Stimulants Meth hypertension and tachycardia choice of medications

[DislikeSobriety]

Hi guys there was few other threads 5/10 years ago discussing beta, alpha blockers and benzos to reduce high blood pressure and fast heart rate caused by meth, but I couldn't find a conclusion on what to use.

So I narrowed it down to benzos of 1g lorazapam, 5-10g diazapam, 15mg temazepam, 6g bromazepam

Vs mixed alpha and beta blockers labetalol, carvedilll though some say will diminish high

Vs alpha blocker phentolamine

Vs vasodilator nitroglycerin

And propranolol or Metoprolol beta blockers was also recommended but there was concerns of the theory of unopposed alpha stimulation increasing bp using betas so I supposed this isn't an option

My friend recently had 160/100bp and 128 heart rate, I'm concerned and decided she's taking one of these to effectively reduce and maintain her usual blood pressure of around 120/80 and a heart rate of 90

Which of these should she take as a priority list to ask her psychiatrist for? Do they all effectively reduce, with unimportant differences? Should she just take take labetalol instead of benzos so that she can consume it the moment her readings surge, unlike benzos needing to be taken near to comedown to prevent loss of meth high but would mean half of the time she would have high readings, and also risk dependancy?

She's never used a benzo and expects her psychiatrist to begin by giving if any the lowest dose possible, the plan to request benzos for her said nervousness and shortness of breath which led to panic attacks due to exam stress but settle for labetalol if unsuccessful. Viable right?

Do she need to take those stated doses recommended by a previous post for it to work as intended or her zero tolerance allows a lower dose of x amount? When should you take whichever suggested medication for the purpose of healthy readings?

We were thinking using labetalol or lorazepam just cause we heard of it before and that it lasts a total 20 hours close to half the time high for a session, unlike diazepam's 3 days total time which would only be suitable if taking it just before smoking is recommended. Thank you for your insights!

 

[DislikeSobriety]

Thought you said Beta receptors have anti anxiety and antidepressants effect blocking them with any medication will decrease meth high but there some option. And labetalol is beta 1,2 antoganist, that means it blocks beta receptors 1,2 which decreases meth high right?

Okay ill just suggest these and see what her doctor is more comfortable prescribing thanks for your input

 

[Jabberwocky]

Whatever you do don’t be tempted to combine seroquel and clonidine with meth. While either one is often used to end a meth high or reduce unpleasamt cardiac effects, in combination they are likely to produce a hypertensive crisis and tachycardia with concomitant panic attack.

Personally if a drug A requires you to add drugs B and C to offset side effects and enjoy drug A, then drug A may not be the drug for you.

It drug A is meth and it is an emergency and you experience cardiac or psychological side effects the ER will give you benzos first and then an anti-psychotic if you are in fact psychotic. Beyond that, I’d let the ER doctor decide what else might be required.

 

[DislikeSobriety]

OK noted, initially its drug A meth and drug B paliperidone, which seemed like standard drug A side effects but introduction of drug C wellbutrin amplfied side effects effects substantially so she needs drug D a benzo/alpha beta blocker to counter I believe effectively is drugs A+C effects..

Does using one drug to offset an combination seem better than using a combination to offset one drug? Or is the combination total of 4 potent drugs counteracting each other purely insane already hahahhaa does sounds like a great cocktail. She'll do it disregarding logic, wilfully ignorant and in denial.

Paliperidone already negated the high and with the introduction of wellbutrin amplifying side effects, she's still struggling to realise that her drug days are effectively over what a degenerate

 

[Jabberwocky]

OK noted, initially its drug A meth and drug B paliperidone, which seemed like standard drug A side effects but introduction of drug C wellbutrin amplfied side effects effects substantially so she needs drug D a benzo/alpha beta blocker to counter I believe effectively is drugs A+C effects..

