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19.06.2015

Drugs for depression anxiety and insomnia, lipoflavonoid pulsatile tinnitus - How to DIY

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If your world is clouded by mood disorders like depression, anxiety, insomnia or a distressing inability to concentrate on what has to be done, Unique Mindcare can help you.
Stress in our modern world can lead to depression, anxiety and insomnia, especially when attention issues are involved. You may be suffering from an anxiety disorder if you experience panic attacks or symptoms such as severe mood swings.
Feelings of sadness and hopelessness that keep you from functioning normally could mean you’re suffering from symptoms of depression. If you’re having trouble falling asleep at night or staying awake during the day you may be suffering from insomnia or a sleep apnea disorder. Unique Mindcare Houston Texas specializes in drug free treatments of Insomnia, Depression, Anxiety, and ADHD. More than 38 percent of Americans use complementary and alternative medicine (CAM) yearly, with 12.7 percent using so-called “natural products” (Barnes PM et al, CDC Nat Health Stat Rep #12, 2008). In this article I’ll cover the most frequently used over-the-counter agents for depression, anxiety, and insomnia— some of our more common presenting complaints and those for which patients often seek alternative treatments.
Saint John’s wort (SJW; Hypericum perforatum) is licensed in several European countries as a treatment for mild to moderate depression, and for anxiety and sleep disorders. Moreover, serotonin syndrome is a risk when taken with SRIs, triptans, sympathomimetics, and cough syrup. Valerian (Valeriana officinalis), a plant native to Europe, has been used for both insomnia and nervous tension since ancient Greece and Rome.
Standardized extracts that have been used in clinical trials are available, including Alluna Sleep, Valerian-400, and Sedonium. Kava may lead to hepatotoxicity and liver failure in susceptible clients taking relatively normal doses, and acute liver failure resulting in transplant has occurred after as few as four to 12 weeks of use. Ginkgo biloba, used medicinally for thousands of years, deserves mention because it’s taken by so many people with mood disorders who seek to improve memory and cognition.
Among the many supplements of amino acids (and their derivatives), the most effective for depression may be S-adenosylmethionine (SAMe). While not technically an amino acid, SAMe helps to form amino acids like the antioxidant glutathione, is required for catecholamine synthesis, and helps to regulate gene expression and membrane fluidity.


Compared with many other nonpharmaceutical supplements, three decades of literature suggest its efficacy and safety in depression.
GABA is used orally or sublingually for relieving anxiety, elevating mood, relieving PMS, and treating ADHD. Keep in mind that much of the research on herbal medications comes from Europe (Germany standardizes herbal remedies), where supplements have been regularly used for decades, although most studies are not randomized, placebo-controlled double-blind trials with an adequate sample size. Furthermore, supplements are products, not drugs, and the FDA does not require data on efficacy, safety, or purity for premarket approval, nor do they require a post-market surveillance period. Our medication-free natural remedies provide effective drug-free treatments to restore and optimize your brain and body functions. Our innovative drug-free medical treatments can help you to regain the physical and emotional balance that allows you to live a fulfilling life free of harmful symptoms. Whether or not you share your patients’ enthusiasm for supplements, their curiosity and participation are thriving, so this is a great opportunity for you to learn together. Though the active ingredients hypericin and hyperforin have been isolated, their mechanisms of action remain hypothetical. I do not use it in my practice and generally talk clients out of it, offering “natural” options I find more effective. Valerian rarely causes poor sleep quality or rebound insomnia when discontinued, or next-day impairment of functioning, problems commonly encountered with other sleep and anxiety medications.
While used for anxiety, insomnia, and menopausal symptoms, clinical trials show clear efficacy only for anxiety, for which it has been compared to buspirone and lowdose benzodiazepines. Data are mixed, but most do not demonstrate significant support for acute or long-term use. Others include GABA and N-acetylcysteine (NAC) (see Emily Deans’ article in this issue for a discussion of NAC).
SAMe supplementation can, theoretically, result in increased levels of serotonin, dopamine, and phosphatides.
It’s somewhat more effective intramuscularly than in its oral form; in fact, there’s only preliminary evidence supporting the use of oral SAMe.
There’s little actual evidence on its effectiveness in humans, although anecdotally, a number of my patients with a trauma history find it calms physiologic symptoms of anxiety and can be helpful for sleep.


Mechanisms of action and bioavailability may be unstudied or unknown, and perhaps dependent on the synergy of other chemicals present in an herb, or cofactors used with an amino acid. There is no legal definition of terms like “standardized,” “certified,” or “verified,” and the presence of additives, fillers, or contaminants is not regulated in any fashion. Many studies are methodologically flawed and outcomes equivocal, so conversations with your colleagues and anecdotal evidence about effectiveness and usage tips are valuable. While the former has been studied throughout the world for many years, the latter is just beginning to receive attention. The FDA also warns against the concomitant use of hypericum with a range of medicines, as it induces CYP3A4 robustly, and the P-glycoprotein transporter to a lesser extent. This herb has been touted as an “adaptogen” for its ability to promote resilience under a variety of stressors (Kelly, op.cit, 2001). Clinical trials for insomnia and other sleep problems have been mixed; systematic reviews of these studies have found the evidence inconclusive due to publication bias and significant variability among studies in subjects (including small sample sizes), and in sources, preparation, and doses of valerian. Typical recommended doses include 450 mg of extract for sleep, taken one hour before bedtime (study doses have ranged 400–900 mg), and 200–300 mg of extract in the morning for anxiety. Evidence for ginkgo’s usefulness in other areas of interest to people with depression—including tinnitus and antidepressant-induced sexual dysfunction — is no more promising than the memory research. Purported mechanisms include the suppression of stress-activated protein kinases, as well as anti-inflammatory and antioxidant pathways.
Few studies of valerian in anxiety have been undertaken, and in a Cochrane Review only one available study met their strict inclusion criteria.
Neuropsychiatric uses of SAMe include depression, anxiety, premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), attention deficit hyperactivity disorder (ADHD), and improving intellectual performance, among many others. Nausea and vomiting may occur, so start low and go slow with 200 mg twice daily for two days, then 400 mg twice daily on day three, increasing to 800 mg twice daily over the following two weeks.
SAMe has been associated with (hypo)mania in case reports and clinical trials of both oral and parenteral formulations, and may exacerbate anxiety.



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