The use of two kinds of benzodiazepines would significantly hasten death. Do not use phenobarbital in this cocktail, due to unwanted mainly unpredictable drug interactions with the amitriptyline. Cimetidine can be replaced with encainide , flecainide or quinidine. It cannot be replaced with Ranitidine or any other antacid medication: see the description for cimetidine in this article. Other benzodiazepines could be usable too. One of the key parameters is the drug half life how long the drug acts which you can look up in the benzodiazepine equivalency table. Mechanism of action and roles of the drugs[ edit ] Amitriptyline is the lethal component of the cocktail. Tricyclic antidepressants TCAs exert their lethality mainly since they are sodium channel blockers. The principal effect of reducing the rate and magnitude of depolarisation by blocking sodium channels, is a decrease in conduction velocity in atrial and ventricular muscle.
The faster a cell depolarises, the more rapid adjacent cells will become depolarised, leading to a more rapid regeneration and transmission of action potentials between cells in the cardiac system. Therefore, blocking sodium channels reduces the velocity of action potential transmission within the heart. This prolongs the QT interval, promoting phenomena like 'torsade de points' or other ventricular tachycardia, which mean that the ventricular muscle would twitch randomly, rather than contracting in unison, and so the ventricles would fail to pump blood into the arteries and into systemic circulation. If the arrhythmia continues, blood circulation will cease, and death as in, ventricular fibrillation will occur in a matter of minutes. The cardiac impact is rather similar to an overdose of Darvon, since Darvon is a sodium channel blocker as well.
Cimetidine[ edit ] Cimetidine inhibits some of the group of liver isoenzymes named Cytochrome P450,or in short CYP450, which is responsible for the drug's first phase metabolism. Tricyclic antidepressants like amitriptyline require liver isoenzyme CYP2D6 along with others of that group to be metabolised, so inhibiting this enzyme increases the levels of amitriptyline in the blood. Cimetidine achieves two goals in the cocktail: it hastens death; it eliminates any possibility of survival and renders the cocktail much more lethal. Cimetidine is normally used to reduce gastric acidity, as a treatment for heartburn or peptic ulcers. But in the cocktail, this mode of action is not relevant; cimetidine is required because of inhibition of the CYP2D6 liver enzyme and not because of its effects on stomach acid. That is why it is not possible to replace cimetidine with ranitidine, or any other antacid medication that a pharmacy might offer to you as a replacement.
Midazolam and Diazepam[ edit ] Midazolam Dormicum is quick acting and of short duration, while Diazepam Valium is slower acting but of long duration; both are powerful sedatives from the benzodiazepine class of drugs. They cause deep sleep before amitriptyline starts to act in overdose. Amitriptyline poisoning would be lethal by itself, but the death it causes would not be peaceful. How long does the cocktail take? Is it recommended to use a plastic bag in addition? So, there is no reason to use a plastic bag. A plastic bag requires significant preparation and must be used correctly to be lethal. The main risk of combining both is that instead of focusing on doing one thing right, you will do two methods and both wrong. Comparison to other methods[ edit ] Amitriptyline is not a narcotic thus, not a scheduled substance. This makes mail-ordering this drug far less problematic.
The cocktail takes a long time to work: up to 36 hours to work for Dr. Admiraal's version and less time for the new, improved one. This obviously increases the chance to be rescued. Potentially, there is a chance to survive with organ damage if rescued at the wrong moment. Evidence and medical reports attesting to the efficacy of the AC[ edit ] Amitriptyline and other TCAs accounted for a very large number of death cases all over the globe some were suicides and some were "accidents". Amitriptyline passes through a placental barrier, gets into breast milk, creating the concentration similar to plasma. Read more... Can I Buy Amitriptyline Online UK For the period of treatment the driving of vehicles, service of mechanisms and other types of works requiring special attention is forbidden. Warfarin athrombin. Instead they nail the wrong victims, little people who do nothing wrong and who are certainly not crooks.
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