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Reclaim Your Brain:
How to Avoid or Get Off Meds &
Optimize Brain Function
Hyla Cass MD
www.cassmd.com
Biography: Hyla Cass, M.D
•Integrative medicine and psychiatry: clinical practice, writings, lectures,
and media
•Former Assistant Clinical Professor of Psychiatry at UCLA School of
Medicine
•Medical Advisory Board, Health Sciences Institute and Taste for Life
Magazine; Associate Editor, Total Health Magazine
•Board Member American College for Advancement in Medicine
(acam.org); California Citizens for Health
•Author of Natural Highs, 8 Weeks to Vibrant Health, Supplement Your
Prescription, The Addicted Brain and How to Break Free, and others
• Website: www.cassmd.com
Goals
• How did I get here?
•Antidepressants and anti-anxiety agents
•Getting hooked - and unhooked - from meds
•How to utilize diet and natural therapies
• The gut-brain connection
•Mental health maintenance
Dietary Link to Depression:
Is Food Making You Depressed?
•3,486 individuals aged 35-55 (none initially
depressed); 5-
year follow-up
• Evaluated two dietary patterns
1. Whole Food (heavily loaded with vegetables, fruits & fish)
2. Processed Food (higher sweets, fried foods, processed
meat, refined grains & high-fat dairy products)
Results: People consuming Processed Food diets
were much more likely to develop depression.
Adbaraly TN, Dietary pattern and depressive symptoms in middle age. British Journal of Psychiatry 2009
Nov;195(5): pp 408-413
Depression: Latest Statistics from the CDC
•
26.2% (1 in 4) Americans 18 and older suffer from
diagnosable mental disorder in a given year
•
Mental disorders are now leading cause of disability in US &
Canada according to The World Health Report (WHO/2004)
•
About 11% of Americans 12 and older are taking
antidepressant medications (over 30 million)
•
Antidepressant use increased almost 400% (1988-94 to
2005-2008)
•
23% women (ages 40-59) take antidepressant (highest of
any group)
Antidepressant & Anti-anxiety Drugs
•
•
Drugs are toxic
•
Over time, this causes nutrient
depletions
•
Reuptake inhibitors actually
accelerate depletion of
neurotransmitters
•
The meds change the structure of
the brain: cause a “down regulation”
of neurotransmitter
receptors…fewer by 40-60
•
These drugs are highly addictive; difficult to
discontinue
Detoxification requires/utilizes many
nutrients
Wamsley JK, et al., “Receptor alterations associated with
serotonergic agents: an autoradiographic analysis,” J Clin
Psychiatry. 1987 Mar;48 Suppl:19-25
SSRIs: Changing The Brain
• Bartholoma, P et al., “Neuronal cell
death induced by antidepressants.”
Biochemical Pharmacology April 15,
2002; Vol. 63 (8): 1507-1516.
•Andrews PW, et al., “Primum non
nocere: An evolutionary analysis of
whether antidepressants do more harm
than good.” Frontiers in Psychology, April
24, 2012
Controversies In Psychiatry
• Depression: most episodes usually last only 3-6 months
• Are we turning short-term suffering into long-term
disability? Antidepressant drugs are causing both
biochemical & structural/anatomical changes in the brain
• Long-term follow-up studies: very poor outcomes for people
treated with antidepressants in hospitals and outpatient
settings
• Overall prevalence of depression is rising dramatically despite
increased use of antidepressants
Controversies In Psychiatry
• Antidepressants only slightly better than placebos;
antidepressants fail in active placebo trials
•Magic bullet theory questioned: belief that
psychotherapy could be replaced by simply taking a pill.
(Psychotherapy = Pill)?
Fournier J. C., DeRubeis R. J., et al. (2010).
