Need Advice - Having Very Adverse Reactions to Promethazine (Phenergan)

[Wayne]

Hi All,

I could use advice from anybody who might have some ideas on how I might counteract some VERY adverse reactions I'm having to a single dose of Promothazine (Phenergan). I took it about 40 hours ago when I went to the ER for extreme abdominal pain and nausea (first ER visit in 50 years).

The pain and nausea dissipated while I was at the ER (after having barely endured it for about 48 hours). Before I left, the attending physician asked me if I would like a prescription for some anti-nausea medication. They could give me a single dose at the ER, and I could fill a prescription on my way home. -- They told me the possible side effects were drowsiness. What they didn't tell me was that there are numerous other possible side effects. I'll list them in the next post so this one doesn't get too long. (I bolded and underlined the ones I'm experiencing).

I put this thread in the Chemical Sensitivity forum because "drug hypersensitivity syndrome", which is what I may be experiencing, seems to be closely related to MCS (which I have big time). I did a quick search here on PR, and discovered this drug has anti-cholinergic properties. I know virtually nothing about this topic, but was wondering if anybody else does. I've thought about eating a bunch of high-choline egg yolks, which might counteract the anti-cholinergic properties.

I just don't know. I noticed right away this drug was affecting my cognition, so I'm grappling with all these symptoms with a struggling brain, and a severe lack of sleep. The tinnitus is so loud and irritating, that I can't sleep for more than an hour or so at a time. -- And when I wake up, I generally experience a new round of shakiness, high anxiety and inco-ordination. My face and feet are generally QUITE flushed when I first get up as well. Not to mention the strange dreams I've been having since this all started. So, this is all very concerning to me.

I'm taking as much activated charcoal as I can tolerate, as I read it absorbs most prescription drugs. I'm also taking lots of Vitamin C, but I haven't noticed much difference. I did a clay foot bath and thought that helped some, and I'm getting ready to do another one. I'm considering what I should eat, because I've eaten VERY little since my abdominal pain started on Thursday morning. I'm also doing some coffee enemas for detoxification, and some simple modified castor oil packs for the calming neurological harmony I've experienced with them in the past.

It's been a pretty rough few days, and have noticed that keeping my mind busy and focused tends to keep my attention off my body and all the things it's going through (or convulsing from). But this is all so very exhausting, so if you have any advice or suggestions, I would love to hear them, so I can go online and start varying avenues of research. I'm wiling to consider just about anything to move myself out of this crisis mode.

Thanks for reading...

Best, Wayne

 

[Wayne]

Below is a brief product description of Phenergan from THIS SITE, along with a list of possible side effects. I'll bold and underline the ones I'm currently experiencing--again, from just a single dose.

Product Description -- PHENERGAN 25MG

Common use
Phenergan is an antihistamine used to treat different types of allergy symptoms, including itching, runny nose, sneezing, itchy or watery eyes, hives, and itchy skin rashes. It works by decreasing the effects of histamine, a chemical the body releases in response to certain irritants. Also Phenegran is used as a sedative and sleep aid for all types of patients and prevent or control nausea and vomiting, treat motion sickness. You can use it with other medications, for pain after surgery also.

Possible side effect

They may include an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Also the most possible side effects include:
twitching, or uncontrollable movements of your eyes, lips, tongue, face, arms, or legs;
tremor (uncontrolled shaking), drooling, trouble swallowing, problems with balance or walking;
feeling restless, jittery, or agitated;
high fever, stiff muscles, confusion, sweating, fast or uneven heartbeats, rapid breathing;
feeling like you might pass out;
seizure (convulsions);
pale skin, easy bruising or bleeding, fever, sore throat, flu symptoms;
decreased night vision, tunnel vision, watery eyes, increased sensitivity to light;
hallucinations, agitation;
nausea and stomach pain, skin rash, and jaundice (yellowing of the skin or eyes);
urinating less than usual or not at all;
joint pain or swelling with fever, swollen glands, muscle aches, chest pain, vomiting, unusual thoughts or behavior, and patchy skin color; or
slow heart rate, weak pulse, fainting, slow breathing (breathing may stop).

