The question of why there were any outliers given the nature of the drugs in this protocol, remained something of a mystery until it was realised that the ‘cardiac switch’ created by the digitalis and propranolol was occasionally failing. When the switch failed, it allowed for some escape heartbeats to occur. This reduced the ischaemic hypoxia. It was reasoned that this failure was associ- ated with the cardio-protective characteristic of a large proprano- lol dose. The propranolol was, therefore, replaced with 8gm of the tricyclic cardiotoxic drug, amitriptyline. This D-DMA mix reduced the outliers again. More than 90 percent now died within 2 hours. The resultant mean time to death became a little over an hour.
In 2019, 2gm of the B blocker Propranolol was replaced by 8gm of the tricyclic Amitriptyline in the 4-drug mix
The tricyclic Amitriptyline is marketed on-line as Endep.
