Editor’s Comment
About a month ago Safe Harbor launched an e-mail list (see notice below) for professionals called Integrative Psychiatry, the purpose being to share information, experiences, research, etc. on non-pharmaceutical treatment of mental disorders. We have been very pleased by the involvement of professionals from around the U.S and the world.
We have included in this month’s issue comments from some of the contributors to the list. Our thanks for their permission to reprint.
One of the key barriers to the expansion of alternative mental health treatments among practitioners is the simple lack of knowledge. We hope this list will contribute toward the greater use of safe mental health treatments around the globe.
Announcement: Practitioners Invited to Join Integrative Psychiatry E-Mail List
Safe Harbor has created an email list called Integrative Psychiatry. It is for healthcare practitioners who are interested in sharing information on integrative (holistic, complementary) mental health treatments.
To join the list, send an email saying so and saying what kind of practitioner you are to: SafeHarborProj@aol.com.
Below are a couple contributions to the list in the past few weeks:
1. From William Walsh, Ph.D., chief scientist, Pfeiffer Treatment Center, Naperville, IL: “I’d like to alert you to a striking abuse of psychiatric medications that is becoming a fad today. This involves the use of Risperdal for very young autistic children. We have seen countless children who were taking heavy doses of this powerful ‘atypical antipsychotic’ medication, including several who were under the age of 3. The Physician’s Desk Reference states, ‘Safety and effectiveness (of Risperdal) in children have never been established.’ I’m especially concerned about the very young children whose brains are still in the formative stage.”
Editor’s Note:
In Sept. 2002, out of concern for this pattern of increased prescribing of antipsychotics for children, Blue Cross of California announced it will not pay for such prescriptions unless prescribed by a “specialist.”
2. From psychiatrist Nancy Mullan, Burbank, CA: “When you come to the issue of diet and nutrition, you come to the heart of the healing process. No one would wonder why a car wasn’t running well on gasoline which was bad for it.
“I frequently recommend food allergy testing. I use Signet Diagnostics in Riviera Beach Florida. Their telephone number is 561 848-7111. I am an aficionado of food allergy testing. I have researched out the best both out of self interest and the wish to succeed with my patients. The importance of diet cannot be overstated. It is the sine qua non of treating any complex illness successfully, psychiatric or otherwise. If you are having reactions to what you are eating, you perpetuate the cycle of forming symptom-producing circulating immune complexes which then tax your liver and use up important nutrients.
“One of the reasons why the yeast syndrome is usually so enduring is because no broad-spectrum yeast diet is right for any particular individual. Each person must find out what foods they are allergic to and eliminate them. Then eliminate the other issue of dysbiosis (wrong organisms in your digestive tract) and the commonly found lack of hydrochloric acid and you can really make progress. You will be feeling much better and have the foundation for investigating hormonal imbalances, amino acid disturbances, heavy metal toxicity, etc.
“Any complex physical or mental health disturbance usually has several or even many contributing factors. As each one is discovered and eliminated, more troubling symptoms are relieved. My experience is that diet is literally 60-70% of the solution to complex health problems. Nutritional supplementation works best after the correct diet is established. And the need for overwhelming amounts of expensive supplementation is eliminated.
“Comprehensive blood testing for food allergy can be expensive, around $500, and the lesser tests aren’t worth the money. Some insurances cover it, others do not. The insurance CPT code (Current Procedural Terminology code) is 83516 for food allergy testing, if you want to find out if your insurance covers it. I have a version of an elimination diet by Dr. Alan Gaby which anyone can do. It is a hassle, but you can pick off the main offending foods and get an impression of how important food allergy is for you without any expense. Call me at 818 954 9267, fax 818 954 0620 or write to 2829 W Burbank Blvd. # 202, Burbank, CA 91505. I’ll send the diet to you.”
Alternative Mental Health Support Group Meeting in Los Angeles
Safe Harbor has established a support group in Los Angeles for people interested in or currently using non-drug approaches for mental health for themselves or loved ones.
