on md, tramadol and drunk. Meds useful if comes back in dangerous mental state

[joe456]

Some1 fallen out with gf, majorly psychologically traumatised. Agressive shouting at passers by on street. Currently calmed down a bit (Im told) and at gfs house "talking things out". With access to diazepam (2mg tablets), propranol (strip of 10mg instant releases and strip of 80mg sustained release), and quietiapine (25mg and 200mg tablets). since he was very hostile towards support from friends on way home and shouting/ swearing/ soemtimes waving arms in frustration while walking regularly while walking, and has a mate from out of town currently staying at his at his (who is trying his best to help, followed him home at a distance 2 give him space after initial loved up condolences were met with anger), might any of the following meds the individual possesses be be recomendable for him (can imagine him reaching for medicine cabinate when he arrived back if meeting goes badly) i fear he may storm in to his house and then storm out again following attempted comfort from v close friend so this self medication may be the best course of acion. He has consumed a 220mg MDMA pill, possibly a small amount of amphetamine, and small dose of 2c-b a few hours ago and 2 tramadols of unknown strength (upon arriving home before leaving, so at time of writting half an hour ago) as well as an excessive amoutn of alcohol throughout the night. If necessary he could be constantly monitored by friends of sound mental state and basic psychological/ v basic pharmological knowledge, if he feel asleep after taking medication.

 

[joe456]

I know this may break rules but i wanted to waste no time since its obv an important sitution. appeared liek he was prepred to have a sensible talk and he woulfd defintely would never cause her any physical harm.

very sorry for typos, but need to do research asap just incase even tho I have good reason to belive he is now mnetally stable.

 

[joe456]

guessing recommending (assuing he is going to take them anyway) a mere 4mg diazepam and maybe a low dose of propranol or seroquel (guessing depending on how much more of the alcohol he has drunk). guessing dosage would depend on if sedation was his aim? assume seroquil could potentilly raise seaizure threshold so diaepam (also has 1mg etizest etizolams) would be advisable even tho it cold potentially trigger more uninhibited beh. and i am strongly assuming zero further intoxication of any kind would be best advised (meds or weed) if there were no signs he could potentially storm out and be at risk to himself (didnt look b4 crossing a road earlier, somewhat narrowly missing a car). i fear attempts to get professional help would potentially put him in his rev state when he may well now be calm,also none of us know the adress he is at. I ran to where i could acess a computer for research knowing other closer mates were with him at the time and he appeared no longer in a state that could be dangerous. No diagnosed condition, meds that he might take not proscribed or tried before, apart from valium. First showed depressive symptoms about situation and have no reason to belive psychosis is present or the anger to have started at a time when the effects of any drug were peaking. while he has a history of anger issues, none of violence or self harm. Exp handling trips means I assume 2c-b is not of as much significance as it sounds, he was not tripping hard and while calmer but depressed could communicate coherently.
I am not in charge of his treatment in any way btw, all i have is a phone number for some1 who is sleeping round his, he told me he would probs have a v quick nap (due to md still in system) then would call me for advice. Realistically while I can imagine professional help being advised I know that while that would be done if necessary, it would have to be truely extreame circumstances and i know no advice given here could be perfect but I would be extreamly grateful for any advice I can give some1 to give him if he sees him in a bad state. I am very sorry for not reading rules and carefully deciding where to put this thread but i hope you can understand my desperation (have done lots of other research as well but thought i should check for if any1 had anything at all to add).
I would like to add I'm aware that if he could be talked down quetiapine could stop the theraputic effects of the MD still in his system. I'm also aware of potenitial dangers of all of these if he is especially drunk. I believe quetiapine lowers seizure threshold but only slightly, so I assume this would not be an issue with a 25mg dose to help him sleep if not sleeping seemed like it could only go badly, assuming no more stims (or trams) have been consumed, will have come down a reasonabe amoutn now i assume. Also aware beta-blockers arnt gr8 with stimulants but assuming low level of stimulation from drugs but a high level from anger I'm guessing it could possibly be a good idea.

