beforeistoolate
Member
- May 13, 2023
- 54
Disclaimer: This is my personal draft. I'm posting this is out of gratitude for the existence of this website, and everyone working on it. Please do your own research.
The main reason I might be choosing this drug is my belief it could have the lowest degree of suffering combined with the lowest degree of side effects or brain injury risk. Having SN as an alternative, I find phenobarbital superior given the drug acts by shutting down sensory feeling (CNS) central nervous system, which is the only way for our brain to experience pain. It's only speculative, but my concern with SN or methods relying on shutting down oxygenation could cause a last minute (seconds) feeling of suffocation before passing.
All phenobarbital OD survivor cases I've found have been reported after medical intervention. Reason why doing this in a very remote location with zero chances of being found is imperative. This is a very slow death but with a quick loss of consciousness.
Basic Kit:
Different ways a phenobarbital coma can kill (over time):
Absorption/Timing:
Following oral administration, onset occurs within 30 minutes. Peak concentrations in plasma occur several hours after a single dose. Half-life of phenobarbital ranges from 4-8 days.
Concentrations of 35-80 mg/mL will develop sluggishness, poor muscle control and rapid eye movements. Coma with reflexes will develop at a concentration of 65- 117 mg/ml, and without reflexes at above 100 mg/ml.
In situ studies indicate that phenobarbital is primarily absorbed from the intestines. Thus, it is concluded that the presence of food decreased the pharmacological activity of phenobarbital by decreasing the rate of absorption and that this decreased absorption rate is due primarily to slowed gastric emptying.
Another study demonstrated the effectiveness of the rectal administration of phenobarbital, with a relative bioavailability reaching 90%.
When you're dehydrated, it can take about three times as long (45 minutes) for fluids to make their way from the stomach into the bloodstream and to the rest of the body. That's because dehydration causes the stomach to produce more acid, which slows down digestion.
Endorsements:
Method of action:
(Barbiturates are neuroprotective) Phenobarbital is a long acting barbiturate suppressing the activity of excitable tissue, including the CNS, the peripheral nervous system, and the cardiovascular system. It also depresses gastrointestinal function. (Low risk of brain damage)
Clinically, CNS depression occurs in a graded fashion, progressing from sedation, anesthesia, coma, and death due to respiratory arrest. Respiratory depression also occurs in graded, dose-dependent fashion starting with mild inhibition of the neurogenic respiratory drive and progressing to loss of hypoxic drive.
Barbiturates depress the vasomotor centers of the medulla, resulting in arteriolar and venous dilatation and hypotension, progressing to shock. It also depresses the sympathetic ganglia, cardiac contractility, and smooth muscle and vascular tone, resulting in bradycardia, cardiovascular collapse, and shock.
In the gastrointestinal system, it reduces muscle tone and peristaltic function, resulting in gastric dilatation with delayed gastric emptying as well as ileus and bowel distention.
Upon reaching the brain, phenobarbital binds with the GABA receptors and affects them differently than benzodiazepines or opiates, 21 Thus, the addition of phenobarbital to the morphine and diazepam of D-DMA/DDMA can augment the sedative and respiratory suppression effects of those protocols.
Coma:
A barbiturate coma may also be extremely deep that a patient can lose all reflexes and encounter brain death.
People in a coma often require extensive medical care to maintain their health and prevent complications such as pneumonia and blood clots.
Aspiration pneumonia, associated with respiratory depression, is another cause of death following barbiturate overdose. Bacterial colonization: Poor oral hygiene can result in colonization of the mouth with excessive amounts of bacteria, which is linked to increased incidence of aspiration pneumonia.
Medical papers survivor cases:
(you may copy and paste on google search to read entire paper)
View attachment 121414
The main reason I might be choosing this drug is my belief it could have the lowest degree of suffering combined with the lowest degree of side effects or brain injury risk. Having SN as an alternative, I find phenobarbital superior given the drug acts by shutting down sensory feeling (CNS) central nervous system, which is the only way for our brain to experience pain. It's only speculative, but my concern with SN or methods relying on shutting down oxygenation could cause a last minute (seconds) feeling of suffocation before passing.
All phenobarbital OD survivor cases I've found have been reported after medical intervention. Reason why doing this in a very remote location with zero chances of being found is imperative. This is a very slow death but with a quick loss of consciousness.