The group meets at 7 PM on the 2nd and 4th Wednesday of each month at the Safe Harbor office at 1718 Colorado Blvd in Los Angeles. For further info, contact the office at (323) 257-7338.
Gant’s Rant: Proper Testing for Mental Disorders
The following “Gant’s Rant” is the first of periodic submissions which will appear in The Alternative Mental Health News from Charles Gant, M.D., Ph.D., of East Syracuse, NY. Dr. Gant is author of End Your Addiction Now and ADD and ADHD: Complementary Medicine Solutions
In my practice, the two most important tests for psychiatric patients, besides the usual thyroid panel, U/A, CBC, etc., are the RBC minerals for both toxic and nutrients metal, and the plasma amino acid panel. Then the next most important is hair testing for heavy metals and fatty acids RBC membrane testing.
If there are gut problems or a significant history, the stool testing and candida antibody testing might be bumped up to the top of the list. Finally, hormone testing, food allergy testing (also bumped up if allergies or GI problems), extensive thyroid testing (including thyroid antibodies, reverse T3), iron/TIBC/ferriten, vitamin panels, and now the genetic polymorphism panels rounds out the list.
There are others, but I don’t stop testing until I find the answers and get the patient well.
My practice is based on an assumption that hobgoblins and stress and video games do not cause chronic mental illness, even though they may play roles that I do not focus on. I make an assumption that the biochemical answers are there if a sufficiently diligent search is made for them. As tests get better and I get more proficient at interpreting them, and as nutritional supplements keep improving, the outcomes of my patients would suggest that that assumption is valid.
It is also possible, as has been pointed out to me, that I love and care about my patients so much, that the biochemical factors may have nothing to do with positive outcomes. If so, I will continue to plod on as if they do because it sure makes for interesting clinical discussions.
Announcement: Speakers on Mental Health/Alcoholism Needed
Safe Harbor received the following request from Foundations Associates. Speakers on non-pharmaceutical approaches for dual diagnosis (mental health/substance abuse) are encouraged to take part.
“Do you have any speakers that would be able to present on mental health/alcoholism in the managed care setting? I would like to line up speakers for our 2003 conferences. We produce national conferences around the United States educating professionals, family members and consumers about the integration of treatment for those that are dual diagnosed. This year we have had four conferences in San Antonio, Atlanta, Baltimore, and Las Vegas. Next year we plan to be in Nashville on March 17, 18, 19, 2003, Washington D.C./Arlington, VA area in May, Orlando in July and Las Vegas in October.”
Therese M. Byrne
Foundations Associates
Training and Education Coordinator
220 Venture Circle
Nashville, TN 37228
1-888-869-9230 ext. 207
fax – 615-742-1009
TByrne@dualdiagnosis.org
www.dualdiagnosis.org
Video Available of Safe Harbor’s Oct. 24 Awards Event
For those who could not attend Safe Harbor’s outstanding awards event of Oct. 24, a video is available from our office for $35 plus shipping (plus tax in California). The video is nearly 4 hours long!
It opens with a one-hour “Ask the Doctor” session, with questions answered by national alternative mental health experts William Walsh, Ph.D., Priscilla Slagle, M.D., and Hyla Cass, M.D.
The awards event follows with inspiring presentations by world champion amputee athlete Paul Martin, two recoverees from mental disorders, psychiatrist Stuart Shipko, Safe Harbor president Dan Stradford, Priscilla Slagle, M.D., and William Walsh, Ph.D. Also included is a 15-minute video presentation and special message by country star Cledus T. Judd, who has recovered from bipolar disorder without psychiatric drugs.
In the middle of the event is a dramatic musical performance by rock gospel queen Robbie Brown and her family that completely brought down the house.
Videos may be ordered at (323) 257-7338 or may be purchased online at https://secure.corpsite.com/secure_alternative/donation.htm (Simply note “Event video” in the message box.)
