Mood Disorders and Orthomolecular Medicine

In any given 1-year period, 9.5 percent of the population, or about 18.8 million American adults, suffer from depression.

1. Major depression is the leading cause of disability. The indirect and direct costs of mood disorder illnesses totals over 43 billion dollars a year. Depression and related mood disorders rank behind high blood pressure as the most common reason people visit their doctors.

Most individuals who consult their medical doctor for mood disorders are placed on prescription medications.

And in fact as many as 10% of the U.S. population has taken one of these medications. Prescription antidepressants sales reached a total of 37 billion in sales in 2003, which came out to $9 million more than was spent on treatments for the heart, arteries and blood pressure.

2. The largest growth spurt in antidepressant use has been among preschoolers, ages 2-4.

3. In 2003 over one million American children were taking an antidepressant medication.
4. However, several studies show that between 19-70% of those taking antidepressant medications do just as well by taking a placebo or sugar pill.

5. These studies help explain why most individuals may initially benefit from taking an antidepressant drug only to find that the positive affects soon wear off. Some may switch from one antidepressant drug to another. And while patients are attempting to correct their mood disorders with prescription dugs that may or may not be more effective than a sugar pill, all of these drugs have potential, sometimes serious, side effects.

Prozac has been associated with over 1,734 suicide deaths and over 28,000 adverse reactions.6
Prescription antidepressants can cause depression, anxiety, addiction, suicidal tendencies, tremors or involuntary muscle spasms, and senility. Yes, prescription antidepressants and anti-anxiety drugs can and do cause depression and anxiety.

7. Those suffering from anxiety are commonly prescribed one of the benzodiazepine (tranquilizer) medications, Ativan, Xanax, Klonopin or others.

National surveys show that 5.6 million adults over the age of 65 are now taking tranquilizers.

8. These medications are associated with numerous unwanted side effects including poor sleep, seizures, mania, depression, suicide, ringing in the ears, amnesia, dizziness, anxiety, disorientation, low blood pressure, nausea, fluid retention, tremors, sexual dysfunction (decreased desire and performance), weakness, somnolence (prolonged drowsiness or a trance-like condition that may continue for a number of days), and headaches.

9. Over 73,000 older adults experience drug-induced tardive dyskinesia (tremors or uncontrollable shakes). For many, these tremors are permanent.

10. Orthomolecular Medicine

Fortunately for those looking for a safer, often times more effective way to beat mood disorders, a group of progressive minded physicians helped pioneer a new way of treating mental disorders, known as orthomolecular medicine.

In 1968, two time Nobel Prize-winner Linus Pauling, Ph.D., originated the term "orthomolecular" to describe an approach to medicine that uses naturally occurring substances normally present in the body. "Ortho" means correct or normal, and orthomolecular physicians recognize that in many cases of physiological and psychological disorders health can be reestablished by properly correcting, or normalizing, the balance of vitamins, minerals, amino acids, and other similar substances within the body. And unlike drug therapy, which attempts to cover-up the symptoms associated with a mood disorder, orthomolecular medicine seeks to find and correct the cause of the illness.

Where do the neurotransmitters come from?
Neurotransmitters are brain chemicals that help relay electrical messages from one nerve cell to another. Neurotransmitters are produced from the amino acids in the foods we eat. Amino acids join together in different patterns to form a protein. Eating a protein rich food allows us to replenish our ongoing demand for the essential amino acids. Half of the amino acids are essential. This means our bodies can't manufacture them and we must get them from the foods we eat (protein). Certain amino acids along with certain B vitamins and minerals produce the neurotransmitters. The amino acid tryptophan turns into serotonin. The amino acid phenylalanine turns into epinephrine. Amino acids are the raw nutrients needed to manufacture the neurotransmitters, which regulate our moods.

