Depression Protocol

Hippocrates, the great Greek physician and Father of Medicine, said: "From the brain, and from the brain only, arise our pleasures, joys, laughter, and jests, as well as our sorrows, pains, griefs, and tears."

It's startling to learn that there are 15 trillion neurons (nerve cells) in the human brain. There are far more glial cells (neuroglia) that fill the spaces between the neurons, Schwann cells, and miles of blood vessels to nourish the three or so pounds of brain tissue in the average head.

Three pounds isn't much: only 2% of the body weight of a person weighing 150 pounds. Brain cells are hungry cells, demanding nourishment from as much as 30% of circulating blood. We used to think that the brain could somehow protect itself from nutrient deficiencies, but today we know that the brain requires specific nutrients. If the brain doesn't get them, its biochemistry changes, resulting in fatigue, depression, irritability, and other symptoms.

For example, the brain needs a good supply of B vitamins to act as coenzymes (catalysts) for many functions, including converting nutrients from food to fuel that our bodies can use. Glucose is the brain's primary fuel. If glucose levels fall, we may feel depressed, tired, or unable to think clearly.

B vitamins also are needed to help the brain make neurotransmitters, the "messengers" that enable brain cells to communicate with each other. Vitamin B6 is needed to manufacture serotonin, a neurotransmitter that produces feelings of well-being. Without proper supplies of vitamin B12, the brain could not make acetylcholine, an important neurotransmitter involved in learning and memory. The B vitamin known as folate (folic acid) is needed to make an important group of mood-regulating chemicals called catecholamines, including dopamine, norepinephrine, and epinephrine (Bukreev 1978; Carney et al. 1990; Carney 1995; Fujii et al. 1996; Masuda et al. 1998; Bottiglieri et al. 2000; Zhao et al. 2001).

In many cases, depressed people with blood levels indicating that they lacked key nutrients respond quite well to supplements. Unfortunately, most physicians do not prescribe natural supplements to treat depression (Carney et al. 1990; Carney 1995).

In general, people who are depressed should follow these dietary guidelines:

Avoid Alcohol
It may make us feel giddy at first, but that's only because it's dulling our inhibitions. In the long run, alcohol is a depressant, which is the last thing depressed people need. If you must drink, limit yourself to one drink a day. (One drink means a single serving of a single alcoholic beverage a day, either one ounce of hard liquor, straight or mixed, four ounces of wine, or 12 ounces of beer.)

Quit Caffeine
Caffeine can leave you mentally and physically drained. Avoid the caffeine in coffee, tea, soft drinks, chocolate, and cocoa, as well as the "hidden" caffeine in Excedrin, Midol, Anacin, and many other medicines. (Ask your physician or pharmacist if the medicines you are taking contain caffeine. If they do, talk to your physician about switching to other medications.)

Avoid Sugar
Sugar jolts us with a burst of energy which can make us feel excited, talkative, and ready to take on the world. However, when the body responds by snatching the excess sugar out of circulation, it often takes too much, leaving us tired and depressed. Some depressed patients experience wild, sugar-induced fluctuations in their moods. Convincing them to stay away from cakes, candy, soda, and refined and processed foods often solves the problem.

NATURAL SUPPLEMENTS TO FIGHT DEPRESSION

NUTRITION AND DEPRESSION

Scientific study and clinical experience show that several natural remedies can help alleviate depression. However, if you are experiencing profound feelings of sadness and hopelessness, please seek professional psychiatric treatment. Unless otherwise noted, follow dosing information on labels, but don't try taking all of these supplements at once. A good rule of thumb is to try one thing at a time to see how it works. Furthermore, three of the supplements listed below--, SAMe (S-adenosylmethionine), and 5-HTP--enhance the serotonin system. Theoretically, a person could raise serotonin levels too high.

SAM-e
SAM-e is a natural substance that the body can produce from the essential amino acid methionine and adenosine triphosphate (ATP). Found in all our cells, it plays an important role in critical biochemical processes. It serves as a precursor for glutathione, coenzyme A, cysteine, taurine, and other essential compounds, and is needed for the production of serotonin and other neurotransmitters.