Guest Article: Underlying Causes of Dementia
The following was contributed by John Dommisse, M.D., of Tucson, AZ, at www.johndommissemd.com in a recent comment on Safe Harbor’s Integrative Psychiatry list.
Hardly anyone is continuing to address the known causes of dementia, like they were in the ’60s and at other times in medical history: Vitamin B12 (and also folate) deficiency; under- or undiagnosed or under-treated hypothyroidism; zinc deficiency; copper and other mineral/ heavy metal excesses; hormonal factors; etc.
The reason why these causes of dementia are not addressed in patients is because the “normal ranges” for the deficiencies are way too low, and, in the case of the excesses, they are hardly ever measured for, including the common copper excess that occurs in people whose homes have copper plumbing.
The neglect of B12 deficiency is the most criminal, and, again, is due to the ridiculously-low “normal range” for this crucial vitamin for brain and nerve function. [Yes, peripheral neuropathy is also hardly ever treated for the B12 deficiency that underlies most of it – because the patients’ B12 levels are “shown to be in the lab normal range”!!] In the US this range is usually about 200-900; in Japan it is 500-1300 pg/ml! Both can’t be right!
I actually use 600-2,000 as my normal range, to be safe and cheaply-preventative. All mammal babies are born with a level of about 2,000 pg/ml, which then slides inexorably downward throughout life, the ones remaining above 600 largely escaping “Alzheimer’s,” the ones below that level suffering this devastating and humiliating condition – undiagnosed between 200 and 600, and only diagnosed when they drop below 200 pg/ml.
By this time, the patient has had several years of memory loss and it has become irreversible – “proving” that B12 treatment doesn’t work!! And almost a CENTURY after Langdon published his paper in JAMA about “pernicious anemia” possibly manifesting its neurological symptoms BEFORE its anemia and macrocytosis, physicians are STILL thinking that B12 deficiency of the brain can’t be present if the patient doesn’t have a macrocytic anemia!!
I treat grade-3, the mildest grade of primary hypothyroidism, and always see dramatic increases in functional abilities and the loss of classic hypothyroid symptoms as a result – including memory difficulties. Thus, no elderly or middle-aged patient of mine, of which I have had thousands, has ever developed “Alzheimer’s.” It’s as simple as that. None of the very expensive genomic, or even enzyme, research is necessary. At least the enzyme type of research is nutritionally oriented.
Depression and bipolar disorders, “unexplained” fatigue, and even violent behaviors, are additional sequelae of the medical profession’s – including alternative practitioners’ – “forgetting” and/ or neglect of these crucial factors. Nowadays, when a neurologist sees demyelination of the nerve sheaths in the brain on MRI, his first thought is MS (multiple sclerosis) and he may entertain NO thought of B12 deficiency, which is much more common. And Prof E.H. Reynolds of London has shown that B12 treatment benefits most cases of MS, most of which have low or borderline-low B12 levels.
New Study Supports Effectiveness of Fish Oil against Depression
Individuals who experience mild to moderate depression may find all the relief they need from an increased intake of omega-3 fatty acids and other nutrients that promote the ideal transmission of nerve impulses in the brain.
Further support for the effectiveness of omega-3 comes from a new study by Peet and Horrobin, reported in the October issue of the Archives of General Psychiatry, and a parallel study conducted at Harvard Medical School with similar group size and methods.
Dr. Malcolm Peet of the Swallownest Court Hospital in Sheffield, England and his colleague, Dr. David F. Horrobin, observed a decrease in symptoms of depression in patients who received a daily dose of 1 gram of the omega-3 fatty acid ethyl-eicosapentaenoate (EPA) for 12 weeks.
70 depressed patients who had not responded to antidepressant medications were given a daily dose of either 1 gram, 2 grams or 4 grams of EPA, or an inactive drug. Before and after the testing period, the patients’ levels of depression were assessed using 3 different rating scales.
The greatest response was recorded in the group that received the 1-gram daily dosage. 69% of this group achieved a 50% reduction in their symptoms of depression, as compared to 25% of the patients given an inactive drug.
