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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Janice on February 5, 2000, at 13:22:52
I've been taking these for a few months and have noticed no difference in mood, etc.
This is my usual response to all 'natural' type substances that I've tried. nothing.
I'm wondering if maybe they work so subtly that i am unaware of them even working at all?
Maybe they are, maybe they're not. Maybe it takes many months of use for them to become effective. I'm sure that for everyone, there are an invariable number of factors that could be contributing to how someone feels.
Anyone had any luck with any 'natural' products?
I don't want to waste my money.
I put quotes on 'natural' because I know that both lithium and arsenic are natural also.
Thank you all for your imput, Janice.
Posted by CarolAnn on February 5, 2000, at 14:38:03
In reply to Omega Oils (salmon oils, flaxseed oil, etc.), posted by Janice on February 5, 2000, at 13:22:52
Janice, I have spent hundreds of dollars on so-called "natural remedies" for depression as well as fatigue. Not once did I find anything worth buying a second bottle of. Seriously, if it says, "lifts moods" or "increases energy", I've tried it! There was never anything that I could even tell a difference if I took it or not. So, now I'm on Wellbutrin and Adderall, and the only supplements I take are: a multi-vitamin, calcium, vitamin E, and fish oil capsules. And, the fish oil, I only keep taking because of all the hype about cold water fish being good for the cardio-vascular system(although, I did *start* taking it to see if it would help my depression, no luck!).
The only thing I have not tried is SAM-e. The reason is, it is so expensive, that I really have to experiment with all the stuff that my insurance will cover, before I try it, in case it works! CarolAnn
Posted by Adam on February 5, 2000, at 15:56:17
In reply to Re: been there, done that, ("natural" stuff), posted by CarolAnn on February 5, 2000, at 14:38:03
I think there may be a middle ground between "all natruopathy and/or supplements are useless" and blind faith in herbalists and the dreaded toxicity of mainstream pharmaceuticals.
There's quite a lot of fair to good research on omega-3 fatty acids, hypericum, SamE, inositol, etc. Few, if any of these have been at any time subjected to the scrutiny that your average FDA-approved pharmaceutical has, though, and even those can have dubious claims made about them.
One of the most troubling problems is the questions of dosage: supplements aren't held to the same standards of quality that pharmaceuticals are, and thus it's difficult to know what you're really buying. It's a sad truth in my country (USA) that if you try to sell something that really has an effect, you must endure an enormously expensive and time-consuming approval process; if you sell some ground-up leaves that do essentially nothing you can market it as a supplement and make any wild claim you want about it, practically, so long as you include a little fine print that nobody reads anyway.
So, often you read a paper that says substance X has been shown in an open trial to significantly improve depressive symptoms in 6 weeks, etc. What you've got then is a preliminary report, with no placebo control, that often shows only a modest but statistically verifiable change in HAMD or BDI scores, or whatever, using carefully measured and administered dosages of that substance from a source that probably isn't available to the consumer. This seems to be, more often than not, where the study of supplements is at currently.
It will get better. HHS has put some real money and personnel to work at the NIH and elsewhere to rigorously study these substances, and that I find encouraging. There's also plenty of good-quality independant academic research underway. For the present, though, I would be somewhat suspicious of supplements unless you can find really good research on their effectiveness, and good consumer reports about a particular brand's purity and actual dosage. There are a lot of variables that are not controled for well in the realm of supplements, and the quality of what's out there, in the way of information and product, may not be worth your hard-earned dollars. Caveat emptor, as always.
> Janice, I have spent hundreds of dollars on so-called "natural remedies" for depression as well as fatigue. Not once did I find anything worth buying a second bottle of. Seriously, if it says, "lifts moods" or "increases energy", I've tried it! There was never anything that I could even tell a difference if I took it or not. So, now I'm on Wellbutrin and Adderall, and the only supplements I take are: a multi-vitamin, calcium, vitamin E, and fish oil capsules. And, the fish oil, I only keep taking because of all the hype about cold water fish being good for the cardio-vascular system(although, I did *start* taking it to see if it would help my depression, no luck!).
> The only thing I have not tried is SAM-e. The reason is, it is so expensive, that I really have to experiment with all the stuff that my insurance will cover, before I try it, in case it works! CarolAnn
Posted by Cam W. on February 5, 2000, at 17:08:39
In reply to Re: been there, done that, ("natural" stuff), posted by Adam on February 5, 2000, at 15:56:17
> I think there may be a middle ground between "all natruopathy and/or supplements are useless" and blind faith in herbalists and the dreaded toxicity of mainstream pharmaceuticals.