Does using one drug to offset an combination seem better than using a combination to offset one drug? Or is the combination total of 4 potent drugs counteracting each other purely insane already hahahhaa does sounds like a great cocktail. She'll do it disregarding logic, wilfully ignorant and in denial.

Paliperidone already negated the high and with the introduction of wellbutrin amplifying side effects, she's still struggling to realise that her drug days are effectively over what a degenerate

I think once you have a potent 4 drug combo in you and are suffering serious seffects you have 2 options:

1. Have someone reliable monitor your vitals while you ride it out. With particular attention to tachycardia, arythmia, excessive temperature, loss of consciousness, or psychosis.

2. Seek medical attention. Prior to that cocktail a benzo would have been safe but I don’t think anybody here can predict what adding any new drug might do at this point.

Also, when people on the internet make helpful and kind-hearted suggestions about adding agonist X or antagonist Y to a given situation they are often extrapolating from a single paper they read about doing that to rats. Or else simply theorising and using logic based on reason and assumptions rather than offering evidence-based medical advice.

 

[4meSM]

Bupropion is a NDRI (norepinephrine and dopamine reuptake inhibitor), it's essentially a non euphoric cathinone analog which shouldn't be mixed with strong stimulants like meth.
Benzos should be fine, they can calm you down but I doubt they would be particularly useful to control hypertension, you also risk getting dependent on them which will only complicate your situation in the future.

Personally I wouldn't take neither alpha nor beta blockers on meth+bupropion unless I was 99% sure of the safety of such combination. Now, meth+bupropion+alpha blocker+beta blocker + who knows what else is playing with fire in my opinion... Unless specifically recommended by a cardiologist or an expert on the matter and not an internet stranger.

Sometimes they treat stimulant-induced hypertensive crisis with alpha and/or beta blockers at the ER, but the difference is that they give you a specific dose and place you under medical supervision in case something bad happens, mixing those kinds of drugs at home is very different and potentially dangerous.

 

[DislikeSobriety]

Thanks for the head ups guys, she's having second thoughts about yoloing. Haha It's weird she doesn't have any other side effects like sweating, have normal temperature, no paranoia/psychosis, doesn't feel anxious though loud sudden noises startles her probably has a heightened sense of hearing throughout. Just unusually high BP of 140/90 and HR 120 even after sleeping for 2 naps of 3 hours each though it will eventually drop back to 120/80 and 100 HR after maybe another 8 hours of sleep.

She thinks her supposed calm state of mind proves it ain't anxiety causing it and wonders if she were to ask her psychiatrist whether mixed blockers like labetolol/benzos is safe and effective for high BP HR caused by panic attacks and anxiousness occurring while on her other meds is the same situation as for meth induced high BP HR while on her other meds. As she can't mention drug use to her psychiatrist. Are both causes of high BP, HR have the same treatment?

 

[Gormur]

Personally if a drug A requires you to add drugs B and C to offset side effects and enjoy drug A, then drug A may not be the drug for you.

That's my thinking. I still don't know why my psych scripted me Clonidine (for sleep) alongside Vyvanse when he started me out on amphetamines. I guess it's standard practice, so I explained the side effects and he switched me to Klonopin. Eventually I'd add Ativan to the list for sleep, but these weren't big doses.

I'm not a doctor but I wouldn't recommend anybody take these drugs unless they're already addicted to them and I don't know why but Clonidine seems like a dangerous drug. I got weird rebound symptoms from it the next day like all the sudden my arm would go numb or my chest would ache. Once I stopped taking it those symptoms disappeared

Mind you I don't get hypertension and just a bit of hypotension from methamphetamine. If the symptoms are worrying or noticeable enough to distract you, maybe add some CoQ10, magnesium, zinc and vitamin B-complex to your diet. If you don't give your body time to recover you may need supplements to help the recovery so you don't develop a tolerance

 

[Jabberwocky]

Yes. I was prescribed Clonidine with dexamfetamine to help with sleep. Although it is approved as supplementary ADHD med. It’s a pretty dangerous drug if mixed with the wrong things.