One of the authors of the Harvard study, psychiatrist Andrew Stoll, M.D., told Prevention magazine: “All cell coatings are made of fats, and when those fats are omega-3s, the serotonin receptors on the surface of brain cells seem to function in a healthier way.”
Earlier studies found relatively low levels of omega-3 fatty acids in the blood of depressed patients and those diagnosed with cardiovascular diseases.
Omega-6 fatty acids are also essential. Abundant in processed foods, omega-6 fatty acids outweigh omega-3 by 20 to 1 in the typical modern diet. The ratio should be 1:1 for optimum functioning, according to Jenny Thompson of the Health Sciences Institute.
Thompson says the best source of omega-3 is fish, particularly dark meat fish such as tuna and swordfish. The problem is the threat of ingesting too much mercury, sometimes present at high levels in these fish. “Fish oil supplements are an excellent alternative, and will deliver far more omega-3 than your diet ever could, unless you happen to eat large amounts of tuna and swordfish every day.”
SSRIs May Stunt Child Growth
The use of SSRI antidepressants in children may have an effect of limiting growth in selective cases, claims a recent report in the Brown University Child and Adolescent Psychopharmacology Update [4(10):1, 2-4, 2002].
The article outlines four case histories of children who were place on SSRIs resulting in attenuated growth in each child. The report provides “new and controversial evidence of a possible association between treatment with SSRIs and endocrinologic adverse events.”
The report was written by Naomi Weintrob, M.D., of the Institute for Endocrinology and Diabetes at Schneider Children’s Medical Center of Israel, and colleagues. All four children showed growth attenuation and decreased growth hormone (GH) secretion during treatment with SSRIs for obsessive-compulsive-disorder or Tourette syndrome.
All patients were treated with either fluvoxamine (Luvox) in the dose range of 50 to 100 mg per day or fluoxetine (Prozac) in the dose range of 20 to 80 mg per day for a period of six months to five years. All demonstrated growth attenuation or arrest despite the absence of chronic disease and other hypothalamic-pituitary function abnormalities. The patients in the study, three boys and a girl, were referred to an endocrinologic clinic for short stature, slow growth rate and/or overweight. In each of the patients, weight gain was consistent during SSRI therapy, and thyroid, prolactin and urinary cortisol levels appeared within normal range.
Responding to the report, Stuart Shipko, M.D., one of the world’s leading experts on SSRI’s, told the Alternative Mental Health News, “This is more than academic. It is a case report of only four cases, but I have already seen one that is similar in my office — and I don’t see that many kids.”
Learning Problems and Central Auditory Processing Disorders
The similarities between hearing problems and learning difficulties have been remarked upon before, and audiologists now have testing available for children (and adults) that go beyond the ear itself, into the central auditory nervous system.
Hearing is a complex process, explains Judith W. Paton, M.A., an audiologist in private practice in San Mateo, CA. “Not all the hearing is done in the ear. In fact, simply stated, the ear merely brings in all the environmental sounds human beings can hear and delivers them unseparated to the bottom of the brain in the brain stem (just above the spinal cord).
“As the hearing nerves criss-cross up these several inches the ‘sorting out’ or processing begins…. The auditory system must convey the speech sounds (they are not yet identified as words) without distortion up to the cortex of the brain. Here the temporal lobe organizes them into words and the information is routed to other centers of thought, action, sight, and so on.”
Several elements are depended upon for these actions to occur. There must be enough nerve fibres, no cell loss, all the nerves have to transmit at normal speed, and the brain must be able to produce proper amount of neurotransmitters for the nerves to carry the messages.
Cells can be lost through improper development of the embryo or by lack of oxygen at birth. Head injuries, strokes, and sometimes allergies, can cause the brain to swell, which, in turn, can cause the nerves to transmit at diferent speeds. Additionally, production of neurotransmitters can be inhibited in certain conditions such as Parkinson’s Disease, Tourette’s Syndrome and autism.
