Researchers explore natural remedies for substance abuse, mental illnesses
IS there a natural product that can help substance-abuse patients like smokers and alcoholics quit the habit? Is there any that could prevent or cure mental disorders like schizophrenia, depression, bipolar disorder, post partum depression, anger and suicidal tendencies? Researchers have found that a combination of fish oil, amino acids and vitamins could not only help drug addicts quit the habit, but bring relief in mental illnesses. CHUKWUMA MUANYA reports.
IN the light of the global economic meltdown, drug and alcohol problems in Nigeria have, according to medical practitioners, assumed epidemiological dimensions. At most hospitals, there are drug-related psychotic disorders and mental health problems such as schizophrenia, bipolar disorder, post partum depression, suicidal tendencies, depression and anger.
Schizophrenia is a chronic, severe, and disabling brain disorder. People with schizophrenia may hear voices that other people do not hear, or they may believe that others are reading their minds, controlling their thoughts, or plotting to harm them.
Manic-depressive illness (bipolar disorder) is a common, severe mental illness involving repeated episodes of depression, mania (rapid mood changes, hyperactivity, and excessive cheerfulness) or both.
A study of five selected psychiatric hospitals show that the substances most abused are alcohol, cannabis, heroin, cocaine, amphetamine, hypnosedatives (diazepam or valium), rubber/glue, petrol, injectible substances, dapsone, tramil, pentazone, pawpaw leaves and phenerga.
However, researchers have created a cost-effective formulation of dietary supplements protocol for alcohol/drug abuse relieve from withdrawal and reduction in craving. This is a multi-component programme involving the use of optimal nutritional products - amino acids, vitamins, minerals, and fish oils.
The technique provides a combination of these amino acid caps, multi-vitamins, and fish oil that will replenish the brain chemistry that is lacking and make withdrawal and craving manageable even in an outpatient setting; hence making rehabilitation possible.
Experience and follow-up also show that when nutritional supplements are ingested, the brain uses them to produce neuro-transmitters that are needed for basic body functions and emotional responses plus replenishing the chemicals that the brain lacks as a result of addictive drug use.
A recent study shows that the supplements could improve neural conduction in those subjects with severe addiction (particularly addiction to heroin or marijuana) and those who have lost their memory. The supplements also reduce the rate of return to treatment and improve both the nutritional and general well being of the addict. The researcher argues that once craving is diminished and the individual is able to function, he or she is less socially disruptive and can become a productive citizen.
The author of the study- a Nigerian medical doctor based in the United States- Dr. Ajibite Salako Akande, claims she has discovered a combination of amino acids that can help drug addicts quit the habit.
Akande, a primary health care physician, a substance abuse specialist and a rehabilitation specialist has been working on addiction and rehab, and primary healthcare process including mental health for the past 11 years. Akande has discovered and patented a food supplement, which she claims can take care of substance abuse and addiction.
The supplement - Combamino A, for alcohol; Combamino C, for cocaine; Combaminos, for marijuma and tobacco; and Combamino H, for heroine is presently undergoing several sub clinical trials at Federal Neuro Psychiatry Hospital Yaba, Lagos, and in the West Indies. Akande is presently in Nigeria to complete the registration of the patented product with the National Agency for Food, Drug Administration and Control (NAFDAC).
Akande said: "We have done observational study in the United States and then in Jamaica we did animal study in the University of West Indies. They just presented it to me September 2008 in Jamaica and it is very positive I cannot say much because we have not published it. I have to wait until they publish it then I can show it to Nigeria as well.
"We are doing case studies now in Nigeria at Yaba Psychiatry Hospital Lagos and it is also showing positive results. Really when you are using nutritional supplements you really do not need too much research because for ages since the 19th century nutritional supplements have been used for various diseases and there have been several researches on them. So it has been shown to be safe and effective. But because I want to contribute to science, that is why I am going through all the stage of research. So the next stage is the clinical trial.
"They are basic amino acids, vitamins, fish oils. What I did was combined different amino acids. As I said understanding the chemistry of addiction, we know that there are different neuro-chemical compounds that create neurotransmitters for the brain to function. So we have tyrosine, glutamine, acetylcholine, serotonin, Gamma-aminobutyric acid (GABA). So understanding that I was able to pick. Over there in America we have different types of basic nutrient, so since I understand nutrients can be used to create a chemical, I just picked them and started using them in different doses for patients."