Researchers from the University of Alabama at Birmingham found that depressed patients were not making enough SAM-e in their brains. After checking red blood cells from patients suffering from depression and schizophrenia, they discovered a decreased amount of methionine adenosyl transferase (MAT), an enzyme necessary for the formation of SAM-e. This enzyme was, however, higher in people with mania (Tolbert et al. 1988).

In a study published in the journal Movement Disorders, SAM-e was administered to 13 depressed patients with Parkinson's disease. All patients had been previously treated with other antidepressant agents and had no significant benefit or had intolerable side effects. SAM-e was administered in doses of 800-3600 mg a day for a period of ten weeks; 11 patients completed the study, and ten had at least a 50% improvement on the 17-point Hamilton Depression Scale. One patient did not improve. Two patients prematurely terminated participation in the study because of increased anxiety. One patient experienced mild nausea, and another two patients developed mild diarrhea, which resolved spontaneously. The mean improvement in depression scores from before to after treatment was approximately 64% (Di Rocco et al. 2000).

Although this study was uncontrolled and preliminary, it suggests that SAM-e is well tolerated and may be a safe and effective alternative to the antidepressant agents currently used in patients with Parkinson's disease. Please note that some of these Parkinson's patients received very high doses of SAM-e, which could account for the few side effects observed. Previous clinical studies show that doses of 800-1600 mg a day of SAM-e produce remarkable antidepressant benefits in otherwise healthy people without significant side effects.

Published scientific studies on SAM-e reveal:

Both oral and injectable forms of SAM-e have a fast-acting antidepressant effect (Bottiglieri et al. 1994).
An analysis of the studies to date concluded that SAM-e performed better than placebo treatment, with 17-38% of patients responding and on par with tricyclic antidepressants (Bressa 1994).
Because it produces quick results, SAM-e has been used to hasten the onset of action of the antidepressant imipramine (Norfranil, Impril) (Berlanga et al. 1992).
A 1993 Italian study found SAM-e significantly more effective than placebo in alleviating depression and dysthmia in 80 postmenopausal women (Salmaggi et al. 1993).
SAMe has also been shown to ease the depression associated with Parkinson's disease (Carrieri et al. 1990).
Another bonus is that this supplement appears to improve osteoarthritis.
Higher Homocysteine/Lower SAM-e
Homocysteine is a by-product of the amino acid, methionine. Normally, homocysteine is converted back to methionine or used to create cysteine and other useful substances in the body. If these conversions are blocked, however, homocysteine accumulates to dangerous levels and can contribute to heart attack, stroke, liver damage, and eye problems.

A clear association exists between elevated homocysteine and major depression. One study shows that homocysteine, depression, neurotransmitters and folate (folic acid) are connected (Bottiglieri et al. 2000). It also shows that depressed people with the highest elevations in homocysteine (>12 micromoles/liter) have significantly less SAM-e--which means they have less capacity to create mood-enhancing neurotransmitters. Low levels of neurotransmitters were, in fact, confirmed in the people with the highest homocysteine and lowest levels of SAM-e. In the whole group, higher homocysteine equalled lower SAM-e.

Since folate deficiency is one of the main reasons for elevated homocysteine, the researchers also looked at folate levels, both in the blood and in cerebro-spinal fluid. They found that the group with the highest homocysteine levels (>12 micromoles/L) had significantly lower folate in cerebro-spinal fluid, red cells, and serum. Folate was also lower in red blood cells of the depressed group as a whole. Nearly a third of the depressed inpatients in the study had red cell folate levels below normal (<150 mcg/L). At the same time, half of them had homocysteine levels higher than the levels of two control groups.

Homocysteine, SAM-e, and folate all participate in the methylation cycle in which methionine is converted to SAM-e, which is used for methylation, producing homocysteine which is then converted back to methionine with enzymes that use folate. One depends on the other. If folate is not available to promote the conversion of homocysteine, homocysteine can build up and block methylation.

Serotonin and other brain chemicals require methylation to be synthesized. When the methylation factor, SAM-e, is injected into rats, certain areas of the brain synthesize more serotonin. In turn, serotonin and SAM-e are both necessary for the synthesis of melatonin, an important hormone for sleep. It's easy to see how homocysteine (which blocks SAM-e) can have far-reaching effects.

The price of SAM-e has come down substantially in recent years, making it much more affordable as a treatment option. The suggested dose of SAM-e to treat depression ranges from 400-1600 mg a day.

