting, all that needs to remain in the body, has to be around 4 or 5 g. TOD might be a bit longer like if 25 g takes 40 mins maybe 4 g might take 6 times longer? so maybe 240 mins - possibly around 4 hrs?

I think it's just SI related anxiety that causes one to think about failure because of possibly not taking the second cup in case of vomiting. Well what happens if the second cup was vomited? There can always be the apprehension that one won't be there for the third cup or the fourth cup and so on ad infinitum..

If vomiting takes place immediately or within 5 mins it's better to take the 2nd cup. I think it should be fine otherwise. I think one must just keep air sickness bags ready and if it happens beyond the 5 to 10 min period, maybe one should just see if one can take the 2nd cup, if one isn't able to reach for the 2nd cup, one shouldn't panic and just go to sleep. Chances of waking up from that are pretty slim IMO.

I believe it was day 2? 5th dose I think
My gastrologist told me to take it 3 times at day before mealtime, but when I did so the spacing between doses was too short. After I got symptoms I reread the pamphlet, noticed the part about needing to wait a certain amount of time between doses, I adjusted my schedule to take them farther apart and I never had issues with extrapiramidal effects after that.
I think I was 56kg back then? Also I'm female if that matters

 

[Endisclose]

I believe it was day 2? 5th dose I think

This is actually not bad. At least it wasn't right away..So there appears to be some tolerance in the body to it. It might be a good idea to just give a long hiatus and then try and take the stat dose and see if there are any symptoms. If one hasn't taken it ever, I think the stat dose shouldn't pose a problem at least for an hour. I am not so sure if it has been taken already especially if symptoms were experienced.

My gastrologist told me to take it 3 times at day before mealtime, but when I did so the spacing between doses was too short. After I got symptoms I reread the pamphlet, noticed the part about needing to wait a certain amount of time between doses, I adjusted my schedule to take them farther apart and I never had issues with extrapiramidal effects after that.

That's heartening to know that you didn't have any further EPS, my hunch is you should be OK.

I think I was 56kg back then? Also I'm female if that matters

Yes. Both of those would matter very much. Might well be the reason. Do you know how much you're supposed to weigh for your age and height?

 

[Topaz111]

This is actually not bad. At least it wasn't right away..So there appears to be some tolerance in the body to it. It might be a good idea to just give a long hiatus and then try and take the stat dose and see if there are any symptoms. If one hasn't taken it ever, I think the stat dose shouldn't pose a problem at least for an hour. I am not so sure if it has been taken already especially if symptoms were experienced.


That's heartening to know that you didn't have any further EPS, my hunch is you should be OK.


Yes. Both of those would matter very much. Might well be the reason. Do you know how much you're supposed to weigh for your age and height?

The events I am describing happened about 3 months ago so it's been a while.
I checked and 56kg is normal weight for me to be.

 

[Endisclose]

The events I am describing happened about 3 months ago so it's been a while.

I think it maybe a good idea to wait another 3 months, then possibly try the stat dose and see what happens

I checked and 56kg is normal weight for me to be.

From what I've read the standard SN dose of 25 g is for a person of weight around 75 kgs. The stat dose of meto might also be recommended for and be better withstood by someone in that weight range IMO. It wouldn't hurt to put on some weight I guess..I am told meto is the most efficient among the AEs.

The alternative to meto is domperidone and that works pretty well too if one has got apprehensions about meto. I know of 2 successful cases of CTB where 48 hr regimen of domperidone was followed. So maybe using domperidone, adjusting dosage of SN as per weight might be a safer alternative from an EPS point of view.

 

[Topaz111]

I think it maybe a good idea to wait another 3 months, then possibly try the stat dose and see what happens



From what I've read the standard SN dose of 25 g is for a person of weight around 75 kgs. The stat dose of meto might also be recommended for and be better withstood by someone in that weight range IMO. It wouldn't hurt to put on some weight I guess..I am told meto is the most efficient among the AEs.

The alternative to meto is domperidone and that works pretty well too if one has got apprehensions about meto. I know of 2 successful cases of CTB where 48 hr regimen of domperidone was followed. So maybe using domperidone, adjusting dosage of SN as per weight might be a safer alternative from an EPS point of view.

I can't put on weight even though I actually want to lol
My GI issues are so bad I'm struggling to keep my weight from dropping further tbh
When I got perscribed the meto I got it for GERD (to speed up gastric emptying) and GERD associated nausea. The nausea got better instantly from the very first dose, completely gone, prokinetic effect took about 3 days to work though.