Basic Kit:
- 20g phenobarbital
- 7 days minimum of alone time
- Clean, no barbiturates nor alcohol tolerance
- 20gr phenobarbital, 300mg diazepam
- Remote location, tent in the woods, winter
- Large bag to use as a coffin exit bag (suffocation post loss of consciousness)
- Clean
- 36 hour metoclopramide regimen
- Crush and dissolve phenobarbital in 96° alcohol
- Mix with alcoholic drink for easier ingestion
- Enter bag/tarp coffin and seal from the inside
- Wait for first signs of sluggishness around 30 mins
- Rectal administration of Diazepam ampoules
Different ways a phenobarbital coma can kill (over time):
- Respiratory failure
- Cardiac arrest
- Gastric aspiration/Aspiration pneumonia
- Suffocation(plastic bag/coffin method)
- Hypothermia
Absorption/Timing:
Following oral administration, onset occurs within 30 minutes. Peak concentrations in plasma occur several hours after a single dose. Half-life of phenobarbital ranges from 4-8 days.
Concentrations of 35-80 mg/mL will develop sluggishness, poor muscle control and rapid eye movements. Coma with reflexes will develop at a concentration of 65- 117 mg/ml, and without reflexes at above 100 mg/ml.
In situ studies indicate that phenobarbital is primarily absorbed from the intestines. Thus, it is concluded that the presence of food decreased the pharmacological activity of phenobarbital by decreasing the rate of absorption and that this decreased absorption rate is due primarily to slowed gastric emptying.
Another study demonstrated the effectiveness of the rectal administration of phenobarbital, with a relative bioavailability reaching 90%.
When you're dehydrated, it can take about three times as long (45 minutes) for fluids to make their way from the stomach into the bloodstream and to the rest of the body. That's because dehydration causes the stomach to produce more acid, which slows down digestion.
Endorsements:
- Death with Dignity recommends 20 grams of phenobarbital in combination with other drugs as an alternative to Nembutal.
- Self Chosen and Humane Death recommends 8 grams of phenobarbital combined with 0,3 grams of diazepam.
- Final Exit the 1991 guidebook to assisted suicide mentions it takes at least 4.5 grams - or 150x30-mg. tablets - to be lethal.
Method of action:
(Barbiturates are neuroprotective) Phenobarbital is a long acting barbiturate suppressing the activity of excitable tissue, including the CNS, the peripheral nervous system, and the cardiovascular system. It also depresses gastrointestinal function. (Low risk of brain damage)
Clinically, CNS depression occurs in a graded fashion, progressing from sedation, anesthesia, coma, and death due to respiratory arrest. Respiratory depression also occurs in graded, dose-dependent fashion starting with mild inhibition of the neurogenic respiratory drive and progressing to loss of hypoxic drive.
Barbiturates depress the vasomotor centers of the medulla, resulting in arteriolar and venous dilatation and hypotension, progressing to shock. It also depresses the sympathetic ganglia, cardiac contractility, and smooth muscle and vascular tone, resulting in bradycardia, cardiovascular collapse, and shock.
In the gastrointestinal system, it reduces muscle tone and peristaltic function, resulting in gastric dilatation with delayed gastric emptying as well as ileus and bowel distention.
Upon reaching the brain, phenobarbital binds with the GABA receptors and affects them differently than benzodiazepines or opiates, 21 Thus, the addition of phenobarbital to the morphine and diazepam of D-DMA/DDMA can augment the sedative and respiratory suppression effects of those protocols.
Coma:
A barbiturate coma may also be extremely deep that a patient can lose all reflexes and encounter brain death.
People in a coma often require extensive medical care to maintain their health and prevent complications such as pneumonia and blood clots.
Aspiration pneumonia, associated with respiratory depression, is another cause of death following barbiturate overdose. Bacterial colonization: Poor oral hygiene can result in colonization of the mouth with excessive amounts of bacteria, which is linked to increased incidence of aspiration pneumonia.
Medical papers survivor cases:
(you may copy and paste on google search to read entire paper)
- A 23-year-old woman with pulmonary edema and cardiac arrest after ingestion of 18 grams of phenobarbital. She was completely recovered by successful cardiopulmonary resuscitation and hemoperfusion.
- A 27-yr-old woman with a history of pseudo-seizures who was admitted after attempted suicide with an overdose of phenobarbital tablets. Patient's phenobarbital serum concentration was 163 mg/l. Despite treatment serum concentrations continued to rise to 233 mg/l by hospital day 3. High-flux hemodialysis was performed on hospital days 3 and 4. On hospital day 4, the phenobarbital serum level had decreased to 87 mg/l and thereafter continued to decline. The patient was discharged on hospital day 8.