As I’ve posted I elsewhere I nearly killed myself mixing it with meth and seroquel.

Although keen drug users don’t like to discuss it much - the first line treatment for anxiety and panic (in Australia at least) is now psychological not pharmaceutocal. CBT, breathing exercises and mindfulness are now supposed to be recommended by doctors before benzos for chronic anxiety (acute temporary panic or anxiety with obvious cause like an incident or trauma can still go straight to benzos).

Personally, I found such things worked way better for long-term anxiety than benzos although they took a long time to learn. I only took benzos for end-of-stim sleep. My BP always in healthy zone for man my age despite endless stim abuse.

 

[MsDiz]

What @4meSM said.

Do not mix meth and that cocktail of drugs
you are asking for trouble.

Meth may not be for her, it can become more cardiotoxic with frequent use which is stating the obvious. Some people are just more susceptible to those effects and she could have an underlying heart condition even.

 

[DislikeSobriety]

Okay she've finished her last dose yesterday had BP 155 and hr 130. She ate 3 big bananas which did nothing for the HR but reduced the BP to 126 for about 18 hours. After I think 30 hours since dose without sleep BP is at 136 with 115 HR. These abnormal readings she didn't use to get during use frightens her.

While wishfully hoping it's just this batch of meth that caused it instead of introduction of bupropion she intends to quit for at least 3 weeks till her appointment with the psychiatrist. Not betting on being able to get benzos, but I guess requesting in sequence labetolol, carvedilll, metoprolol/propranolol would be prescribed as its not abusable. Hopefully it doesn't come with compulsory counselling for anxiety.

Its the same psychiatrist who prescribed her all her meds and should know their interactions, also saw a few Web pages and posts suggesting beta blockers are effective for meth toxicity and that unopposed alpha stimulation is a theory that has not occurred before for use on meth toxicity. Well if she dies, it's at least before she graduates and had sacrificed much accomplishing life goals

Here's the source I think I understood from that labetolol is best, carvedill is identical. Metoprolol works. IV propranolol kills. Unopposed alpha stimulation is debunked. Alpha blocker phentolamine, nitric-oxide mediated vasodilators (nitroglycerin, nitroprusside), and calcium channel blockers treat hypertension, not heart rate.

Beta blocker Wikipedia under adverse effects, reference 49 and 50 refers medscape Article 1 Another link and recommending labetolol and debunking of unopposed alpha stimulation written by the same guy in source and many others, I suppose its reliable as website states its for healthcare professionals. (uni essays references didn't teach me how to vouch for them ) I registered in 2 mins as a non professional as my profession to gain access.

 

[Captain.Heroin]

alpha and beta blockers should not be played around with, and alpha blockers (or both?) are not going to be immediately effective - are you already taking these drugs?

Benzos will help, minimally.

Gradual physical activity, water, food, and rest should help with any lingering hypertension.

Tell me, what is your normal resting BP when not using? What is it now (or you can just tell it's "too much")?

 

[Captain.Heroin]

hoping it's just this batch of meth that caused it instead of introduction of bupropion she intends to quit for at least 3 weeks

Here's your problem.

NDRI's are going to kind of fuck with meth's high. Reuptake inhibition is pointless when you reverse the dopamine transporter. Forcing more NE back into the synapse = higher BP.

Though most of the BP change is likely from meth.

Do not mix meth and that cocktail of drugs

This, plus a scientific explanation about why the combo is not ideal. Diz knows whats up!

 

[DislikeSobriety]

Yeah she's been taking paliperidone and started on a like 3 days of 1 pill of bupropion that's when her BP and HR increased to 160/100 and 130 during use. Usually its 140/110 110 max she thinks. Without use its 120/78 90-100 HR.

She hasn't used any type of blockers but intends to get them prescribed for panic attacks by a psychiatrist. Having considered paliperidone and bupropion won't spikes of BP and HR be the same treatment of beta blockers whether its due to meth or panic attacks?