What do neurotransmitters do?
Neurotransmitters help regulate pain, reduce anxiety, promote happiness, initiate deep sleep, boost energy, and mental clarity.
The neurotransmitters that cause excitatory reactions are known as catecholamines. Catecholamines, epinephrine and norepinephrine (adrenaline) are derived from the amino acid phenylalanine.
Inhibitory or relaxing neurotransmitters include serotonin and gamma-amino butyric acid (GABA). The neurotransmitter serotonin is produced from the amino acid tryptophan. GABA is produced from the amino aid glutamine.

Amino Acid Replacement Therapy
The most popular antidepressant drugs are known as selective serotonin re-uptake inhibitors (SSRI's). SSRI's including the drugs Lexapro, Prozac, Paxil, Celexa, and Zoloft are supposed to help the brain re-uptake the serotonin it produces. It is analogous to using a gasoline additive to help your car get more mileage out of the gasoline in your tank.
Unfortunately, many of the individuals who suffer from mood disorders, don't have any serotonin in their brains to re-uptake. A gasoline additive poured into an empty gasoline tank doesn't help much, if at all.
No one is born with a Prozac deficiency. However, people can develop a serotonin deficiency. Orthomolecular medicine uses amino acid replacement therapy to correct serotonin and other neurotransmitter deficiencies. I've found this approach to be just as effective (if not more so) than prescription antidepressant medications.
I've found very few problems with mixing amino acids with prescription anti-depressants. In fact, ninety percent of my patient's are initially on prescription antidepressants when I first start them on amino acid replacement therapy.
Over the years I've used various questionnaires or tests to determine which amino acids needed to be recommended. I've been using the questionnaire below and have found it provides a quick and accurate assessment tool to diagnose a person's brain chemistry.

Brain Function Questionnaire

The "S" Group
If three or more of these descriptions apply to your present feelings, you are probably part of the "S" group:
o It's hard for you to go to sleep.
o You can't stay asleep.
o You often find yourself irritable.
o Your emotions often lack rationality.
o You occasionally experience unexplained tears.
o Noise bothers you more than it used to; it seems louder than normal.
o You flare up at others more easily than you used to; you experience unprovoked anger.
o You feel depressed much of the time.
o You find you are more susceptible to pain.
o You prefer to be left alone.
Serotonin is a hypothalamus neurotransmitter necessary for sleep. A lack of serotonin causes difficulty in getting to sleep as well as staying asleep. It is often this lack of sleep that causes the symptoms mentioned above.
Serotonin levels can easily be raised by supplementing with the essential amino acid L-tryptophan, but dietary supplements of L-tryptophan are banned in the United States.
However, 5-hydroxytryptophan (5HTP), a form of tryptophan, is available over-the-counter and works extremely well for most patients. Patients should start with 50mg. of 5HTP, 30 minutes before bed. They should take on an empty stomach along with 4 oz. of grape juice. They may need to increase this dose, up to 300 mg. per night. Individuals who don't have trouble sleeping at night but do have other symptoms of the "S" group might want to take 100 mg. of 5HTP three times daily, with food. 5HTP doesn't usually cause drowsiness when taken with food.

The "G" Group
If three or more of these descriptions apply to your present feelings, you are probably part of the "G" group:
o You often feel anxious for no reason.
o You sometimes feel "free-floating" anxiety.
o You frequently feel "edgy," and it's difficult to relax.
o You often feel a "knot" in your stomach.
o Falling asleep is sometimes difficult.
o It's hard to turn your mind off when you want to relax.
o You occasionally experience feelings of panic for no reason.
o You often use alcohol or other sedatives to calm down.
The "G" group symptoms are from the absence of the neurotransmitter gamma-aminobutyric acid (GABA). GABA is an important neurotransmitter involved in
regulating mood and mental clarity. Tranquilizers (benzodiazepines) used to treat anxiety and panic disorders work by increasing GABA.
GABA is made from the amino acid glutamine. Glutamine passes across the blood-brain barrier and helps provide the fuel needed for proper brain function.
A deficiency in L-glutamine can result in foggy thinking, anxiety, depression, and fatigue.
Usually only a small dose of GABA is needed, 500-1,000 mg. twice daily. Some individuals may need to take it three-four times a day. Like most amino acids, GABA needs to be taken on an empty stomach.

