Supplements have a role in treating depression/sleep disorders

As 2013 drew to a close, there was much buzz about new studies showing that curing insomnia in people with depression might double the chance of a complete recovery from depression. The studies, financed by the National Institute of Mental Health, were welcomed as the most significant advance in treating depression since the introduction of Prozac 25 years ago. In effect, the new research findings turn conventional wisdom on its head, since they suggest that insomnia may be a main cause of depression, rather than just a symptom or a side effect, as has usually been assumed. So, if you can successfully treat a depressed person’s insomnia, you may be eliminating one of the main factors causing the depressed state.

As we followed news stories about this breakthrough research on insomnia and depression, we were especially encouraged to read comments from Washington DC psychiatrist James Gordon, who has advocated for an integrative approach to treating depression. Here’s his letter to the New York Times:

I welcome a new report’s finding that cognitive behavioral therapy is improving the outcome for depressed people with significant insomnia (“Sleep Therapy Seen as an Aid for Depression,” front page, Nov. 19).

It reminds us that changes in attitude and perspective, and a therapeutic relationship, can right biological imbalances — like disordered sleep — and significantly enhance the lives of troubled people. The study also puts the therapeutic role of antidepressant medication in perspective: the depressed participants who received behavioral therapy did equally well whether or not they were taking the drugs.

I hope that these results will encourage the National Institute of Mental Health, researchers, clinicians and all of us to expand our horizons.

There are a number of other nonpharmacological therapies — including meditation, physical exercise, dietary change and nutritional supplementation, acupuncture and group support — that show promise for improving clinical depression and enhancing brain function.

It is time to undertake authoritative studies of integrative approaches that combine these therapies, perhaps as well as behavioral therapy, in the treatment of both depression and insomnia.

JAMES S. GORDON
Washington, Nov. 19, 2013
The writer, a psychiatrist, is the author of “Unstuck: Your Guide to the Seven-Stage Journey Out of Depression.”

We at NYBC have long been interested in exploring research on supplements and mood disorders, and supplements and sleep disorders. In fact, you’ll find these categories of supplements in a single section of our catalog, at

Supplements for Mood and Sleep Disorders

Please feel free to browse this section, and learn more about supplements such as melatonin, theanine, SAMe, DHEA, and others. There is considerable research on many of these already published, and we believe they will have a role to play in a new, more integrative treatment strategy for depression.

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Supplements as alternatives to benzodiazepines

Here’s an update on this topic:

In her 2007 book, Supplement Your Prescription: What Your Doctor Doesn’t Know About Nutrition, Dr. Hyla Cass has an interesting section (pp. 139-140) dealing with supplement alternatives to benzodiazepines and other drugs such as Ambien. (These drugs are generally prescribed as anti-anxiety agents and as sleep aids.)

Dr. Cass is a practicing physician and an expert on integrative (“holistic”) health, and one of her main concerns is to present ways to counter prescription medication side effects, or to identify supplement alternatives to prescription drugs.

Of benzodiazepines (the best-known tradenames in this category are Valium, Xanax, Ativan, Klonopin, Librium, Halcion), Dr. Cass writes that a principal problem is that these drugs develop dependence, and so can require steadily increasing dosages as time goes on. (Ideally, she says, they are intended as short-term therapies, but in fact many patients end up being prescribed them for a much longer time.) Withdrawal from these drugs can be quite hazardous, and should be done only under medical surpervision. Moreover, the effect of this class of medications is often a dulling of response, so their use can be associated with accidents.

Since benzodiazepines deplete needed nutrients, Dr. Cass advises supplementing as follows if you take them:

1000-1200mg Calcium/day, plus 400-600mg/Magnesium
400-800mg Folic acid/day
1000 IU Vitamin D/day
30-100mcg Vitamin K/day

She also states that in her own practice she has often successfully substituted supplements for these prescription drugs. Among the calming supplements that she has used:

5-HTP: 100-200mg at bedtime
Melatonin: 0.5-3.0mg at bedtime
L-theanine: 200mg, one to three times daily, as needed

In Dr. Cass’s view, supplements such as these, sometimes used in combinations, can provide a good alternative to the addictive benzodiazepines and their side effects (which, she says, are also characteristic of the newer drug Ambien).

—–

See the following NYBC entries for additional information on the supplements mentioned above:

Melatonin 1mg and Melatonin 3mg

Theanine Serene (includes L-theanine)

NYBC also stocks 5-HTP and the closely related Tryptophan.

Also note that the Jarrow supplement Bone Up very closely matches the set of supplements recommended by Dr. Cass to offset the nutrients depleted by taking benzodiazepines (Calcium, Magnesium, Folic acid, Vitamin D, Vitamin K).