>
> There's quite a lot of fair to good research on omega-3 fatty acids, hypericum, SamE, inositol, etc. Few, if any of these have been at any time subjected to the scrutiny that your average FDA-approved pharmaceutical has, though, and even those can have dubious claims made about them.
>
> One of the most troubling problems is the questions of dosage: supplements aren't held to the same standards of quality that pharmaceuticals are, and thus it's difficult to know what you're really buying. It's a sad truth in my country (USA) that if you try to sell something that really has an effect, you must endure an enormously expensive and time-consuming approval process; if you sell some ground-up leaves that do essentially nothing you can market it as a supplement and make any wild claim you want about it, practically, so long as you include a little fine print that nobody reads anyway.
>
> So, often you read a paper that says substance X has been shown in an open trial to significantly improve depressive symptoms in 6 weeks, etc. What you've got then is a preliminary report, with no placebo control, that often shows only a modest but statistically verifiable change in HAMD or BDI scores, or whatever, using carefully measured and administered dosages of that substance from a source that probably isn't available to the consumer. This seems to be, more often than not, where the study of supplements is at currently.
>
> It will get better. HHS has put some real money and personnel to work at the NIH and elsewhere to rigorously study these substances, and that I find encouraging. There's also plenty of good-quality independant academic research underway. For the present, though, I would be somewhat suspicious of supplements unless you can find really good research on their effectiveness, and good consumer reports about a particular brand's purity and actual dosage. There are a lot of variables that are not controled for well in the realm of supplements, and the quality of what's out there, in the way of information and product, may not be worth your hard-earned dollars. Caveat emptor, as always.
>
> > Janice, I have spent hundreds of dollars on so-called "natural remedies" for depression as well as fatigue. Not once did I find anything worth buying a second bottle of. Seriously, if it says, "lifts moods" or "increases energy", I've tried it! There was never anything that I could even tell a difference if I took it or not. So, now I'm on Wellbutrin and Adderall, and the only supplements I take are: a multi-vitamin, calcium, vitamin E, and fish oil capsules. And, the fish oil, I only keep taking because of all the hype about cold water fish being good for the cardio-vascular system(although, I did *start* taking it to see if it would help my depression, no luck!).
> > The only thing I have not tried is SAM-e. The reason is, it is so expensive, that I really have to experiment with all the stuff that my insurance will cover, before I try it, in case it works! CarolAnnJanice - Some controlled trials have been done recently showing some good results from omega-3-faty acids (in fish oils) in bipolar disorder, but Dr.Calabrese (an expert in bipolar disorder) has pointed out some design flaws and has raised some questions not addressed by the study. He does not believe that they work.
Posted by JohnL on February 6, 2000, at 4:58:46
In reply to Omega Oils (salmon oils, flaxseed oil, etc.), posted by Janice on February 5, 2000, at 13:22:52
Whether any over the counter remedies work or not I think depends on how closely they target the individual's underlying malfunction. There are so many different chemical imbalances that yield symptoms of depression or anxiety or whatever. If a person's underlying chemical imbalance happens to be targeted by a particular remedy, they will experience a great deal of success. If not, they will either have no response or get worse.Personally I have found SJW and SAMe to be slightly helpful. Perhaps a notch or two on a ten point scale. Everything else imaginable has either had no effect or made me worse. From this I can assume that SJW and SAMe partially target whatever problem(s) I have, but only partially.
Sometimes the doses needed are huge. For example, inositol was studied at doses of 12g a day. Since the capsule form comes in 500mg, that's 24 capsules a day. Yikes. That's a lot of swallowing! I think it also comes in powdered form, but even so, 12g is a lot of spoonfuls.
Whether it be over-the-counter or prescription, I think it is best to use medication reactions to guide treatment rather than symptoms or diagnosis. All too often drugs expected to work don't, while others that are not expected to work do. Like someone who tried everything in the book for anxiety but was finally cured with Ritalin, of all things. Or someone who tried every antidepressant in the world, only to be finally cured with a child's dose of Ritalin. I'm rambling, but I'm just trying to say that nothing is going to work--natural or prescription--unless it is closely targeting whatever the underlying problem is. There isn't any one shoe that fits all.