Caution: SAM-e is not recommended for people with bipolar disorder or mania. Also, some practitioners recommend gradually increasing the dosage to avoid mild and transient nausea and vomiting occasionally seen at the start of treatment. Joseph Pizzorno, N.D., President Emeritus of Seattle's Bastyr University, author of Total Wellness and coauthor of Encyclopedia of Natural Medicine, recommends 200 mg twice a day for 2 days, 400 mg twice a day on days 3 through 9, then 400 mg three times a day on days 10 through 19, followed by 400 mg four times daily thereafter.

(Hypericum perforatum)
In Germany, where it is covered by health insurance as a prescription drug, some 20 million people take hypericum for depression. A meta-analysis and review of 23 randomized clinical trials involving 1757 people with mild or moderately severe depressive disorders showed that was 2.67 times superior to a placebo in relieving depressive symptoms and was as effective as standard antidepressant drugs. Side effects occurred in 19.8% of patients on , compared with 52.8% of those taking standard antidepressant drugs. The conclusion of the researchers was that is more effective than a placebo for treatment of mild to moderately severe depressive disorders (Linde et al. 1996).

A more recent analysis selected eight of the best-designed studies and found that the response rate (the percentage of volunteers who improved) on was 23-55% higher than it was for placebo, but was 6-18% lower than that of tricyclic antidepressants (Gaster et al. 2000).

Most of the studies have examined the benefits of in people with mild to moderate depression. However, Vorbach et al. (1997) compared 600 mg three times a day, a dosage double the usual prescribed dosage, with 50 mg three times a day of imipramine in patients with severe depression. proved to be equivalent in efficacy, but with far fewer adverse effects (35.6%, compared to 81.4% for imipramine) (Vorbach et al. 1997). If you have serious depression, please don't interpret this study as an invitation to self-medicate. You owe it to yourself to work with a mental health professional.

One criticism of the research was that, although the herb had compared favorably to drugs such as imipramine, amitriptyline, and maprotiline, it had yet to be compared to the more commonly prescribed selective serotonin reuptake inhibitors (SSRIs) such as Prozac. Three studies in patients with mild to moderate depression have changed that.

In the first study, Harrer et al. (1999) found 800 mg a day of extract to be as effective in elderly German patients as Prozac.

In the second study by Schrader (2000), a rather low daily dose of (500 mg a day) was equivalent to 20 mg a day of fluoxetine (Prozac). Significantly, more of the 240 volunteers responded to than Prozac (60% versus 40%) and the herb produced significantly fewer side effects (8% of patients versus 23% of Prozac patients). In a 2000 study, the same low dose (500 mg a day) proved as effective as 75 mg twice a day of imipramine, but with far fewer side effects (Woelk 2000).

A third study by Brenner et al. (2000) judged extract (600 mg for 1week, then 900 mg for 6 weeks) as beneficial as sertraline (Zoloft, 50 mg for 1 week, then 75 mg for 6 weeks).

Health practitioners have also found helpful in treating low mood associated with menopause, premenstrual syndrome, and seasonal affective disorder. Grube et al. (1999) gave menopausal women 300 mg three times daily of for 12 weeks. Surpisingly, both the psychological and physical symptoms of menopause improved substantially. So did sexual well-being. Kasper (1997) found that decreased the low mood associated with seasonal affective disorder on par with results the same researcher had found earlier for fluoxetine (Prozac).

The usual dosage for is 300 mg three times a day of herb standardized to 0.3% hypericin (one of the active ingredients). Take a 300-mg dose at breakfast, lunch, and dinner or take two of the 300-mg doses in the morning and the third with dinner. Not everyone needs a total of 900 mg a day. Note that two studies found a mere 500 mg of extract equivalent to imipramine and fluoxetine. Hyla Cass, M.D., assistant clinical professor of psychiatry at UCLA School of Medicine and author of : Nature's Blues Buster (Cass 1998) tailors the daily dose to the individual. Cass says, "While some people need only 300 mg of an extract standardized to contain 0.3% hypericin, most require two to three times that amount."

Depression Pg (1) (2) (3) (4) (5) (6)

These statements have not been evaluated by the FDA. These products are not intended to diagnose, treat, cure, or prevent any disease