Supplements for anxiety

A while back, we posted a review of holistic M.D. Hyla Cass’ recommendations for avoiding the dependence-inducing benzodiazepines for anxiety. Her prescription was to use supplements instead, and she had some specific recommendations:

In her 2007 book, Supplement Your Prescription: What Your Doctor Doesn’t Know About Nutrition, Dr. Hyla Cass has an interesting section (pp. 139-140) dealing with supplement alternatives to benzodiazepines and other drugs such as Ambien. (These drugs are generally prescribed as anti-anxiety agents and as sleep aids.)

Of benzodiazepines (the best-known tradenames in this category are Valium, Xanax, Ativan, Klonopin, Librium, Halcion), Dr. Cass writes that a principal problem is that these drugs develop dependence, and so can require steadily increasing dosages as time goes on. (Ideally, she says, they are intended as short-term therapies, but in fact many patients end up being prescribed them for a much longer time.) Withdrawal from these drugs can be quite hazardous, and should be done only under medical surpervision. Moreover, the effect of this class of medications is often a dulling of response, so their use can be associated with accidents.
[…]
She states that in her own practice she has often successfully substituted supplements for these prescription drugs. Among the calming supplements that she has used:

5-HTP: 100-200mg at bedtime
Melatonin: 0.5-3.0mg at bedtime
L-theanine: 200mg, one to three times daily, as needed

In Dr. Cass’s view, supplements such as these, sometimes used in combinations, can provide a good alternative to the addictive benzodiazepines and their side effects.

—–

See the following NYBC entries for additional information on the supplements mentioned above:

Melatonin 1mg and Melatonin 3mg

Theanine Serene (includes L-theanine)

NYBC also stocks 5-HTP and the closely related Tryptophan.

If you do decide to take one of the prescription benzodiazepines, Dr. Cass further notes, it is advisable to supplement to offset the key nutrients that these drugs tend to deplete in the body. We note that the Jarrow supplement Bone Up very closely matches the set of depleted supplements listed by Dr. Cass (Calcium, Magnesium, Folic acid, Vitamin D, Vitamin K).

One last note: rather small doses of melatonin may do the trick in terms of helping you to sleep. A 1mg dose may be all that’s necessary.

Drugs versus supplements as sleep aids

One of the reasons people turn to supplements is that drugs often have side-effects which make their use, especially over the long term, more damaging than helpful. That may be the case with long-term use of some common over-the-counter drugs to aid sleep.

A 2010 study published in the journal Neurology, for example, looked at drugs called anticholinergics, which block acetylcholine, a nervous system neurotransmitter. They include such common over-the-counter brands as Benadryl, Dramamine, Excedrin PM, Nytol, Sominex, Tylenol PM, and Unisom. They are taken for a variety of common medical conditions including insomnia or allergies. Unfortunately, according to this Indiana University study, over the long term these drugs also produce cognitive impairment. According to the study authors, taking “one anticholinergic significantly increased an individual’s risk of developing mild cognitive impairment and taking two of these drugs doubled this risk.”

Given these risks, it makes sense to consider such alternatives as Melatonin or 5-HTP. While these supplements, like many others, should be taken carefully and according to recommendations, we don’t know of any research suggesting that they produce cognitive impairment over the long run!

Supplement recommendations in “The Ultramind Solution” by Dr. Mark Hyman

NOTE: NOW SEE NYBC’S LOW-COST ALTERNATIVE TO THE ULTRAMIND SOLUTION MULTIVITAMIN PACK–

https://nybc.wordpress.com/2011/04/02/nybcs-brainpower-multi-pak-low-cost-ultramind-solution/

One-third less than the over-priced “Ultramind Solution” supplements!

The UltraMind Solution: Fix Your Broken Brain by Healing Your Body First
Mark Hyman, M.D.

This is one of many books published in recent years that seek to translate the enormous body of research findings from the last few decades about nutrition and brain function into simple, useful guidelines for improving and maintaining good mental functioning and psychological well-being. While it’s a popularizing text (Dr. Hyman has even been on Martha Stewart–see link below!), this book does, we feel, accurately register many important trends in our knowledge of nutrition and nutritional supplements and how these factors relate to mental health.

Here’s the statistic that sets off Dr. Hyman’s project: one in three Americans suffer from some kind of “brain dysfunction” (one term in use: “brain fog”), including symptoms such as depression, anxiety, memory loss, attention deficit disorder, autism, and dementia.

“The Ultramind Solution” contends that revising your diet–changing your nutritional intake–can often make a huge difference in these symptoms. Dr. Hyman’s recommendations focus both on weeding out elements that adversely affect the system (too much sugar, poorly chosen carbs, alcohol, cigarettes), and sticking to a menu of what’s good, especially what’s good for brain function: 1) omega fatty acids (found in salmon, sardines, flaxseed); 2) amino acid sources (nuts, lean meats); 3) high-quality carbs (for example, beans, peas, and lentils); 4) phyto-nutrients (plant foods containing antioxidants and other helpful substances, like blueberries, cilantro, etc.).