Antidepressant drug effects and depression severity:
a patient-level meta-analysis. JAMA, 303, 47–53. doi:
10.1001/jama.2009.1943
Kirsch I., Moore T. J., et al. (2002). The emperor’s new
drugs: An analysis of antidepressant medication data
submitted to the U.S. Food and Drug Administration.
Prevention and Treatment, 5, 23 doi: 10.1037/15223736.5.1.523a
SSRI Side Effects
• GI disturbances, headache, sedation, insomnia,
activation, weight gain, impaired memory, excessive
perspiration, sexual dysfunction, birth defects in fetus,
and paresthesias (tingling or heightened sensitivity).
• Akathisia (motor restlessness)
• Violence, homicide, suicide
• Many occur during withdrawal
Getting Off Meds
• Stacking of meds can make it worse
• SNRIs even more difficult than SSRIs
• Understanding the underlying issues: e.g. genetics, nutrient
deficiencies both pre-existing and secondary to meds
• Go off slowly vs (commonly)abrupt -> ‘discontinuation
syndrome’ including “brain zaps”
• Amount varies case to case – can try larger decreases eg
Sertraline 100-50- 25-12.5 mg every 7-14 days OR if
needed: 10% lower every 7-14 days (may need compounded
liquid), even 5% or 2%
Getting Off Meds
• Multiple meds: general rules but not in stone: last one first;
benzo first so others can “‘cover” the symptoms; otherwise
rotate the dose/med
• Work with nature to repair the damage, restore balance
• Provide ingredients to produce neurotransmitters
• Caution: 5 HTP at least 2 hrs away from meds
• Methylation issues
Nutrient Precursors / Cofactors
Required for Neurotransmitter Synthesis
Tryptophan
Iron
Calcium
Folic Acid
Magnesium
Vitamin B6
5-HTP
Vitamin C
Vitamin B6
Zinc
Magnesium
Serotonin
TYROSINE
Folic Acid
Iron
Vitamin B6
L-Dopa
Vitamin B6
Magnesium
Dopamine
Vitamin C
Copper
Noradenaline
Natural Therapies For Depression,
Anxiety, Withdrawal
• Nutrients/neurotransmitter synthesis: 5-HTP,
vitamin B6, tyrosine, B12, B3
• SAMe (S-adenosylmethionine)
• Folate & vitamin B12 (methylation issues)
• Omega-3 fish oils
• Magnesium, Mn, Cr-
Natural Therapies For Depression,
Anxiety, Withdrawal
• Vitamin D, Vitamin C
• Herbal products
• Lifestyle Factors: exercise, sleep, diet
• Light therapy, Acupuncture, Neurofeedback
• Probiotics
• Combination products
The Gut Brain Connection
• 90% of the cells in the body are bacteria
• Estimated 90-99% of the DNA in our body is
bacterial
• The vagus nerve directly connects the gut to the
brain
• We have 2 nervous systems w/ common embryonic
source
1. Central Nervous System: brain & spinal cord
2. Enteric (autonomic)Nervous System (The
Second Brain): Gut/GI tract
Revolutionary Psychiatry
“The Psychobiotic Revolution”
• How gut bacteria control/influence your emotions & state
of mind
• Lead article in Psychology Today/April 2014 : Can
Yogurt Cure depression? “The Psychobiotic
Revolution”
• Various strains of probiotics produce neurotransmitters
that counter anxiety(GABA), depression (SE) and stress
(affects cortisol)
What About Gluten?
Gluten sensitivity can be primarily and at
times exclusively be a neurological disease
affecting not only the brain and nervous
system directly, but also causing cognitive
and psychiatric illness
Neurology (vol 56/No.3 2/13/05)
Summary & Points to Ponder
• Depression is not a Prozac deficiency
• Anxiety is not a benzo deficiency
• Live, eat, & supplement well, feed your
microbiome, & balance your brain
• Aging is not optional: brain aging can be
Thank you!
Hyla Cass MD
Visit www.cassmd.com for a free E-Report: “Reclaim Your Brain”