Diltiazem + propranolol + metoclopramide (+amitriptyline as failsafe) = surefire "legal" online pharmacy-obtainable combo

[Egg]

An overlooked but seemingly highly effective option that can be obtained as oral tablets via online pharmacies is Diltiazem + propranolol. A couple of other elements are added for safety (anti-emetic and sedative).

Diltiazem in combination with propranolol will stop the heart in a painless way, metoclopramide will eliminate nausea and amitriptyline as a failsafe sedative seems like a surefire combo.

What's nice about this recipe is these are all prescription drugs that are easily and cheaply obtainable from international online pharmacies without a prescription.

A Possible Suicide by Diltiazem Overdose

Abstract. This report describes a possible suicide by overdosage with diltiazem. The deceased, a 39-year-old male who had been under treatment for an unide

academic.oup.com

Other drug options I have seen are hard or risky to obtain because of customs or controlled substances restrictions.

The only concern I see with this option is that the amount of tablets that needs to be ground up and consumed might be hard on the digestive system without triggering vomiting. But In theory an anti-emetic should do the trick.

Also, even if you get caught ordering any of these things, none of them are so restricted that you're going to end up in jail.

 

[TheRottingContinues]

In how much amounts will I need to take these for a successful CTB? If it's so easily obtainable then there must be some sort of catch, like you must have to consume huge amounts of it for this method to work?

 

[Praestat_Mori]

Diltiazem 740 mg·kg−1 (LD50, Maus, oral) (Source: Wikipedia) probably alone not very lethal but with propranolol may work. How much would you need to ingest?

If you have access to amitriptyline I'd consider this a better method (just my opinion):

Amitriptyline guide

Translation from German "Selbstbestimmt Sterben - Handreichung für einen rationalen Suizid (German Edition) Jessica Düber Amitriptyline guide "Tricyclic antidepressants General info Tricyclic antidepressants are psychotropic drugs with a general mood-lifting...

www.sanctioned-suicide.net

 

[Egg]

Some discussion of dosages here:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2399841/?page=1

 

[Sunset Limited]

Deadly but not peaceful. You will face many arrhythmias until the heart goes into asystole or fibrillation. With oral administration, the plasma concentration of drugs increases slowly. So that's enough time for the body to fight bradycardia. The time until death may be 2-3 hours. It would be quite disturbing. Additionally, the CNS effects of propranolol may cause convulsions.

This dual drug combination can only be peaceful with IV administration. With highly concentrated solutions, of course.

 

[Egg]

@Sunset Limited So glad to have gotten your perspective on this. This is very valuable information to have which I could not find anywhere else although I had seen one of your earlier postings mentioning Diltiazem as one partial avenue for an IV route.

Do you think the addition of a fatal dose of amitriptyline would ease the struggle against bradycardia, at least experientially?

And could timing play a role here?

For example, if step 1 is:

- Metoclopramide + Amitriptyline (fatal dose)

and we wait for the amitriptyline to start to take effect before consuming the already-prepared:

- Diltiazem + Propranolol

The risk of this approach is the onset of sleepiness from such a large dose of Amitriptyline might be too great to allow any subsequent actions to be carried out. However, since the dose of Amitriptyline itself is fatal alone, this might work. The problem I see with this is that I have some skepticism about Amitriptyline as a sole agent. It seems to work best in conjunction with some additional compounds. Hence the reason for kicking a dead horse and adding Diltiazem + Propranolol.

 

[Sunset Limited]

I'm sorry, but this isn't a good idea. Although amitriptyline + propranolol + diltiazem seems like a good combination, metoclopramide will not prevent vomiting. If you vomit while unconscious, you may wake up with aspiration pneumonia and cardiogenic shock. This is truly a terrible situation. In order for this to be peaceful, a sedative that has a short onset time and a long effect is needed. Like pentobarbital :) Vomiting is the biggest problem though. Considering all these, SN is much more peaceful and reliable. Propranolol or diltiazem could be peaceful, just by IV.

 

[Egg]

I guess I thought metoclopramide or some other anti-emetic would be enough to prevent vomiting in this scenario since it's referenced a lot in PPH.

Are you saying that there are no anti-emetics that would prevent vomiting in this scenario? Because PPH doesn't cite your concern about aspiration pneumonia in relation to the methods listed in the book - maybe it is specific to my approach here.

But even if the vomiting is overcome, you mentioned that the propranolol may cause convulsions.

However, let's assume I go with this approach - you estimated about 2 to 3 hours of awfulness before death arrives - convulsions, arrythmias, vomiting, aspiration pneumonia and cardiogenic shock. Not a pretty picture. But assuming I am not able to find any acceptable alternative to this route, are there any additional steps I could take in advance - additional medications I could obtain via an international online pharmacy - that might soften some of the adverse reactions of this approach? (You mentioned pentobarbital but I doubt I would be able to obtain that and I'm not confident I can get hold of SN either.)

Thanks @Sunset Limited. Sounds like it's back to the drawing board for me then.

I've been reeling from this news a bit. Not your fault, of course. It's my fault not asking these questions earlier, before taking the time and expense of gathering these requirements. But if they don't work, they don't work. Better to know now than end up with a disastrously failed attempt.

Appreciate all the helpful information.

 

[todienomore]

@Sunset Limited do you think a specific drug is responsible for the vomiting?

