Last updated Thursday, 21-Aug-2008 19:39:42 MST

This section gives a scientific breakdown of how the three medications in the PTSD Cocktail work.

1. Geodon [Zeldox, Ziprasidone] (20 mg)
2. Propranolol [Inderal] (10-20 mg)
3. Vistaril (25 mg)

Post traumatic stress disorder (PTSD) is associated with excess fight-or-flight chemicals called catecholamines. These chemicals (or hormones) are elevated in individuals who are suffering posttraumatic stress and result in behavior and physical changes including anger, sadness, moodiness, racing heart, racing thoughts, chest pain, diarrhea, constipation, sweating, trembling, sleeplessness, nightmares and SO much more!

One way to assess the level of fight-or-flight chemicals is to take a 24-hour catecholamine test. This will have you collect urine for 24 hours in the same container to review the average level of catecholamines throughout the day.

Another important test is to have your levels of cortisol checked. Coritisol is the chemical the body releases in order to reduce the fight-or-flight hormones that are released in response to stress. If your cortisol levels are low, it is difficult for them to remove the elevated levels of catecholamines in your body. An initial cortisol test can be done with your general practicioner. It *MUST* be completed as a fasting blood draw between 8 and 9 am to get an accurate number. Cortisol levels are highest in the morning, so the ideal number should land in the teens. However, there is a "range" reviewed and you may fall at the low end of that range and be told that your levels are within "normal." Be certain to ask for your SPECIFIC number. While you may be enough in range for the levels to not be considered life threatening, your level may be low enough that your body cannot deal with the excess fight-or-flight chemicals produced by PTSD.

In example, I tested at 3.1 for my cortisol levels - enough to scare my practitioner and enough that it explained the symptoms I had before PTSD, during, PTSD and after recovering from PTSD symptoms. I had problems with weight, appetite, vomiting, chest pain, diarrhea, constipation, irritability, extreme fatigue and muscle weakness. The endocrinologist was not concerned because she was looking for a number of 2 or lower. However, I was the one living with the symptoms so I knew that 3.1 was clearly not high enough for *MY* body. Perhaps it is enough for someone else, but if I wanted symptoms to stop and the PTSD to stay at bay permanently, I had to insist that we address the fact that my cortisol levels were clearly much lower than 10-17 and insist that the matter taken seriously.

Remember, we are the only people who truly know what is going on in our bodies and we must be our own advocates. Doctors may have more expertise by studying medicine, but we have all met supposed "experts" who are not as effective as we expect. Despite the leaps we have made in Western medicine, any good doctor will admit they do not know everything. Heck, if they did PTSD would already have been cured, right? :) So, ask for the specifics and work with a trusted psychiatrist or general practitioner that can help you put the pieces together. Low cortisol, plus low blood pressure, plus low blood sugar can all come together to create a perfect storm. While they may be in-range individually, together the total is too much for one body.

The formula for the PTSD cocktail should help you control PTSD symptoms while you work towards a final cure. The cocktail works by blocking PTSD chemicals - adrenaline (epinephrine), noradrenaline (norepinephrine) and dopamine. Geodon [Zeldox] blocks norpeinephrine, dopamine and some serotonin. Propranol [Inderal] blocks adrenaline (epinephrine). Vistaril can help by acting as an antihistamine and reducing the release of adrenaline. This can also be substituted with Benadryl. One Benadryl capsule over the counter essentially works just like one Vistaril capsule and may work even better than the prescription. Together, this "cocktail" of medicines will make fight-or-flight responses manageable so that you can commit to the spiritual and mental healing that will retrain your brain to normal levels of catecholamine release. For more information, read the PTSD Cure and PTSD Research Grant.

Remember, Geodon [Zeldox} is not available in generic yet, but the Pfizer website has information about a program to help you pay for your medicine. The US website can also provide the number for other Pfizer programs overseas.

The information below provides the scientific research and pharmacology that will help your physician make a more educated choice for your care. It also includes two important research studies that show just how effective these medicines are in treating PTSD specifically.

Geodon should be taken twice a day. Start with the lowest dose of 20 mg once a day and then step up to twice a day. Geodon lasts in the system for 8 hours, so a twice-a-day dosage will cover you during a normal 16 hour day.

Propranolol is MOST EFFECTIVE AT LOW DOSES. It lasts only 4 hours, so start with 10-20 mg four times a day. Also, at these lower doses, you can always pop an extra 10 mg pill in order to stop a panic attack or whenever you know you will be involved in a particularly stressfull situation. The maximum dosage used for stage fright is 40 mg. Because most PTSDers have low blood pressure in common, insist on a lower dose. Trust me, it will be extremely effective and you will be amazed at what one little pill can do. I have extremely low blood pressure, 88/58 on average, yet I can take propranolol with tremendous success and no side effects. Avoid extended release propranolol as that can cause an unsafe drop in blood pressure. When you talk with your doctor, insist on starting with the little 10 mg pills and you should have great success.

Most importantly, let us know about your success as well as your needs while using the PTSD cocktail. The greatest power is when we all pull our knowledge together to find the most effective treatments and cures!

Best wishes and a Carrot of Hope from your friends.

 Resources to Share with Your Doctor

      Geodon [Zeldox, Ziprasidone] Pharmacology: A direct link to Pfizer's website which explains, scientifically, the way Geodon (Zeldox) works in the body.

      Geodon [Zeldox, Ziprasidone] Works 89% of the Time!

      Inderal [Propranolol] Pharmacology: A link to the United States National Institute of Health (NIH) that discusses, scientifically, how propranolol works in the body. *CAUTION* Extended release (Inderal LA) does NOT work with PTSD, so insist that your doctor give you 10 or 20 mg tabs. We strongly recommend 10 mg. This way, you can use as little or as much as you need depending on the situation.

      Inderal [Propranolol]: A Pill to Calm Traumatic Memories

      Vistaril [Hydroxyzine Pamoate] Pharmacology: A link to the United States Federal Drug Administartion (FDA) that discusses, scientifically, how Vistaril works in the body. Also equivalent to hydroxyzine hydrochloride.