Less serious include:

dizziness, drowsiness, anxiety;
blurred vision, dry mouth, stuffy nose;
ringing in your ears;
weight gain, swelling in your hands or feet;
impotence, trouble having an orgasm; or
constipation.

If you experience one of them stop using Phenegran and tell your doctor as soon as possible. Also consult with your doctor about any side effect that seems unusual.​

 

[TreePerson]

Below is a brief product description of Phenergan from THIS SITE, along with a list of possible side effects. I'll bold and underline the ones I'm currently experiencing--again, from just a single dose.

Hi Wayne. I just looked it up and saw the info that it has a half life of 10-19 hours and that it normally takes 5 1/2 half-life cycles to completely eliminate a drug from your system. According to my maths that’s 70 hours so don’t panic yet.

I have no suggestions other than magnesium baths which is pure intuition.
Antihistamines make me worse but I haven’t taken this one. Eggs sound like a good idea and maybe soup for the potassium magnesium etc.

 

[Wayne]

so don’t panic yet

Thanks so much @TreePerson. That's really good to know about the half life. I had wondered about that, but then poof, that thought was gone. So I'm REALLY glad you let me know. -- Umm, regarding that panic.... ​

 

[TreePerson]

LOL @Wayne. I feel so sorry for you. I believe it will pass maybe just take longer than a healthy person.

Oh and my maths is way off. I think it could be as long as 105hours.

 

[brenda]

@Wayne

Weren't you poisoned with pesticide like me? If so you must avoid anything with an anti-cholinergic action.

There is advice here which may help I don't know.

http://www.agriinfo.in/default.aspx?page=topic&superid=6&topicid=1511

 

[Runner5]

Back in the day, two decades ago, I couldn't hack phenegran - stuff was awful. It was supposed to make me stop puking but it didn't do that, it just made me cramp and feel sick. I switched it out for benedryl which is a very good anti-nausea drug. I had to do something for nausea on account I was 110lbs and dropping rapidly (while 6mo pregnant). Anyway, though, if you don't do well on antihistiamines that wouldn't work anyway. Tree Person had a good idea, the soup / eggs / and waiting for that clock to tick down might be the best bet!

Sorry you had to go through all that Wayne, gosh it sounds like the worst. Any idea what caused your abdominal pain and nausea? That sounds serious.

((Hugs from Oregon))

 

[perchance dreamer]

@Wayne, I'm so sorry that happened to you. I've only rarely taken Phenegran, and it was always when I was throwing up repeatedly.

It never really bothered me. The only thing I noticed is that it messed up my bowel movement the next day.

Once, when DH and I both got sick and were throwing up a lot, I used it and offered him one. He didn't know anything about it and asked how to take it. He was horrified when I told him he had to insert it.

 

[Shoshana]

I have no idea, Wayne, but am so sorry you are experiencing this, and hope you find something, very soon!
In addition, thanks for sharing with us about it, so the rest of can beware.

The above mentioned charcoal was a good idea to try,

and the magnesium... such as soaking in Epsom salt water... could possibly help.

But I don't know anything specific to help that.

Take care and keep us posted on how you are doing.

 

[pattismith]

@Wayne ,
It looks awful and I hope you will improve soon; I don' have more advise or experience to add, but would you able to explain what kind of Tinnitus you got?

 

[Wayne]

would you able to explain what kind of Tinnitus you got?

Thank you everybody for your suggestions, kind words, and support.

Patti, I don't know what different kinds of tinnitus there are, but I would describe mine as screeching. It gets much louder when I lay down to rest, and especially if I close my eyes. When I sleep, which I've only been able to do for 10 minutes or so 3-4x today, I generally wake up with a start, and the screeching is way worse.

The waking up is then usually accompanied by a strong sense of panic, anxiety, and shakiness. My best guess this is happening because I have a severe case of hyperacusis (sound sensitivity), and when I'm able to sleep, the tinnitus signals comes pouring into my brain uninterrupted and unfiltered in any manner.

Most of my symptoms are waxing and waning. There are times when I note some incremental improvement, and then it kind of goes away. For example right now I can see the computer screen fairly well with my normal eyeglasses, which I haven't been able to do since this started. But my eyesight could unexpectedly get worse again.