And if you want to talk about similar drugs can you private message me? I found several interesting studies recently but I dont want to post publicly just yet.

 

[Egg]

I don't want to claim that I know more about this than @Sunset Limited because I definitely don't. I hadn't even heard of aspiration pneumonia until it was mentioned in this thread.

However, I have been searching Google Scholar to try to understand it better and according to this review, aspiration pneumonia would seem to be just as likely in an IV overdose as in an orally administered overdose since the mechanism of the blockage has to do with suppressed respiration due to the medication rather than the delivery method.

https://www.sid.ir/FileServer/JE/50007820160409.pdf

Unless Sunset's point is that the IV approach works so quickly - 15 minutes or so - that aspiration pneumonia doesn't have time to set in whereas with the oral route we're looking at a few hours until death and therefore the length of unconsciousness is more likely to lead to respiration issues.

Reading "Oral Overdosing V2" guide: https://sanctioned-suicide.net/threads/my-advice-on-oral-overdosing-v2.111882/ and realizing I don't understand any of this stuff as well as I thought I did.

 

[Egg]

"aspiration pneumonia" and "cardiogenic shock" are the two scariest terms I learned from @Sunset Limited in this thread. Changed the direction of my research.

Had no idea about these issues with sedation.

Not sure if they're discussed in PPH but they should be. Seems to be a not-uncommon issue facing people taking pharmaceutical approaches.

 

[Aburach]

"aspiration pneumonia" and "cardiogenic shock" are the two scariest terms I learned from @Sunset Limited in this thread. Changed the direction of my research.

Had no idea about these issues with sedation.

Not sure if they're discussed in PPH but they should be. Seems to be a not-uncommon issue facing people taking pharmaceutical approaches.

Sorry if I have misunderstood something here but I thought the downsides of the pharmaceutical approaches (time to death, risk of convulsions etc.) were offset by hefty sedation - basically, very large dosages of benzos or similar? They should keep you asleep while the drugs do their thing? Amitryptiline is not my personal choice but I think it's suggested as an option in various well-researched books - with meto and sufficient sedation (both fast acting and long lasting).

 

[Egg]

Sorry if I have misunderstood something here but I thought the downsides of the pharmaceutical approaches (time to death, risk of convulsions etc.) were offset by hefty sedation - basically, very large dosages of benzos or similar? They should keep you asleep while the drugs do their thing? Amitryptiline is not my personal choice but I think it's suggested as an option in various well-researched books - with meto and sufficient sedation (both fast acting and long lasting).

That was my initial understanding too but as pointed out above, the amount of time it takes for death to happen with orally administered pharmaceuticals allows a large enough window in which some additional issues may arise, as described above. And those issues could potentially both interrupt your ctb attempt AND make your life after the failure quite miserable if your failed attempt results in serious enough health side effects. My understanding is that @Sunset Limited recommends an intravenous approach to avoid any potential for these side effects to happen because that approach brings about death faster than the oral approach - so it short-circuits the possibility of those side effects that arise from the sedation-based unconsciousness and consequent muscle relaxation which produces these problems. I'm surprised there isn't more discussion of this in PPH or here but if you use the search feature you will see previous accounts of what @Sunset Limited is describing. This is not some crazy theory. This happens and causes serious problems for people.

 

[Aburach]

That was my initial understanding too but as pointed out above, the amount of time it takes for death to happen with orally administered pharmaceuticals allows a large enough window in which some additional issues may arise, as described above. And those issues could potentially both interrupt your ctb attempt AND make your life after the failure quite miserable if your failed attempt results in serious enough health side effects. My understanding is that @Sunset Limited recommends an intravenous approach to avoid any potential for these side effects to happen because that approach brings about death faster than the oral approach - so it short-circuits the possibility of those side effects that arise from the sedation-based unconsciousness and consequent muscle relaxation which produces these problems. I'm surprised there isn't more discussion of this in PPH or here but if you use the search feature you will see previous accounts of what @Sunset Limited is describing. This is not some crazy theory. This happens and causes serious problems for people.

Noted, thank you. I'm aware of the long time to CTB on these methods which is the main point against them. IV wouldn't be a self-administered option for me personally, sadly, so I'm going to have to take my chances if/when the time comes. I'll admit I am quite nervous as there are so many variables during that long period after taking the necessary drugs.

 

[Egg]

Noted, thank you. I'm aware of the long time to CTB on these methods which is the main point against them. IV wouldn't be a self-administered option for me personally, sadly, so I'm going to have to take my chances if/when the time comes. I'll admit I am quite nervous as there are so many variables during that long period after taking the necessary drugs.

There are indeed many variables. Success is not guaranteed.

 

[bigfishlittlefish]

I'm sorry, but this isn't a good idea. Although amitriptyline + propranolol + diltiazem seems like a good combination, metoclopramide will not prevent vomiting. If you vomit while unconscious, you may wake up with aspiration pneumonia and cardiogenic shock. This is truly a terrible situation. In order for this to be peaceful, a sedative that has a short onset time and a long effect is needed. Like pentobarbital :) Vomiting is the biggest problem though. Considering all these, SN is much more peaceful and reliable. Propranolol or diltiazem could be peaceful, just by IV.

Do you happen to know if any IV drugs are obtainable online on either DN or normal?