Cure for Life
June 10, 2015 9:24 PM Subscribe
Which Western medicines, when taken at a higher dose than what is prescribed, will reliably lead to a quick and nasty death?
For a story I'm writing.
I don't mean "eat a bucket of Tylenol" but rather, an amount of prescription medication that is anywhere from 2x to 20x the prescribed dosage, ingested only once.
The pills would be given to the person who was already using the prescription, not someone else.
Key words for the kind of resultant deaths I'm looking for are "reliably" "quick" and "nasty."
Thanks!
For a story I'm writing.
I don't mean "eat a bucket of Tylenol" but rather, an amount of prescription medication that is anywhere from 2x to 20x the prescribed dosage, ingested only once.
The pills would be given to the person who was already using the prescription, not someone else.
Key words for the kind of resultant deaths I'm looking for are "reliably" "quick" and "nasty."
Thanks!
This post was deleted for the following reason: Sorry for the delayed delete on this one. We needed to get input from more mods on this one since it's a borderline call, but ultimately, a question asking for specifics about how to bring about someone's death through readily-available means is, we finally decided, beyond the scope of what we want to keep up and make available to searches through AskMe, even though the OP is only going to use the info for a story. Sorry OP, you haven't done anything wrong here, and thank you to the people who gave answers. -- LobsterMitten
You could probably take enough beta blockers to slow your heart down until it stops or near enough.
posted by phunniemee at 9:40 PM on June 10, 2015
posted by phunniemee at 9:40 PM on June 10, 2015
What you're looking for is a drug with a very low therapeutic index. I'd go with Digoxin. Sounds mean; is mean- ten times the regular dose is potentially fatal.
posted by fifthrider at 9:40 PM on June 10, 2015 [1 favorite]
posted by fifthrider at 9:40 PM on June 10, 2015 [1 favorite]
Oh, and you wanted it to be nasty:
The classic features of digoxin toxicity are nausea, vomiting, diarrhea, abdominal pain, headache, dizziness, confusion, delirium, vision disturbance (blurred or yellow vision). It is also associated with cardiac disturbances including irregular heartbeat, ventricular tachycardia, ventricular fibrillation, sinoatrial block and AV block.
posted by fifthrider at 9:43 PM on June 10, 2015
The classic features of digoxin toxicity are nausea, vomiting, diarrhea, abdominal pain, headache, dizziness, confusion, delirium, vision disturbance (blurred or yellow vision). It is also associated with cardiac disturbances including irregular heartbeat, ventricular tachycardia, ventricular fibrillation, sinoatrial block and AV block.
posted by fifthrider at 9:43 PM on June 10, 2015
How quick are we talking?
Warfarin/Coumadin is a drug that's pretty commonly prescribed as a blood thinner. But if you take a bit too much, you start bleeding from all your orifices, then you turn purple all over and eventually die from massive, massive internal bleeding. Kind of like Ebola in a pill. Takes about a day to kick in, though. That effect's what makes it such an effective rodenticide too.
posted by un petit cadeau at 9:43 PM on June 10, 2015
Warfarin/Coumadin is a drug that's pretty commonly prescribed as a blood thinner. But if you take a bit too much, you start bleeding from all your orifices, then you turn purple all over and eventually die from massive, massive internal bleeding. Kind of like Ebola in a pill. Takes about a day to kick in, though. That effect's what makes it such an effective rodenticide too.
posted by un petit cadeau at 9:43 PM on June 10, 2015
Look up drugs commonly used for overdose suicides such as barbiturates or opiates. Seconal, Nembutal, or codeine cough syrup, for example. Any kind of CNS depressant.
posted by Tanizaki at 9:44 PM on June 10, 2015
posted by Tanizaki at 9:44 PM on June 10, 2015
Response by poster: Teraflop -- would ingesting one dose of 24 grams of tylenol kill someone very quickly?
posted by np312 at 9:44 PM on June 10, 2015
posted by np312 at 9:44 PM on June 10, 2015
Acetaminophen can certainly give you fatal liver damage in not-ridiculous doses, but it won't be quick--liver failure usually takes a couple of days to kill you.
most opiate painkillers will cause death by respiratory depression and/or vomiting with aspiration if given in sufficiently high doses.