Some symptoms of Central Auditory Processing Disorders (CAPD) can mimic hearing loss within the ear itself, but if a regular hearing test has normal results, it may be time to test for CAPD. There are many symptoms to look for, including:
greater tendency to ignore a speaker when engrossed in something;
unusual sensitivity to or complaints about noise;
difficulty telling the direction from which the parent is calling;
tendency to confuse similar-sounding words;
confuses or forgets directions if several given in one sentence.
It is usual that CAPD is accompanied by other problems such as difficulty focusing the eyes and tracking words across a page. The condition is also not limited to children. For guidelines to help you decide if audiological tests are indicated, and for more information on symptoms, diagnosis, and remedies, see Paton’s article at www.ldonline.org/ld_indepth/process_deficit/capd_paton.html.
County Mental Health System Achieves Almost No Recoveries
If you are mentally unwell and are treated in a county mental health system, your chances of full recovery are less than one in 1000 – at least if you are in King County, Washington – and it is one of the most progressive counties in the United States, home of the city of Seattle.
So says the first Annual Report on the mental health system in King County, Washington submitted at the end of April this year.
In October, 2000 an ordinance was passed by the Metropolitan City Council of King County requiring improved “customer service and performance measurement for clients” and setting the new purpose of the mental health system as “to assist individuals in progressing towards recovery.” The Alternative Mental Health News was the first to report on this when it happened and the full ordinance is posted at www.alternativementalhealth.com/articles/article_KingsCounty.htm.
The “clients” are patients with diagnoses of schizophrenia and depression, including major depressive, bipolar and dysthymic (long-term depression) disorders. The first report on the efficacy of the system was due April 30, 2002, and covered the period January 1, 2001 through December, 2001.
Per the report, of 7831 patients, 6,949 (88.7%) showed no improvement, 597 (8%) showed some improvement, 285 (4%) regressed, and four (.05%) recovered.
The goal for patients in the system is recovery – defined in the ordinance as “a process, a way of life, an attitude, and a way of approaching the day’s challenges. It is the hope and expectation that a meaningful life is possible despite mental illness. Recovery emphasizes the restoration of self-esteem and on attaining meaningful roles in society. Recovery includes development of self-esteem through active participation in society.”
King County alone budgeted $90,199,426 to the mental health division to serve clients as well as budgeting significant dollars for related services in 2000.
Ireland Says No to Seroxat (Paxil)
Bloomberg News reports that the Irish government has taken action to protect the Irish from Seroxat (Paxil in the U.S.), a drug linked to suicidal behavior and to severe withdrawal symptoms.
Ireland told GlaxoSmithKline to recall its $2.7 billion drug, because its information leaflet to patients fails to warn about possible suicidal behavior. SSRI antidepressant drugs that were touted as a treatment to reduce suicide have been linked to inducing suicide in some patients.
The U.K. pharmaceuticals company has been ordered to recall all stocks of the antidepressant drug Seroxat stored by wholesalers, said the Irish Medicines Board, which controls the sale of medicines in Ireland.
The board had asked GlaxoSmithKline to change the leaflets at the end of 2001. Glaxo’s revised wording merely warned patients that suicidal thoughts may increase in the first few weeks of treatment.
The Brentford, England-based company has now been told to “revise the wording on the license and patient information leaflets to include a reference to suicidal behavior and depression,” the board said in the statement.
On October 13, the British Broadcasting Company BBC aired an investigative report about the adverse side effects of Seroxat (Paxil) and the other SSRIS, presenting patients who had been affected, doctors and pharmacists. The BBC expose can be viewed online at www.drugawareness.org.
The report interviewed David Healy, MD, an expert on SSRIs, who was allowed access to confidential documents in the GlaxoSmithKline archives. He served as an expert witness in a successful U.S. lawsuit against the company last year.
“Donald Schell was a man with a history of several relatively brief episodes of depression,” Healy wrote in an informative article titled Ploughing the Archives.
“He had a prior history of an adverse response to Prozac in 1990.