 

[Jabberwocky]

Yeah she's been taking paliperidone and started on a like 3 days of 1 pill of bupropion that's when her BP and HR increased to 160/100 and 130 during use. Usually its 140/110 110 max she thinks. Without use its 120/78 90-100 HR.

She hasn't used any type of blockers but intends to get them prescribed for panic attacks by a psychiatrist. Having considered paliperidone and bupropion won't spikes of BP and HR be the same treatment of beta blockers whether its due to meth or panic attacks?

I’m not sure if it is contraindicated with bupropion but a first line treatment for BP is Clonidine. It works by stimulting a2 receptors and works by slowing the pulse and reducing serum levels of renin, aldosterone, and catecholamines.

After 30 hours I don’t think your issue is the meth.

 

[DislikeSobriety]

Yeah man maybe it's not meth, it's been 2 days since she started sleeping nightly 4 days since last dose and her BP still fluctuates from 130-150 HR 100-115 it also appears that her top number BP never reduced back to 120 as previously though the bottom number has often been 80, within healthy range.

Doubt it raised due to the past month of twice weekly use over 5 days each week of. 75 average dose per session. She gonna stop bupropion and see how it goes and quit meth if it has simply risen.

Thanks all for the warnings, now that she's more sober she sadly accepts that although her source being medscape and reliable, it would be on iv and can titrate dose accordingly unlike her fixed oral dose and should not be treated the same or used with her cocktail of drugs.

 

[Jabberwocky]

I’ve noticed since quitting meth my BP is consistently higher than it ever was before or during taking meth. I was normally spot on 120/80 even at age 49. Two weeks after quitting meth I’m around 147/100. Which is hypertensive disorder level 2. I don’t know if there is a post-meth relationship to elevated BP.

 

[DislikeSobriety]

What the hell? That can't be right.. Did you take months for it to gradually subside?

 

[Jabberwocky]

What the hell? That can't be right.. Did you take months for it to gradually subside?

I was taking meth 5/7 days a week for about 12 months with a few weeks or months off here and there. Then the last two weeks I smoked 1 gram of super pure stuff every 24 hours with sleep breaks every 48 hours or so using benzos and Seroquel.. Then I went cold turkey around 3 weeks ago. First week I felt fine but over the last week my BP has spiked, stayed high, and is accompanied by insomnia and nausea.

It’s very weird since I never had cardiac issue on meth or when I was taking prescribed dexamfetamine. I have re-started taking prescribed dexamfetamine 10-20 mg daily in the last week and suspect there might be some connection there. So I’m going to stop and see if BP lowers. I’m surprised that taking Clonidine is having no effect in lowering my BP at the moment.

 

[DislikeSobriety]

I was taking meth 5/7 days a week for about 12 months with a few weeks or months off here and there. Then the last two weeks I smoked 1 gram of super pure stuff every 24 hours with sleep breaks every 48 hours or so using benzos and Seroquel.. Then I went cold turkey around 3 weeks ago. First week I felt fine but over the last week my BP has spiked, stayed high, and is accompanied by insomnia and nausea.

It’s very weird since I never had cardiac issue on meth or when I was taking prescribed dexamfetamine. I have re-started taking prescribed dexamfetamine 10-20 mg daily in the last week and suspect there might be some connection there. So I’m going to stop and see if BP lowers. I’m surprised that taking Clonidine is having no effect in lowering my BP at the moment.

Always figured BP reverts to normal upon resting. Hahaha well I guess the good part is not being alone and both have lingering BP. The bad part though is we dont exactly know the cause and how long it's gonna last. Dayummm the thought of clogging arteries. I think she should do a 5km jog, been laying or sitting still for weeks, may have been the cause for her BP and shes only in her late twenties and not fat. Meth's a truly a love-hate drug, she wished she never took it and fell in love with. Gonna post about how it ruined her but she still justifies the good in it and how to rediscover life lol