- A 30-year-old female found unconscious, with grunting and frothing from mouth, 4 h after a suspected overdosage of 5,4g of phenobarbital (90 tablets of 60 mg each). She had a cardiac arrest en route and required chest compressions and mouth to mouth breathing for about ½ h until she reached the emergency department. There she was intubated and ventilated, with a Glasgow coma scale GCS:3. She developed severe hypoxia due to large aspiration of gastric contents. Therapeutic hypothermia was not advocated as barbiturates are neuroprotective and can cause hypothermia.
- A 34-year-old admission after he intentionally took 125 tablets of phenobarbital 90 mg/tab after discordant discussion with his common law wife. Patient was unarousable hence was brought to a tertiary hospital. He was comatose with a Glasgow coma score of GCS 3. In massive phenobarbital overdose, patients not only present with coma but may sometimes be accompanied by cardio-respiratory collapse. Luckily for this patient, due to his multiple suicide attempts with phenobarbital, he developed tolerance and had minimal adversities with the drug
- A 37 year-old woman. At the initial examination, the patient was not conscious. Later on, her phenobarbital blood levels slightly decreased, but the patient's consciousness remained unchanged. Consultation with a neurologist was performed to identify the cause of consciousness decline, and the neurologist expressed the possibility of toxic encephalopathy. After the second dose of dialysis, the patient's breathing recovered spontaneously, and her consciousness increased gradually, she even extubated herself, and her condition continued to improve.
- 38-year-old man took 189 tablets of 100 mg. He was brought unconscious had GCS of 3 blood pressure 120/75 pulse 85 per minutes' respiratory rate 12 per minutes. Our patient took approximately twice the fatal dose was hemodynamically stable likely due to long-term tolerance to phenobarbital. Total duration of continuous veno-venous hemofiltration was 72 hours and patient was extubated on day five of admission.
- A 45-year-old man with history of epilepsy referred to us after he was found in deep coma. His relatives had found an empty bottle of phenobarbital pills with him and therefore, suicidal attempt was suspected. Epileptic discharges disappeared eventually and the patient became fully conscious in seven days.
- A 45-year-old man with no past medical history was found unconscious. At the scene, paramedics noted empty packaging for 200×30mg phenobarbital tablets, and a 40mg clonazepam liquid bottle. After approximately four days of forced alkaline diuresis, he still had no clinical neurological response (GCS3). The patient was extubated 5 days post-intubation and 1 day post hemofiltration commencement, with full neurological recover.
- A 47 year-old man with acute case of intoxication from high concentration veterinary phenobarbital, complicated by ethanol abuse. Initial phenobarbital serum concentration of 124 mcg/mL. Patient was status-post motor vehicle accident and unresponsive with an initial Glasgow Coma Scale (GCS) score of 3. On day two of hospitalization, hemodialysis (HD) was initiated due to the patient's persistent comatose state. The phenobarbital serum level declined from 112 mcg/mL to 62 mcg/mL and GCS score improved to 10 after one 4-hour session of HD. On hospital day six neurological status significantly improved prompting his hospital discharge.
- A 50-year-old woman was discovered unconscious after a suspected overdose of 12.5 g of phenobarbital. Following 96 h of supportive care, the patient remained on GCS 3, and despite the incremental reductions in serial levels, her phenobarbital level remained at 115 mg/L. Given the lack of progress in her neurological status, we opted to trial veno-venous hemodialysis. At a phenobarbital level of approximately 55 mg/L, the patient spontaneously opened her eyes. The patient was fit for discharge from critical care within 24 h and went on to make a full recovery. The reported lethal dose of phenobarbital is in the range of 6–10 g with concentrations of 80 mg/L reported as fatal. Our patient ingested a higher dose than that reported as fatal, and was haemodynamically stable, potentially due to the long-term tolerance of the drug.
- A 56-year old woman was addressed to the intensive care unit (ICU) for a massive phenobarbital poisoning (assumed ingested dose: 5.5g). The estimated maximum delay between phenobarbital ingestion and ICU admission was 6hours. The patient presented with hypotension (77/44mmHg), hypothermia (33°C).. allowing for the patient to be successfully extubated on day-7.
- A 68-year-old woman tried to commit suicide using phenobarbital, which was initially prescribed for her dog that suffered from seizures. At admission she was unconscious and ventilated. Five days of intensive care therapy did not improve her state of consciousness. Subsequent continuous veno-venous hemodialysis accelerated the elimination of phenobarbital compared to endogenous elimination by a factor of five. The patient survived without sequelae.
View attachment 121414