The "D" Group
If three or more of these descriptions apply to your present feelings, you are probably part of the "D" group:
o You lack pleasure in life.
o You feel there are no real rewards in life.
o You have unexplained lack of concern for others, even loved ones.
o You experience decreased parental feelings.
o Life seems less "colorful" or "flavorful."
o Things that used to be fun aren't any longer enjoyable.
o You have become a less spiritual or socially concerned person.
Dopamine is a neurotransmitter associated with the enjoyment of life: food, arts, nature, your family, friends, hobbies, and other pleasures. Cocaine's (and chocolate's) popularity stems from the fact that it causes very high levels of dopamine to be released in a sudden rush.
A dopamine deficiency can lead to a condition known as anhedonia. Anhedonia is the lack of ability to feel any pleasure or remorse in life. Brain fatigue, confusion, and lethargy are all by-products of low dopamine.
The brain cells that manufacture dopamine use the amino acid L-phenylalanine as a raw material. Like most cells in the hypothalamus, they have the ability to produce four-five times their usual output if larger quantities of the raw materials are made available through nutritional supplementation.
Start your patients with 1,000 mg. of L-phenylalanine one-two times daily on an empty stomach. If they don't seem to notice any benefits, keep increasing the dose, up to 4,000 mg. twice a day. If they experience a rapid heart beat, agitation, or hyperactivity, have them reduce or stop taking L-phenylalanine.

The "N" Group
If three or more of these descriptions apply to your present feelings, you are probably part of the "N" group:
o You suffer from a lack of energy.
o You often find it difficult to "get going."
o You suffer from decreased drive.
o You often start projects and then don't finish them.
o You frequently feel a need to sleep or "hibernate."
o You feel depressed a good deal of the time.
o You occasionally feel paranoid.
o Your survival seems threatened.
o You are bored a great deal of the time.

The neurotransmitter norepinephrine, when released in the brain, causes feelings of arousal, energy, and drive. On the other hand, a short supply of it will cause feelings of a lack of ambition, drive, and/or energy. A deficiency can even cause depression, paranoia, and feelings of apathy.
Norepinephrine is also used to initiate the flow of adrenaline when you are under psychological stress. The production of norepinephrine in the hypothalamus is a 2-step process. The amino acid L-phenylalanine is first converted into tyrosine. Tyrosine is then converted into norepinephrine. Tyrosine, then, can be supplemented to increase norepinephrine (and dopamine). But too much tyrosine can cause headaches, so I usually recommend L-phenylalanine replacement first.

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2. Beth Hawkins, A Pill is not Enough, City Pages.com
Vol 25 issue 1225 Minneapolis MN.
3. JAMA February 23, 2000;283:1025-1030,1059-1060
4. Drug report barred by FDA
Scientist links antidepressants to suicide in kids
Rob Waters, Special to The Chronicle
Sunday, February 1, 2004
5. Joan-Ramone Laporte and Albert Figueras, "Placebo Effects in Psychiatry," Lancet 334 (1993):1206-8.
6. Death and near death attributed to Prozac, Citizens Commission on Human Rights.
7. Whittle TJ, Wiland Richard, The story behind Prozac the killer drug, Freedom Magazine, 6331 Hollywood BLVD., suite 1200 Los Angeles, CA 90028. 7. Monthly Prescribing Reference Haymarket Media Publication Nov 2005, New York NY.
8. Sidney Wolfe, Larry Sasich, and Rose-Ellen Hope, Worst Pills Best Pills.
Pocket Books New York, NY 1999 pg179.
9. Sidney Wolfe, Larry Sasich, and Rose-Ellen Hope, Worst Pills Best Pills.
Pocket Books New York, NY 1999 pg11.
10. Sidney Wolfe, Larry Sasich, and Rose-Ellen Hope, Worst Pills Best Pills.
Pocket Books New York, NY 1999.