Posted by ChrisK on February 6, 2000, at 6:12:45
In reply to Omega Oils (salmon oils, flaxseed oil, etc.), posted by Janice on February 5, 2000, at 13:22:52
Try this for a report about oils from Psychiatry Times. It explains some of the testing and theories going on currently.
http://www.mhsource.com/pt/p991211.html
Posted by Adam on February 6, 2000, at 10:25:06
In reply to Re: Omega Oils (salmon oils, flaxseed oil, etc.), posted by ChrisK on February 6, 2000, at 6:12:45
Thank you very much for that reference, ChrisK.
One thing I found very interesting was the link to phosphatidylinositol: I think the authors are suggesting that Omega-3s or some metabolite thereof are incorporated chemically into the cell membrane phospholipids, and render these fatty acids resistant to conversion into second messengers. This is fascinating, and fits very well into the theory of PI metabolism, for instance, and intositol triphosphate in bipolar disorder.
Re. what JohnL said about targeting specific illnesses with specific compounds, and the frustrations one experiences with Dx not doing much to inform the proper Rx: I think in some cases biochemistry and diagnosis do correspond. Maybe this is often fortuitous, maybe it is the work of a keen diagnostician. Anyway, some diagnoses I think are easier to make than others, like OCD and bipolar disorder.
On that note, it seems to me, from what I've read, that what is good for OCD may not be good at all for bipolar disorder. Take inositol: I the few studies of this supplement that have been done, it's been shown that myo-inositol actually can aggravate bipolar symptoms, while it seems to be helpful for OCD. Other research on SSRIs and 5-HT1C receptor agonists support the signal transduction theory of OCD: the postsynaptic events appear to involve inositol triphosphate-mediated signalling as opposed to, say, DAG.
Of course this is just a stab, but maybe OCD-types ought to avoid Omega-3s and try inositol, and bipolar types should do just the opposite.
One interesting note: I think there are at least two papers that have demostrated that inositol as an adjunct to SSRI treatment of OCD has no efficacy. One double-blinded controlled study with a reasonable but not impressive N showed efficacy with inositol alone.
The doctors in the paper ChrisK cites don't like the idea of Omega-3s as a first-line or monotherapy for bipolar disorder.
So, if you need meds for bipolar disorder, stay on them and augment with omega-3s if you think it helps.
If you're taking meds for OCD (almost certainly an SSRI), chances are augmenting with inositol won't do anything for you.
The nice thing about the above two is they are such benign compounds, even in large doses, that the risks of a trial are minimal. All you have to lose, really, is some money.
As far as I know, there is no research available on the use of inositol to aument an MAOI. I have OCD, so I'm going to try that in about a month. I think I'll steer clear of the Omega-3s except to keep eating fish, which I'm trying to do more these days just to keep healthy.
Interesting stuff.
> Try this for a report about oils from Psychiatry Times. It explains some of the testing and theories going on currently.
>
> http://www.mhsource.com/pt/p991211.html
Posted by janice on February 7, 2000, at 21:47:34
In reply to Re: Omega Oils (salmon oils, flaxseed oil, etc.), posted by Adam on February 6, 2000, at 10:25:06
so much information, and I'm not sure what i will do. Keep swallowing the omega oils (& I do hate all the swallowing); and wait for more studies to be done, and hopefully as Adam says, better studies. I'm bipolar so at least I'm targeting the right malfunction.
Sometimes I think that by the time a Western person actually acknowledges their illness, it is far too late for natural medicine to make much of an impact.thanks again, Janice
Posted by Cam W. on February 8, 2000, at 7:05:18
In reply to thanks everyone..., posted by janice on February 7, 2000, at 21:47:34
> so much information, and I'm not sure what i will do. Keep swallowing the omega oils (& I do hate all the swallowing); and wait for more studies to be done, and hopefully as Adam says, better studies. I'm bipolar so at least I'm targeting the right malfunction.
>
>
> Sometimes I think that by the time a Western person actually acknowledges their illness, it is far too late for natural medicine to make much of an impact.
>
> thanks again, JaniceJanice - The late acknowledgement of your bipolar disorder would have no impact on the effects of the disorder. Bipolar illness is perhaps one of the most biological of the psychiatric disorders (probably to do with a breakdown of the phosphatidylinositol cycle). I really believe that the first break of the illness is probably "programmed" into your genes and that a stressor just helps manifest that first episode. Admitting that you had the disease earlier in the course would have given you treatment sooner and prevented some kindling, but I do not think it would have impacted that much, that natural therapies (or any therapies) would have been that much more effective. Just my opinion. - Sincerely Cam W.
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