“He had then subsequently been put on Seroxat by another physician in 1998 and 48 hours later had murdered his wife, along with his daughter and granddaughter who were staying with Don and Rita Schell for a few days before killing himself.
“His surviving son-in-law, Tim Tobin, took out a case for wrongful death against Glaxo-SmithKline.
“As part of my background research for this case, I had been given access to GlaxoSmithKline’s Seroxat healthy volunteer archive. This involved being brought into a room with several hundred thousand pages of data from healthy volunteer trials.
“The reason to chase these files was that it had shortly before become clear to me from a study conducted in north Wales on healthy volunteers taking sertraline, another SSRI, and from looking through the healthy volunteer archives held by Pfizer on sertraline, that SSRIs could trigger suicidality in even healthy volunteers.
“Access to GlaxoSmithKline’s archive in Harlow had only been granted, as far as I know, essentially a week before my final report in the case was due to be submitted.
“Nevertheless, it was possible to find and assess all the records that were present from studies conducted before Seroxat came on the market. Some records were clearly missing and have not been provided since.
“It was clear from this that Seroxat caused agitation in around 25% of takers, that it made things worse when the dose of the drug was increased and problems cleared up when the drug was stopped only to re-emerge when it was restarted.
“According to the usual rules therefore this drug was causing agitation. There had also been a suicide in the program. And Seroxat in one healthy volunteer study was linked with withdrawal effects in around 85% of subjects.”
In the course of the proceedings, it was not contested that key studies had been terminated early with their results left unpublished.
The experts for SmithKline in the case agreed they had not seen the raw data from the clinical trials programme for Seroxat. It was also not contested that despite grounds for concern, no tests had been conducted to see whether Seroxat or other SSRIs could make people suicidal.
On June 6th the Court came to a verdict, which found against GlaxoSmithKline and awarded damages of $6.4 million.
“All the records in my possession have now had to be returned, and as far as I know the only other outsiders who could conceivably get access to them, would be expert witnesses in further legal cases,” Healy concluded.
Food Colorings, Additives Linked to Behavioral Problems
In the September issue of Alternative Mental Health News, we published the findings of an Australian study on the behavioral effects of the food additive, calcium proprionate. These included irritability, restlessness, inattention, and sleep disturbance. Used to prevent mold when hot loaves of bread are put in plastic bags, calcium proprionate is found in nearly all bread in Australia. The study showed that after eating only four slices of bread a day for three days, nearly half of the children who participated in the study showed worse behavior.
A recent government-funded study by UK’s Asthma & Allergy Research Centre has now found that food colorings in food commonly eaten by children also can effect a child’s mood and behavior – even in those who have no history of hyperactivity.
The month-long study in the Isle of Wight tested 277 three-year-olds. For the first two weeks, the children drank fruit juice dosed with 20 mg. of artificial colorings, and 45 mg. of a preservative. During the last two weeks, the children drank an identical-looking placebo fruit juice with no additives.
Parents assessed behavior such as “interrupting,” “fiddling with objects,” “disturbing others,” “difficulty settling down to sleep,” “concentration,” and “temper tantrums,” and then filed reports.
The researchers concluded that “significant changes in children’s hyperactive behaviour could be produced by the removal of colourings and additives from their diet. The findings of the present study suggest that benefit would accrue for all children from such a change and not just for those already showing hyperactive behaviour or who are at risk of allergic reactions.”
Further, the researchers estimated that if the problem additives were removed from all children’s diets in the UK, the rate of hyperactivity would go down from one child in six to one child in 17.
The preservative Sodium Benzoate E211 was used in the study, as well as the artificial colorings known as Tartrazine E102, Sunset Yellow E110, Carmoisine E122, and Ponceau 4R E124.
A survey by the Food Commission, a national non-profit watchdog organization, found that 41% of children’s food products in the UK contain added color. The Food Commission has now written to the UK Food Standards Agency asking what action it will take to protect children from the problem additives, and whether guidance will be issued to food companies to remove these additives from children’s food.