 

[Speed King]

Professionals are trained to handle psychotic people. Hopefully your mate comes down/snaps out of this state on his own, but if he is in a agitated state, acting dangerous toward himself or other people, you really have no choice but to get professional help.

 

[joe456]

Yeah, luckily to the best of my knowledge he's inside his gfs (or ex gfs) house talking things thro calmly. Wouldn't say he was psychotic (although reminding me of the possibility was probably a good idea). I would say it would probs be best described as a huge exaggeration of normal angry behaviour. Like some1 might swing their arm aimlessly shouting a swear word while walking away from a situation that made them really angry. He was just doing that regularly throughout a 10 min period where he was being followed at a distance after being reminded ppl were there for him but would respect his stated need for personal space.
But yeah, sad but true hypothetically professional help would be needed, espec since seroquel and mdma has been said to be dangerous and I'm sure the tramadol will only add to that. I can only imagine diaz being a gd idea if the goal was sedation (or to help prevent a seizure from doing a stupid combo). If he's still excessively angry but not a danger to himself/ others tomorrow anyone got any advice regarding whether seroquel or propranolol would help hi keep his emotions in check. Even if he slept and woke up sounding sensible I think diaz would be best advised against considering the effect on inhibitions when mixed with drink. Guessing tramadol might help him restore serotonin and generally act calmer once the MD has fully left his system (assuming of course a sensible dose). I don't think I would recommend it, but given its effect on serotonin I'm guessing it would probably be the best drug for him to take if he was gonna go for something addictive that would make him feel better short term. Although I don't know if the noradrenaline reuptake inhibition might not help, guessing it would be no big deal tho? Maybe a few days usage of 5htp or even amiltriptyline would help him through the next few days assuming he's not acting very erratically any more (I know it can trigger hypomania/ mania, but I believe it is more likely to help if the symptoms are not to severe, and don't know if him (presumably) not being bipolar would mean this could even be a problem (think his anger is always related to events but to my knowledge this doesn't vary based on "phases". I know seeking professional help would still be the obv option, but I'm pretty sure he won't and I'm quite confident it wouldn't need to be sought on his behalf (although thank you Speed King for reminding me of the grim possibility of its necessity). Was also nice just to get a reply and know someone was showing concern, not that I'm sure others weren't but weren't sure what to say).

 

[manboychef]

Is your friend okay? Did he get to bed?

Did his girlfriend break up with him because of his incredibly spun up state?

Did he end up in the psyche ward?

I need answers to this saga!

 

[joe456]

I shall know those answers soon. They r probs still asleep but i stayed up (3rd day in a row) trying to assess the risk/ find out what to tell his m8 to advise against him having if he got back (he said he'd wake up and txt me if he came in). While the mate that went nuts wasn't online I warned him, and espec his m8, they may best avoid 5htp etc for a few days, having both mixed with trams and since his m8's eyes were proper rolling back and he felt quite scared at one point (luckily he past the peak and was fine when shit went down with the other mate who went psycho and had to be followed at a distance with people warned to steer clear at times!). Think it was his gf or ex that triggered the whole thing, will probs find out, but not gonna inquirer about that (1st time I'd seen him since summer). Decided since I'm still a bit speeding and will b likely be asleep most of the day after a 200mg seroquel (probably) upon my return, I'd drop him a care package of 5htp, pyrazolam and Etizest (said no drink with etizest plz cos then it defeats the idea of me doing a favor cos that will probs make something worse). Doubt any1 will b up so I'll probs just drop it thro the letterbox but may learn the full story if they're up, will see them later if not now, assuming they don't cancel their plans for tonight and go to bed before I finish my hibernation upon my return. Reckon he'll wake up ashamed and hopefully not in a psych ward and need some etizest to calm down as he remembers last night, as will the others who witnessed it (also said dnt introduce ppl 2 it without saying how bad downers can be lol). Said to have a think about if to start 25mg seroquel (or more if needed)to sleep, or just stay calm, maybe tomorrow cos of the apparent threat of SS (reli doubt it but better safe than sorry) can have 80mg sustained release propranolol today (assuming no plans for much stims, if any, tonight) and 'tiz (if not drinking) and 2mg total pyraz (if only having a few drinks tonight since it makes you less stupid). Recommended having 20mg of amiltriptyline b4 bed for a few days, if he feels he needs it, starting tomorrow (thought errr on the low side as it should still work based on knowing it would for me and 2 mates who have also had it, not make him constantly slow and possibly make him manic if he's bipolar, (I get more hypomanic if I'm already v much so, take a higher dose and havn't slept the night b4, but low continuous doses dull both extreames), as I said the advice was based on assumption I don't think he got too fucked on the MD itself, but I'll warn his friend whose eyes rolled back and puked, off anything like ami/ 5 htp/ trams for at least a week or so. Anyone got anything to add to that (or something they think could do with ammending)? Have said I researched on the 3rd day no sleep so maybes look some stuff up himself just incase lol. Also plz comment if you can think of something that would be handy if a similar situation happened again.