Digoxin, which is still commonly prescribed and can kill quickly due to cardiac arrythmias.
You could also use a diabetes medication like glyburide or insulin that rapidly causes death from hypoglycemia.
posted by The Elusive Architeuthis at 9:49 PM on June 10, 2015
most opiate painkillers will cause death by respiratory depression and/or vomiting with aspiration if given in sufficiently high doses.
Digoxin, which is still commonly prescribed and can kill quickly due to cardiac arrythmias.
You could also use a diabetes medication like glyburide or insulin that rapidly causes death from hypoglycemia.
posted by The Elusive Architeuthis at 9:49 PM on June 10, 2015
You could probably take enough beta blockers to slow your heart down until it stops or near enough.
Especially in combination with other stuff. I've nearly passed out from just my normal prescription dose if I don't time it quite right and my Adderall wears off first. A very usual thing when you hear that youngish minor celebrities have died of drug overdoses is that, rather than it being just some massive dose of heroin or something, it turns out that they took not-that-huge doses of multiple depressants at the same time. I am incredibly glad that suicidal ideation is not a problem I have, because right now, in my apartment, I have Inderal, about a third of a bottle of Tussionex left from ages ago, a nearly-full bottle of Ativan, and a liquor cabinet.
I don't know that I'd call it nasty, as a way to go, but it would be reliable in the sense that I don't think it'd be too hard to get a sufficient dose of benzos and opiates to someone who'd been drinking. And entirely too few people know just how dangerous the combination is, which is exactly how people like Heath Ledger and Brittany Murphy end up dying.
posted by Sequence at 10:04 PM on June 10, 2015
Especially in combination with other stuff. I've nearly passed out from just my normal prescription dose if I don't time it quite right and my Adderall wears off first. A very usual thing when you hear that youngish minor celebrities have died of drug overdoses is that, rather than it being just some massive dose of heroin or something, it turns out that they took not-that-huge doses of multiple depressants at the same time. I am incredibly glad that suicidal ideation is not a problem I have, because right now, in my apartment, I have Inderal, about a third of a bottle of Tussionex left from ages ago, a nearly-full bottle of Ativan, and a liquor cabinet.
I don't know that I'd call it nasty, as a way to go, but it would be reliable in the sense that I don't think it'd be too hard to get a sufficient dose of benzos and opiates to someone who'd been drinking. And entirely too few people know just how dangerous the combination is, which is exactly how people like Heath Ledger and Brittany Murphy end up dying.
posted by Sequence at 10:04 PM on June 10, 2015
Lithium? Not sure if such a prescription would be suitable for the character, but it fits most of your criteria (including the 'nasty' part). I took it for a while many years ago and was occasionally reminded by my doctor, during the monthly blood-draws required for taking such a med, of how dangerous overdosing on it can be.
posted by stubbehtail at 10:25 PM on June 10, 2015 [1 favorite]
posted by stubbehtail at 10:25 PM on June 10, 2015 [1 favorite]
Seconding warfarin. My brother in law had a doctor who didn't know how to adjust it and started pissing blood within a day. A true overdose could kill you quickly.
Also, aspirin might be quicker than tylenol, and possibly nastier,but I cannot remember why I have hat impression.
posted by SLC Mom at 10:33 PM on June 10, 2015
Also, aspirin might be quicker than tylenol, and possibly nastier,but I cannot remember why I have hat impression.
posted by SLC Mom at 10:33 PM on June 10, 2015
Fentanyl patches are fairly safe but incredibly lethal if you smoke one.
posted by benzenedream at 12:26 AM on June 11, 2015
posted by benzenedream at 12:26 AM on June 11, 2015
Best answer: Short-acting insulin ODs are not particularly nasty but they are very quick (less than 20mins). I have known two doctors kill themselves that way because it's quick, painless, hard to detect post-mortem unless you specifically go looking for it, and unlikely to fail.
Betablockers and other anti-dysrhythmic drugs kill you with exciting and difficult-to-fix cardiac dysrhythmias - we always hate these coming into hospital because they are an almighty pain. We are usually talking 6-8hrs to death. They are dramatic from our point of view looking at the cardiac monitor, I'm not sure how exciting they would be if the patient did not seek medical attention - they'd feel a funny sensation in their chest and then their heart would stop.
