selegiline and methedrine overdose effects

loki · guinea pig

A little elf came to me this afternoon and wished to report what the effects of methedrine overdose effects are when one has been taking regular 5mg doses for long enough to establish constant MAO-B inhibition.

He was quite terse:

pupillary dialation with 'drifting'
hypothermia (36.5 degrees C) (he said that a hot shower was effective for treating this effect)
respiratory depression (to the point of almost falling unconscious, adequately high dose probably would the elf said, he was able to consciously elevate it)
low systolic high diastolic blood pressure (he was unable to measure peak effect blood pressure and only was able to after a cigarette which would have increased systolic, which was what he wanted to do to reduce the instability of blood flow it caused - he said he was sure it was low systolic, or normal systolic, because he could see his pulse clearly, estimated by the elf to have been about 80/160)
(when he went under the hot shower, this is probably important too, it seemed to him that his penis was contracted in diameter, presumably related to the lowered body temperature)

He said that during the peak of it he could clearly see, albeit muddled by visual distortions and intensified colour sensitivity, that his fingernails were purplish at the bases and he could see when blood levels were elevated by lowering the limb and the decrease of blood levels by elevating the limb.

He said that he'd popped a migraine medication at one point because when he tried to get up of his bed he 'saw stars' which his first thought was 'brain cappillary vasoconstriction' but I think it may have been from vasodialation actually.

Without the selegiline MAO-B inhibition normally the pupillary dialation is not 'drifting', the basal temperature is elevated, the systolic pressure is high too. I am no medical professional, so I could not say whether this type of overdose would be more dangerous or not, from what the elf described I suspected that ischemia may have been a problem in parts of the body pressed against something, although the colder temperatures may have slowed down the blood stagnation, and that falling unconscious from respiratory depression could possibly be problematic too.

I gave the elf a stern lecture about playing sillybuggers with untested combinations. The elf smirked and said that he'd taken vitamin B6 a couple of hours earlier too, and just before it happened he'd eaten eggs on toast... BAD BAD ELF.

I swatted him away and said stop telling me stories... but anyway, I thought i'd better report it because I don't believe that this has been reported. The elf looked like he'd survived it ok, but by the sounds of it, if the dose had been a bit higher it might have been a bit nasty.

loki · guinea pig

I did a bit of research and it would appear that selegiline specifically blocks or impedes alpha adrenergic stimulation, which explains the lack of hyperthermia and the drifting pupillary dialation (intermittent alpha blocking).

The blocking of alpha adrenergic receptors probably is why it reduces euphoria in cocaine, and more than likely has the same result with methedrine.

The cold effect is probably from beta 2 adrenergic vasodilation, and does not present any danger other than possibly causing rapid changes in oxygen availability by changing body orientation, or by pinching blood vessels (the elf talked about tingling and blood flow related sensations). vasodilation would increase heat loss to the periphery (explains other things too) The slow respiration could actually have been caused by strong bronchidialation too, again beta 2.

It seems to me that the biggest danger was from the diastolic pressure (working pulse phase), and a beta-1 blocker would fix that up immediately. A nonspecific betablocker would stop all of the unpleasant side effects altogether. As far as dangers go, the vasodialation would to a degree ameliorate the dangers caused by the higher pulse strength, but the combined dialation and pressure caused the superficial circulation alterations.

IN THEORY... If that elf had a nurse around he could have asked here what she'd give to someone who looked like he did.