Finally, Dr. Hyman observes that, since more than 90% of Americans don’t get adequate nutrients from food (a finding of an often-cited US government survey), people realistically will need to supplement at least periodically in several key categories: 1) a multivitamin; 2) fish oil (omega fatty acids); 3) Calcium/Magnesium; 3) Vitamin D; 4) B complex vitamins; 5) probiotics (for good digestion/absorption of nutrients); and 6) occasionally a sleep aid like melatonin to insure a good amount of rest.

Here are some NYBC suggestions for supplementing in the categories recommended by Dr. Hyman:

Multivitamins: Added protection with Iron (Douglas) ; Added Protection without Iron (Douglas) – recommended for those with liver conditions; Opti-Pack – iron-free (SuperNutrition); Super Immune Multivitamin – iron-free (SuperNutrition)

Fish oil: Max DHA (Jarrow); ProOmega (Nordic Naturals) 60 caps; ProOmega (Nordic Naturals) 180 caps;

For Calcium, Magnesium, Vitamin D, NYBC recommends Bone-Up (Jarrow), which provides all three nutrients in the most useful dosages.

B complex vitamins: B-right (Jarrow)

Probiotics: NYBC recommends Jarrodophilus EPS (Jarrow) because it doesn’t require refrigeration. But other probiotics may be useful as well–see the Probiotics entry on the NYBC website.

NYBC also stocks Melatonin in several formats.

See Dr. Hyman on Martha Stewart:
http://www.marthastewart.com/portal/site/mslo/menuitem.3a0656639de62ad593598e10d373a0a0/?vgnextoid=0f545e9ea969e110VgnVCM1000003d370a0aRCRD&vgnextfmt=default

Melatonin for high blood pressure (hypertension)

There’s a long history of studies of melatonin as a sleep aid, but more recently there has also been research with human participants suggesting that this hormone may be helpful not only in regulating sleep patterns but also in lowering blood pressure.

High blood pressure or hypertension poses a risk over the long term to the cardiovascular system, and it’s now widely agreed that controlling hypertension is one of the most significant steps people can take to prevent adverse events such as heart attack.

Using melatonin as an aid to lowering blood pressure presents some advantages over prescription medications used for this purpose, since the prescription drugs often have unwanted side effects such as decreased sexual performance and fatigue.

Note that when low-dose melatonin was used at bedtime to reduce blood pressure in a Harvard Univ. study, the decrease in blood pressure was not dramatic, but still significant enough to help those with borderline blood pressure problems.

Of course anyone interested in the potential of melatonin supplementation for control of blood pressure should consult with a doctor before using.

For further information on this supplement, including comments on dosing, see the NYBC entries:

Melatonin – 1mg

Melatonin – 3mg

Melatonin – 5mg

Melatonin, best known as sleep aid, now studied as adjunct in some breast cancer treatment regimens

The University of Maryland Medical Center’s Complementary Medicine website provides an assessment of some recent studies on melatonin as an adjunct treatment for breast cancer. Of course melatonin is best known and has been most researched for its effects on sleep and its potential to address sleep disorders. Most of these investigations have focused on people whose circadian rhythms are disrupted by factors such as jet lag or work schedules, but there have also been studies looking at melatonin as a sleep aid for the elderly or for those with HIV (see other “Melatonin” entries on this Blog).

This excerpt from the UMMC article on Melatonin indicates, however, that this supplement may be eliciting additional interest as an auxiliary to certain cancer treatment regimens. We have highlighted the last sentence in this passage, which repeats one of the crucial guides in using supplements: be sure to consult your health care professional.

“Several studies indicate that melatonin levels may be linked with breast cancer risk. For example, women with breast cancer tend to have lower levels of melatonin than those without the disease. In addition, laboratory experiments have found that low levels of melatonin stimulate the growth of certain types of breast cancer cells, while adding melatonin to these cells inhibits their growth. Preliminary laboratory and clinical evidence also suggests that melatonin may enhance the effects of some chemotherapy drugs used to treat breast cancer. In a study that included a small number of women with breast cancer, melatonin (administered 7 days before beginning chemotherapy) prevented the lowering of platelets in the blood. This is a common complication of chemotherapy, known as thrombocytopenia that can lead to bleeding.

In another study of a small group of women whose breast cancer was not improving with tamoxifen (a commonly used chemotherapy medication), adding melatonin caused tumors to modestly shrink in over 28% of the women. People with breast cancer who are considering taking melatonin supplements should consult their doctors before beginning supplementation.