You might also want to look at plants and trees such as yew - there was an amazing series of case reports in Clinical Medicine a couple of years ago about a girl who kept taking yew leaf overdoses. It sounded like an absolute nightmare. Lots of dramatic dysrhythmias, not responsive to drug therapy, and went on and on and on for days (she survived to do this multiple times - initial onset of symptoms was about four hours in, so you could kill off your protagonist much quicker if you wanted to).
Huge warfarin overdose would be my vote (or better yet one of the newer agents like rivaroxaban which does not show up on routine blood tests and isn't reversible) - very dramatic, lots of blood, would probably work within 24hrs.
posted by tinkletown at 1:36 AM on June 11, 2015
Betablockers and other anti-dysrhythmic drugs kill you with exciting and difficult-to-fix cardiac dysrhythmias - we always hate these coming into hospital because they are an almighty pain. We are usually talking 6-8hrs to death. They are dramatic from our point of view looking at the cardiac monitor, I'm not sure how exciting they would be if the patient did not seek medical attention - they'd feel a funny sensation in their chest and then their heart would stop.
You might also want to look at plants and trees such as yew - there was an amazing series of case reports in Clinical Medicine a couple of years ago about a girl who kept taking yew leaf overdoses. It sounded like an absolute nightmare. Lots of dramatic dysrhythmias, not responsive to drug therapy, and went on and on and on for days (she survived to do this multiple times - initial onset of symptoms was about four hours in, so you could kill off your protagonist much quicker if you wanted to).
Huge warfarin overdose would be my vote (or better yet one of the newer agents like rivaroxaban which does not show up on routine blood tests and isn't reversible) - very dramatic, lots of blood, would probably work within 24hrs.
posted by tinkletown at 1:36 AM on June 11, 2015
Best answer: What? No votes for tricyclic antidepressants? Very narrow therapeutic range. Toxic effects starting with dry mouth, blurred vision, urinary retention and moving quickly to chest pain, palpitations, blood pressure tanking. Then seizures, coma, death.
Example: Nortriptyline. Regular dose is 25 to 150 mg. Toxic dose is 2.5 mg/kg. That means for me toxicity can be expected at or above 225 mg.
This class of med isn't as commonly prescribed as it used to be, but it's still not rare at all.
posted by wjm at 2:48 AM on June 11, 2015 [2 favorites]
Example: Nortriptyline. Regular dose is 25 to 150 mg. Toxic dose is 2.5 mg/kg. That means for me toxicity can be expected at or above 225 mg.
This class of med isn't as commonly prescribed as it used to be, but it's still not rare at all.
posted by wjm at 2:48 AM on June 11, 2015 [2 favorites]
Came in to say lithium. Great drug for manic depression (if it doesn't mess with your GI tract; it about tore my guts apart) great for treatment of manic depression as it will sometimes deal with not just the manic symptoms but also the depression piece.
But shrinks generally don't like to write it, because people who have manic depression um, well, they have manic depression, and could at any time decide to pull the plug. Not to mention that there is now a huge palette of other drugs to address mania that are not able to be used in suicide.
Death from lithium OD is No Fun.
Incidentally, I've known two people to attempt suicide by saving up extra and then taking a shitload of benzodiazepenes (klonopin in both cases, if memory serves.) They both woke up, like two days later, very unhappy indeed to find themselves still here, and with one hell of a hangover.
posted by dancestoblue at 4:21 AM on June 11, 2015
But shrinks generally don't like to write it, because people who have manic depression um, well, they have manic depression, and could at any time decide to pull the plug. Not to mention that there is now a huge palette of other drugs to address mania that are not able to be used in suicide.
Death from lithium OD is No Fun.
