Antidepressant Update I
By Andrew Gaeddert
Earlier this year, we presented a teleseminar on antidepressant herbs as well as printed material pointing out that many Americans want to stop taking prescription medications due to side effects and lack of efficacy. Another concern is that it can be very difficult for patients to stop these medications cold turkey. Furthermore, it has been reported that these medications may be unsafe for children and adolescents. It is estimated that children taking SSRI (Selective Serotonin Reuptake Inhibitor) medication have an 80 percent increased risk of suicide than children and young adults taking a placebo. Interestingly, adult and childhood depression looks much different. When it comes to the biological underpinnings of depression in young people and adults, “the differences far outnumber the similarities,” says Robert A. King of the Yale University Child Study Center. “We don’t even know if depression that begins in childhood is the same disease as adult-onset depression.”(wsjonline.com)
For example, teens diagnosed with depression feel bored, moody and irritable, whereas adult depression can be characterized as a consistently down or sad feeling, commonly referred to as “the blues”. Adults with depression show elevated levels of the stress hormone cortisol whereas young people do not typically show elevated levels. Brain imaging studies suggest that the prefrontal cortex, the seat of higher thought, analysis and planning, is more developed in adults than young people. It acts to inhibit intrusive and impulsive thoughts. As antidepressants are known to disinhibit, they may further loosen impulse control. Another theory is that the increase in neurons produced by SSRI medication, is more dangerous to children than adults. Finally, young people diagnosed with depression are more likely to develop bipolar disorder than adults. In young people with underlying bipolar disorder, antidepressants can make patients agitated enough to contemplate suicide.
For your adults and pediatric patients who suffer from mild to moderate depression, Health Concerns solutions such as Aspiration, for depression and Calm Spirit for anxiety-based depression, can be effective substitutes. These formulas are also helpful in the process of weaning patients off of pharmaceuticals. SAMe is another antidepressant substitute that can be safely combined with SSRI medications. Health Concerns’ SAMe is the same as used in European clinical trials. In addition, Griffonex 5-HTP boosts serotonin in the brain without the side effects associated with SSRI antidepressants.
Additional formula information can be found in the Health Concerns Clinical Handbook. Download teleseminars, Antidepressant herbs and Antidepressant Update and Thriving During the Holidays – www.healthconcerns.com.
Antidepressant Update II
By Andrew Gaeddert
For several thousand years, Chinese medicine has worked on the belief that there is an association between heart health and the emotions. Most recently Western medicine has been exploring this link. It appears that pro-inflammatory cytokines activated by depression may promote the progression of heart failure. Furthermore, studies have uncovered evidence demonstrating the adverse relationship between depression and heart disease. Platelet aggregation is found in both depression and ischemic heart disease.
A number of studies have demonstrated a relationship between depression and low perceived social support with increased cardiac morbidity and mortality in patients with coronary heart disease. There is also evidence that depression increases the risk of acute myocardial infarction and morbidity and mortality following it.1
I became interested in the link between the motions and heart health after one of the clients at our clinic, Kevin, was administered an SSRI (Selective Serotonin Reuptake Inhibitor) following his first heart attack as he was having signs of depression. Was Kevin’s depression because he was in his forties and having a heart attack, or was Kevin depressed due a “weakening of his heart”? Was the weakening of his heart caused by the heart disease or the fact that his wife was having an affair? In addition to taking Shen Gem and St. John’s Seng, Kevin decided to embark on an exercise program, one of the most powerful things one can do to combat depression and to improve cardiovascular function.
To create and maintain a healthy heart, you might want to look at Flavonex. This formula treats circulatory-related problems and is widely used for the prevention of degenerative cardiovascular diseases. In addition, to help reduce high LDL cholesterol, one of the leading contributors to heart disease, Polilipid is an excellent solution. For these, and other healthy heart solutions, please refer to your Health Concerns Clinical Handbook.
Notes
- 1. Prev Cardiol. 2004 Spring; 7(2):83-90
Antidepressant Update III- Star-D Study
By Andrew Gaeddert
Americans spend about $12 billion a year on antidepressants, but we still have little understanding of how or whether they work. In 2006, the National Institute of Mental Health released the results of the largest and longest depression study ever undertaken, the Sequenced Treatment Alternatives to Relieve Depression Study, or Star-D. Star-D rejected typical clinical study design and aimed to create a real-world representation of how patients actually experience and treat depression: through trial and error, taking one drug after another, searching for one that helps.