But a consultant psychiatrist and Medical Director of Federal Neuro Psychiatry Hospital Yaba, Lagos, Dr. Harry Taiwo Ladapo disagrees. "I am aware of the drug and the doctor but there is no collaborative evidence even from our centre here to justify such claims. Do not forget that people speculate a lot on few studies and sometimes by chance it can happen and then you now generalise it. We do not believe in generalisation. We believe in facts and scientific evidence," he said.
Ladapo further stated: "Supplements? We all get nutrition from what we eat. What are supplements? Most of these supplements are things that are available in your food on a daily basis that you eat. You cannot discover special proteins from heaven anyway. It has to be the ingredients from the food either from what you eat, the milk products, the fish products, animal products or whatever that you are consuming."
A nutritional protocol for substance abuse may include the following broad spectrum, high potency, daily multivitamin/mineral supplement; 50 mg of vitamins B1, B2, B3, B5 and B6 twice dally 1,000 mcg of vitamin B12 daily; 4,000 mcg of folic acid daily; 1,000 mcg of chromium daily; 1,000 mg of vitamin C three times daily; 400 IU to 800 IU of natural vitamin E or mixed tocopherols daily; 25,000 IU of beta-carotene or mixed carotenoids daily; 200 mcg of selenium daily; and fish oils (EPA and DHA) 1,000 mg twice daily.
There is considerable evidence that fish oils help in combating depression, schizophrenia, anger, bipolar disorder, post partum depression and other mental illnesses. There is also evidence that low levels of omega-3 fatty acids are associated with low levels of the mood hormone serotonin. Fish oils are rich in omega-3 fatty acids. What is not quite clear is whether it is eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA) that is the most active component.
The standard medical therapy for depression involves the use of tricyclic antidepressants or selective serotonin reuptake inhibitors (SSRIs). These drugs, however, are not terribly effective. Prozac, for example, produces a 50 per cent improvement in symptoms in only 38 per cent of patients starting treatment. This is not much better than the placebo effect, which provides 50 per cent improvement in about 25 per cent of patients.
A team of British and Scottish researchers has just completed a study aimed at determining if the ethyl ester of EPA, ethyl-eicosapentaenoate (EEP), would be effective in strengthening the beneficial effect of standard antidepressants.
The study involved 60 patients who were already being treated with SSRIs or tricyclic antidepressants. 14 patients received a placebo while the remaining 46 received either one, two or four grams/day of EEP. All participants were evaluated for depression using several different scales at the beginning of the experiment and after 12 weeks.
The study tilted "A dose-ranging study of the effects of ethyl-eicosapentaenoate in patients with ongoing depression despite apparently adequate treatment with standard drugs" was published in Archives of General Psychiatry by M. Peet and D. F. Horrobin, D. F.
At the end of the study it was clear that the 1gram/day dosage of EEP was highly effective in reducing depression and associated conditions such as sadness, pessimism, inability to work, sleep disturbances, and diminished sex drive.
The researchers conclude that concurrent treatment with one gram/day of EEP is effective in reducing depression in patients who are still depressed despite treatment with standard medications. They are now planning on evaluating EEP on its own as a treatment for depression.
Researchers suggest that fish oils can also cool anger levels and may mitigate aggressive behaviour in substance abusers.
A small, double-blind study found that those who took 3g of fish oil per day had lower levels of anger, potentially reducing tendency towards aggressive behaviour.
An abstract reporting the results, 'N-3 Polyunsaturated Fatty Acids Decrease Feelings of Anger in a Population of Substance Abusers', was published in Neuropsychopharmacology.
Researchers at the University of Kuopio report that regular fish consumption reduces the risk of depression and suicide. Their study involved 1767 Finnish men and women who were evaluated for depression and suicidal tendencies using the 21-item Beck Depression Inventory.
They were also asked about their fish consumption. The researchers conclude that people who consume fish twice a week or more have a 37 per cent lower risk of being depressed and a 43 per cent lower risk of having thoughts of harming themselves (suicidal tendencies).