Incidentally, I've known two people to attempt suicide by saving up extra and then taking a shitload of benzodiazepenes (klonopin in both cases, if memory serves.) They both woke up, like two days later, very unhappy indeed to find themselves still here, and with one hell of a hangover.
posted by dancestoblue at 4:21 AM on June 11, 2015
Ask.me questions are searched by lots of people. For anybody reading this who is considering self harm:
There is help
Suicide Helpline
The Samaritans
How Not to Commit Suicide, Art Kleiner
posted by theora55 at 5:23 AM on June 11, 2015 [27 favorites]
There is help
Suicide Helpline
The Samaritans
How Not to Commit Suicide, Art Kleiner
posted by theora55 at 5:23 AM on June 11, 2015 [27 favorites]
My insulin dependent mother (injects at least 4 times a day) always said if she wanted to kill herself no one would know, if she wanted to kill someone else she could make it look like an accident. Usually while dramatically shooting some insulin out the end of her syringe before injecting herself.
Not sure how dramatic it would be in RL, but with really low blood sugar my mother hallucinates & is very confused and has at various times under the influence of not enough sugar has been confused enough to wander off into the bush, drive a car into a tree. Walk into oncoming traffic, pull a kitchen cupboard down on top of her & get arrested for shoplifting all while trying to get to food as she knew she had to eat. Add to that people will often think she is drunk. You could make someone not used to low blood sugar very confused with a big old dose of insulin & have them do all sorts of horrible things to themselves accidentally in their confusion before slipping into a coma & dying. It's also not as much of a controlled substance as some drugs & pretty easy to get, my mother usually has all sorts of stores of insulin around for various pens etc
posted by wwax at 7:45 AM on June 11, 2015
Not sure how dramatic it would be in RL, but with really low blood sugar my mother hallucinates & is very confused and has at various times under the influence of not enough sugar has been confused enough to wander off into the bush, drive a car into a tree. Walk into oncoming traffic, pull a kitchen cupboard down on top of her & get arrested for shoplifting all while trying to get to food as she knew she had to eat. Add to that people will often think she is drunk. You could make someone not used to low blood sugar very confused with a big old dose of insulin & have them do all sorts of horrible things to themselves accidentally in their confusion before slipping into a coma & dying. It's also not as much of a controlled substance as some drugs & pretty easy to get, my mother usually has all sorts of stores of insulin around for various pens etc
posted by wwax at 7:45 AM on June 11, 2015
Not sure how dramatic it would be in RL, but with really low blood sugar my mother hallucinates & is very confused and has at various times under the influence of not enough sugar has been confused enough to wander off into the bush, drive a car into a tree.
That's fairly typical for acute hypoglycemia. Below that you start to get into weirder territory - clamminess, seizures; generally un-fun stuff. Since even the most minimally equipped BLS unit has the equipment and training to mitigate it, though, you'd need a pretty huge insulin overdose to serve OP's narrative purposes. The 'silver lining' of the present diabetes epidemic, such as it is, is that diabetic crises are very high on EMS evaluation checklists - I'd wind up checking blood sugars more than half the time, out in the field.
posted by fifthrider at 8:08 AM on June 11, 2015
That's fairly typical for acute hypoglycemia. Below that you start to get into weirder territory - clamminess, seizures; generally un-fun stuff. Since even the most minimally equipped BLS unit has the equipment and training to mitigate it, though, you'd need a pretty huge insulin overdose to serve OP's narrative purposes. The 'silver lining' of the present diabetes epidemic, such as it is, is that diabetic crises are very high on EMS evaluation checklists - I'd wind up checking blood sugars more than half the time, out in the field.
posted by fifthrider at 8:08 AM on June 11, 2015
Ever since I had back surgery, I've had pretty regular access to the full panoply of opiates, from hydrocodone all the way up to morphine. One could easily, over time, stockpile enough of those to bring about a fairly nasty little death. I'm not sure about the "quick" part, though.
posted by Thorzdad at 8:23 AM on June 11, 2015
posted by Thorzdad at 8:23 AM on June 11, 2015
When I was a teen I took about over forty prescription painkillers, mostly Vicodin and the muscle relaxer Soma, in a suicide attempt. I had my stomach pumped and was fed a bunch of charcoal (which is how I'm typing this!) but I was reassured I would have definitely have died without treatment.
I was around 100 pounds and did not have a major opiate tolerance (like an addict would have), however.
posted by Juliet Banana at 8:31 AM on June 11, 2015
I was around 100 pounds and did not have a major opiate tolerance (like an addict would have), however.
posted by Juliet Banana at 8:31 AM on June 11, 2015
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posted by teraflop at 9:35 PM on June 10, 2015 [2 favorites]