The one thing that doesn't seem to change is the tinnitus, and it's my biggest concern going forward. I literally can't imagine trying to live with constant screeching. What helps is staying busy, and having other sound going on to mask it. But trying to do more than normal on very little sleep can only be done for so long.

I really don't know what tonight's going to bring. I'm going to put on a fan, and try to find some white/pink noise on youtube. I'm also considering taking some much larger amounts of melatonin. I have a friend who takes 15 mg/night, and says she's heard of some people taking 60 mg. Won't jump up there, but may take more than the 9 mg I took last night.

I hope I can report much more progress by tomorrow. Countdown in my mind is about another 48 hours, so that would be 2 nights from now. My wife reminded me that it once took me a week to recover from a very difficult reaction I had to a single dose of fludrocortisone.

Thanks again for all your support! I'll try to review some of the things you brought up, and then get back tomorrow. I'm sure there's things I missed commenting on tonight.

Wayne

P.S.

Any idea what caused your abdominal pain and nausea? That sounds serious.

Nothing definitive, but I feel I have a pretty good idea (something I ate) which I'll write more about tomorrow. The lab results at the ER all showed normal, so I was relieved to find out I didn't have an infection going on. Given how vulnerable my system is, I think Abx would probably about do me in.​

 

[RWP (Rest without Peace)]

@Wayne,

Sorry for your suffering. Hope you're going to get some sleep and recovery overnight.

From your fellow Oregonians,

RWP + PWR

 

[TreePerson]

There is an antidote to anti-cholinergenic toxicity which is discussed here.

https://emedicine.medscape.com/article/812644-treatment#d10

It’s administered in hospital for what sounds like really extreme cases. But I did notice that anxiety, agitation and hallucinations are part of the symptoms which struck me as similar though not the same as what you are experiencing.

They suggest benzos for this. I thought it might be worth you trying them for the tinnitus and sleep if you have any to hand. Although the symptoms are alarming reading it also reassuringly says most cases resolve.

I really hope you are doing a bit better.

 

[Wayne]

I really hope you are doing a bit better.

I think I'm now over the worst, but numerous challenges remain. I did manage to sleep last night with the help of a bubbling brook sound + a small box fan. When I first started listening to the sound of water, my brain interpreted it as angry people yelling at each other. So I turned the volume down so the fan was louder. That seemed to work.

I'm feeling more sleepy tonight than I've felt since this started, so I think that's a good sign. I've done a little research, and discovered anticholinergic syndrome (which Is what I believe I experienced) is well known, and is caused by a wide variety of drugs, both legal and illicit. I think it's a topic we should all be aware of as we get older, since age makes a person more vulnerable to the type of experiences I had.

Will followup with more at a later date...

Thanks again for all your support and well wishes!

​

 

[Wayne]

I'm waking up today, feeling like I've pulled back from the precipice. I feel I could have passed away at various junctures in the past five days, with the closest call coming just 30 hours ago. After I managed to go to sleep the night before last, I woke up about 30-45 minutes later with a seizure. I didn't know what would happen next, but felt if it got worse, I might have about a 10% chance of passing away (my mind tends to think in percentages; perhaps even at the oddest moments ).

Along with other symptoms, I went into an almost frenzied shaking for about two minutes or so. I focused on relaxing during this time, and afterwards, felt like I may have gone into almost a "semi-coma" (there's probably no such thing, but that's how it felt to me). It allowed me to sleep (very broken) for about 8 hours, which felt like a godsend. Looking back, I think what helped me stabilize was my eating about 10 egg yolks the day before, which I now view as being critical to my beginning to turn things around. My eyesight very noticeably improved within about 30 min. of ingesting the first 3 yolks. I believe other things I did, including taking copious amounts of charcoal were also very important.

I discovered there's only one drug available that can reverse the effects of anticholinergic toxicity--but has its own serious dangers. Here's what I found: "Physostigmine can reverse the central effects of coma, seizures, severe dyskinesias, hallucinations, agitation, and respiratory depression. The most common indication for physostigmine is to control agitated delirium."

