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Dx Depression/ Alternative Treatments:


There is no consensus on which alternative medical treatment works best for depression. Howland states "only omega-3fatty acids and SAM-e have sufficient supporting evidence for their efficacy to warrant safe use". Nahas concluded that "St John's wort and regular exercise appear effective in the treatment of depression. Acupuncture appears ineffective for depression, but it might offer other health benefits. Other promising therapies include SAM-e, omega-3 fatty acid, and folic acid supplementation in selected patients; further study is warranted."

Clinical Depression

The Merck Manual Home Edition states:
"The disorder depression is a feeling of sadness intense enough to interfere with functioning. It may follow a recent loss or other sad event but is out of proportion to that event and lasts beyond an appropriate length of time."

Alternative Medications Used in the Treatment:
1. Sam-e: 1600mg orally in divided daily dosing
2. Supplements: B12, folate, thyroid prescription medications
3. Pregnenolone, 5-HTP and DHEA
4. Transcranial Magnetic Stimulator
5. Supplements of Amino-acids, Omega-3, Oral and Intravenous
6. Exercise
7. Lightbox
8. IV ketamine-- see Bipolar Depression
9. Hormonal Replacement: Estrogen and Testosterone for Women
10. Testosterone Replacement for men.

[Editor] A number of natural vitamins, minerals and supplements are used internationally to treat depression/anxiety. The two that have raised the most interest are 5-HTP and SAM-e.
*SAM-e and 5-HTP: The Medline and Cochrane Databases were searched...Supplements predominantly used by patients with depression include S-adenosylmethionine (SAM-e), l-tryptophan and 5-hydroxytryptophan (5-HTP) and inositol".
* Pregnenolone, "in the brain, neurosteroids such as allopregnanolone and pregnenolone, acting as positive TSPO modulators of gamma-aminobutyric type A (GABA(A)) receptors, exert anxiolytic activity [block anxiety]... Unlike benzodiazepines (Bzs), which represent the most common anti-anxiety drugs administered around the world, selective TSPO ligands have shown anxiolytic effects in animal models without any of the side effects associated with Benzodiazipines. Therefore, ...[these]... may represent the future of therapeutic treatment of anxiety/[depression] disorders".

Recent research has focused on the role of vitamin B12 and folate deficiency with depression. One form of folate called l-methylfolate 15mg is available over the counter yet has shown internationally to significantly improve self-reported depression symptoms. L-methylfolate is effective in some of the SSRI resistant depressive individuals.

*Omega-3 eicosapentacenoic acid (EPA) weighed preparations should be the focus of studies with depressive mood disorders than docosahexaenoic acid-weighted preparations.
*Similarly, recent work with high dose thyroid replacement shows the benefits and safety to bipolar I, II and NOS patients. The Chinese document that T3/T4 ratios change with states of depression.
This study underlines a strong association between subclinical hypothyroidism and depressive symptoms, which could have some important diagnostic and therapeutic implications in the clinical practice.

[Editor]: Is it not likely that higher doses of thyroid will improve depression?
Many university centers, such as Indiana University, have specialists who are attuned to using high doses of thyroxine 200mcg or more, to treat resistant dipolar depression. Kelly's article focused on using triiodothyronine in resistant bipolar II.
[Editor] Major medical university research studies have concluded that a
Light Box and "light therapy had a specific antidepressant effect beyond its placebo effect, but it took at least 3 weeks for a significant effect to develop. The benefit of light over placebo was in producing more of the full remissions."

[Editor]: There is 50 years of research documenting that of testosterone in both men and women improves depression. Furthermore, while post-menopausal women benefit from topical and vaginal estrogen, the recent presentation at the ACOG Annual meeting using nandrolone and stanozolol sets this regimen apart and potentially superior to other treatments.

Suggested Links
*N.H.S. Choice

[Editor] Screening for Laboratory tests may offer evidence that simple hormones may be out of balance. With these laboratory tests in hand, discuss them with your health care professional.

[Editor]: Recent peer reviewed publications have documented the use of nasal ketamine (a single 50mg dose) in a double-blind, crossover study. Using the Montogmery-Asberg Depression Rating Scale at Mt. Sinai Hospital in NYC 8 of 18 responded. Co-author Dennis S. Charney MD

[Editor]: Augmentation Therapy with serial intravenous ketamine over 18 months was effective treatment for a patient with treatment resistant depression.Dosage: .5mg/kg IV; Treatments: 6 over 3 week period. Treatment repeated. No significant adverse events.

[Editor] Reported cases of ulcerative cystitis are associated with chronic ketamine use. Based on the literature, intermittent use seems to be potentially safer.

*See Depression/ Anxiety- All Natural Products

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