 

[joe456]

posted his care package and then he came down the road, didnt even look me in the eye, was just dead to the world, i tried to talk 2 him 2 say id posted stuff 2 help him thro the hard time but he just kept repeating "im just gonna get in and sleep".

 

[UpInFlames]

Both tramadol and seroquel LOWER the seizure threshold and should be used together with caution, especially with excessive alcohol consumption.

I hope by know your friend is feeling better. Keep us posted on how things work out.

 

[manboychef]

Yeah, that is some bonified craziness. He seems like a zesty sort, you know, bold and spicy.

 

[joe456]

He took quite a few etizolams and 100mg amiltriptyline that afternoon/ evening (seen him since so don't worry). He was very calm and while sometimes seeming a bit down and sometimes normal he seemed very mellowed out by the amiltriptyline (which he was planning on continuing for a few days on a much lower dose). He kept saying he was really surprised how tired and drousy he was (I had to frequently tell him that he really shouldn't have found that surprising, especialy since the box of ami said 1-5 as needed before bedtime). I guess that's the last of his worries, since I was shocked about how much better he looked. He's not taking (or in possession of) etizolam any more, which can only be a good thing. Etizolam being given with strict instructions "please accept a condition of being given these for free is you don't drink on them" was met with later insistence he knew how to handle himself with things (despite me saying I can't with lots of booze and etiz and you're not aware how stupid it makes you at the time). I said I'd probs wait a few days before starting ami as well but that advice was also disregarded. Oh well, its ended as well as it could have so far it seems. I know amitriptyline can prevent mania in bipolar so that might have some effect on whatever a psychiatrist might label the situation. However, it can make it worse too! I've only known that to happen when I've already missed a night of sleep and its not being taken continuously, then its like wtf its become a stimulant. Since he's not a regular stim user (can be bad for heart together) and while he was quite out of it while being asked, said while he could get very angry he didn't go through phases where it was more likely than other times (so guessing not bipolar). I think low dose amiltriptyline until whatever the exact situation is blows over is probably likely a good call. Have warned him to be careful taking trams on it (although since he's survived up until now I can't imagine a few while on ami would do him much harm), also don't think he has access to many. Thanks Upinflames for the reminder, there were so many potential things that could go wrong with everything that could help prevent things continuing to go horribly wrong, so glad that even tho unadvisable things were done, he seems ok now. Anyone know if seizures would generally have warning signs beforehand? Everyone else seemed convinced tramadol and MD would be fine as long as they took them vaguely slow and judged the situation as they went along.

 

[justtakethat]

If u tried to be nice and calm him down and he got mad from that then fuck that piece of shit pussy, let him swallow the whole cabinet

 

[Johndoedoe.junk]

Sounds like you're trying to play doctor and throw a bunch of meds at him which would only add to an already dangerous cocktail it sounds like he has I his system. Let him come down off the drugs, go through the motions of coping with this in the natural way and he should be fine. Maybe the etiz in a low dose could have been warranted to calm his anger although dangerous with ETOH hence the low dose recommend, but I wouldn't recommend loading him up on meds especially if he has no preexisting condition and this is a natural reaction to a unpleasant situation.

Please don't take this as a flame but I just don't agree with raiding the medicine cabinet as a first line solution.