I'm going to start delving deeper into anticholinergic syndrome and toxicity, and maybe even start a separate thread on it. Since I experienced so many of the serious effects of anticholinergic toxicity, including those mentioned in the above paragraph, I think it may be a particular vulnerability for pw/MECFS. This syndrome can be caused by many other means than a drug that's made specifically to reduce choline, including various herbs and supplements. I have an elderly neighbor who's mentioned serious difficulties with anxiety, and I'm going to check with him on whether his current medications may be causing anticholinergic syndrome. From what I can gather, millions may be affected to one degree or another.

I'd never before had anxiety that even approached what I experienced in the past 3-4 days. I think my biggest fear in this whole ordeal was whether I'd ever again be able to experience peace and calm. When in the middle of such extreme, unrelenting anxiety and major brain and neuronal mis-firing, it's quite hard to imagine. But now that I'm past the worst, and am steadily stabilizing, I can look forward with more hope than I had a day or two ago.

I even had a feeling of happiness again this morning, even though I still have lingering anxiety (about 10% of what I had originally). The half-life cycle still won't be complete until the next 12-24 hours or so, so it seems probable that further improvements are in store. @TreePerson, thanks so much for getting me that information on the half-life! Other information shared was invaluable as well. It really helped me be able to begin to see an ending to this all.

Thank you all again--Sincerely. ​

 

[TreePerson]

Hi @Wayne it sounds horrific! I am so glad you are feeling better. It does feel like a very good idea to delve more deeply and start a separate thread. My brain isn’t functioning very clearly but I do know that some ME sufferers are getting help from Mestonin which is a drug for Myasthenia Gravis. One of the contra indications for anti cholinergenics is not to give them to people who suffer from MG. So it all seems to tie in and helps flag up where our problems lie.

 

[perchance dreamer]

@Wayne, do you still use your Alpha-Stim? I was thinking of how it can help for anxiety and sleep.

Baclofen is a good muscle relaxer that also helps with sleep. It works on Gaba-B, so is not habit-forming the way that prescriptions that work on Gaba-A are. I take Baclofen every night.

A couple of times a week I'll take 100 MG of Phenibut. This is a really small dose, but helps with anxiety and sleep. I never take it on consecutive nights, though, since it works on Gaba-A in addition to Gaba-B. I use the Neurogistics brand:

https://www.rxhca.com/products/gaba

I'm glad things are starting to improve for you.

 

[pattismith]

@Wayne

you had such a frightening experience; It reminds me when i was given Amitriptyline (Laroxyl), I was in a semi-coma for 24 hours (Although I did take only half the dose that was prescribed)... And another time, I was very very bad after an injection of metoclopramide, an antivomiting drug that acts on the brain...

We are over sensitive to meds, especially on meds affecting the central nervous system or ion channels, which are already dysfunctionning for us..;

"Promethazine affects ligand gated ion channels such as purinergic P2 or cholinergic ACh receptors and voltage dependent ion channels such as sodium, calcium, or potassium channels. Beside, these effects, promethazine also inhibits the brain NaþKþ-ATPase and the mitochondrial permeability transition pore."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3852816/

I wonder if Acetylcholine receptor polymorphism could predispose to bad reactions, there is a thread here on PR about This polymorphism potentially linked to CFS/ME:

http://forums.phoenixrising.me/inde...e-receptors-in-chronic-fatigue-syndrom.37738/

 

[Sushi]

I'm waking up today, feeling like I've pulled back from the precipice. I feel I could have passed away at various junctures in the past five days, with the closest call coming just 30 hours ago.

That is just so horrifying Wayne. Really glad that you seem to have turned the corner. Knowing the half life and time for a drug's complete clearance is something I have found really helpful when I had a bad reaction.

Keep us posted. This thread has been an important caution about this class of drugs.

I even had a feeling of happiness again this morning

That is really good to hear! I hope it grows in the coming hours.

 

[Sushi]

@Wayne I just noticed the banner article today: Choline on the Brain? A Guide to Choline in Chronic Fatigue Syndrome. It is an old Blog by Cort summarized here: http://forums.phoenixrising.me/inde...to-choline-in-chronic-fatigue-syndrome.56944/