The results were mixed. Star-D found that if you are depressed and spent three months on a potent psychotropic drug, you had a one-third chance of achieving remission. After almost six months on drugs, your chances improve up to about fifty percent and you still risk side effects like sexual dysfunction, insomnia, and weight gain.1 For clients who have mild to moderate depression, the nutritional supplement SAMe and herbal treatments maybe the best treatment options, whereas for clients with major depression including suicidal thinking, drugs and other psychiatric treatments may hold the best option.
SAMe, S-Adenosyl-L-Methionine, occurs in the body naturally. It is made from the amino acid, methionine, and is believed to be involved in many critical biochemical processes in the body. It is an antioxidant, an anti-inflammatory and even helps in the production of brain chemicals called neurotransmitters. “It does in fact have activities in a number of places in the body — it’s ubiquitous,” says Mary Hardy, a University of California, Los Angeles physician, and principal investigator of a U.S. government commissioned review. The review, published in 2002 by the U.S. Department of Health and Human Services, found evidence supported the use of SAMe for depression, arthritis, and liver disease, but concluded that additional research is needed. SAMe has also been shown to increase the response rate of standard antidepressants such as Zoloft and Effexor, and has been used in clinical trials for Chronic Fatigue Syndrome and Fibromyalgia.
“When we added SAMe to standard antidepressants such as Zoloft or Effexor we achieved response rates of 40% to 50%,” says Harvard scientist Jonathan Alpert, associate director of the Depression Clinical and Research program at Massachusetts General Hospital in Boston. Harvard is now conducting two placebo-controlled depression studies on SAMe funded by the National Institutes of Health.2
SAMe hasn’t been found to cause weight gain or sexual dysfunction, as do some standard antidepressants. It is usually not recommended for patients with bipolar disease as it may trigger mania. Health Concerns produces the original Tolyslate form of SAMe, which has been used in approximately ninety percent of the clinical trials. Unlike many products that have ecologically wasteful blister packaging, ours is stabilized without this type of packaging.
Health Concerns also produces Aspiration an all herbal supplement that can be used by itself or incorporated into pharmaceutical or nutritional regimens. Aspiration addresses all the major aspects and complications of depression: stagnant Qi, stagnant blood, heat, dampness, as well as food and phlegm entanglement. The formula treats the physical conditions, which are the felt symptoms of depression, including chest oppression and constriction, irritability, anger, frustration, flank pain, and various digestion complaints. Polygala is traditionally used to disperse stagnation in the chest, and is used in formulas for restlessness, palpitations, and insomnia. Albizzia bark promotes the free flow of liver qi and is used to treat depression. Poria leaches dampness, quiets the heart, and calms the spirit. Two Western herbs, vervain, and damiana are used to lift depression. The remaining herbs calm the liver, relieve blood stasis, and regulate the movement of Qi. As the formula does not contain St. John’s wort or other herbs known to interact with Western antidepressants, we have used Aspiration, for clients wishing to reduce Prozac and other SSRI medications.
Aspiration
- Polygala root (yuan zhi)
- Vervain herb (Herba verbenae officinalis)
- Uncaria stem (gou teng)
- Gardenia fruit (zhi zi)
- Albizzia flower (he huan pi)
- Damiana leaf (Folium Turnerae aphrodisiacae)
- White Peony root (bai shao)
- Tang Kuei root (dang gui)
- Pinellia rhizome (ban xia)
- Poria sclerotium (fu ling)
- Aquilaria sinensis wood (chen xiang)
(See CD #8, Antidepressant Herbs or download the MP3 from our website:
www.healthconcerns.com; for more information about Star-D see: www.nimh.nih.gov/health/trials/practical/stard/).
Notes
- 1. Goetz, Thomas. Practicing Patients. nytimes.com.March 23, 2008
- 2. Johannes, Laura. Supplement to Ease Pain and Brighten Mood. wsj.com. April 1, 2008: Page D2.