The results are consistent with those of a large Japanese study involving 265,000 subjects who were followed up for 17 years. This study found a decreased risk of suicide among people who consumed fish daily. Dr. Andrew Stoll, MD of the Harvard Medical School, United States, points out that Icelanders who consume a lot of seafood have far lower rates of seasonal affective disorder (SAD) than do inhabitants of other countries situated at similar latitudes.
The study titled "Fish consumption, depression, and suicidality in a general population" was published in Archives of General Psychiatry.
Several studies have shown that mothers with Post-partum depression (PPD) tend to be deficient in long-chain omega-3 fatty acids, specifically EPA and DHA. Other studies have found that women with an adequate intake of DHA (from seafood or supplements) tend to be less likely to develop PPD. Based on these observations researchers at the University of Arizona Medical School, United States of America decided to evaluate if fish oil supplementation would diminish depression in women diagnosed with PPD.
Their eight-week pilot study involved 16 women with PPD. The extent of depression was evaluated using the Edinburgh Postnatal Depression Scale (EPDS) and the Hamilton Rating Scale for Depression (HRSD). The EPDS scores ranged from 15.3 to 19.0 at the start of the study (a score equal to or greater than 9.0 indicates depression). The HRSD scores ranged from 18 to 20.3 with a score equal to or greater than 15 signifying depression.
The researchers conclude that fish oil supplementation in women with PPD is well tolerated and effective in reducing symptoms of depression. The study titled "Randomised dose-ranging pilot trial of omega-3 fatty acids for postpartum depression" was published in Acta Psychiatrica Scandinavica.
Researchers at the Imperial College School of Medicine, United States, now report that fatty acid levels can be restored to normal and schizophrenia symptoms eliminated or at least vastly diminished by oral supplementation with EPA, the major component of fish oils.
Their experiment involved a 30-year-old man who had suffered from schizophrenia for over 10 years. He had frequent (at least daily) hallucinations and also suffered from persecutory delusions and thought disorder.
The patient was put on two grams/day of EPA and was evaluated for schizophrenia symptoms and blood plasma and red blood cell membrane levels of fatty acids at monthly intervals for six months. The results were spectacular. After six months the overall score for schizophrenia symptoms had dropped by a factor of six (an 85 per cent reduction in severity). Episodes of delusions were completely eliminated and there was an 88 per cent reduction in the number of hallucinatory episodes.
The remarkable clinical improvement in symptoms was associated with substantial increases in the levels of EPA, DHA and arachidonic acid (AA) in red blood cell membranes and with significant increases in EPA and DHA levels in blood plasma. The researchers conclude that EPA supplementation is able to reverse the abnormal fatty acid profiles found in schizophrenics and that this reversal is associated with, and is likely to be the cause of, the clinical improvement.
The study titled "Red cell and plasma fatty acid changes accompanying symptom remission in a patient with schizophrenia treated with eicosapentaenoic acid" was published in European Neuropsychopharmacology.
Omega-3 fatty acids are known to dampen over-activity in bipolar disorder and the hypothesis has been advanced that they may be useful in the treatment of the medical condition.
Medical scientists at the Harvard Medical School, United States, confirmed this in a double-blind, placebo-controlled study involving 30 patients (men and women 18 to 65 years of age) who had all been diagnosed with bipolar disorder. Half the patients were given seven fish oil capsules twice a day while the placebo group were given seven olive oil capsules twice a day. Each fish oil capsule contained 440 mg of EPA and 240 mg of DHA.
The study titled "Omega 3 fatty acids in bipolar disorder," was published in Archives of General Psychiatry.
All of the participants except four in the fish oil group and four in the placebo group also continued to receive a standard mood-stabilising drug prescribed previously. The mental state of the participants was measured using four scales (Clinical Global Impression Scale, Global Assessment Scale, Young Mania Rating Scale, and the Hamilton Rating Scale for Depression) at the start of the study and after two, four, six, eight, 12 and 16 weeks.
Twelve of the 14 participants in the fish oil group completed the four- month study without major episodes of mania or depression as compared to only six out of 16 participants in the placebo group. Also, while nine of the placebo group members experienced worsening depression none of the fish oil group members did.
The four patients in the fish oil group who had not been prescribed mood-stabilising drugs all completed the study without major episodes, but only one member in the placebo group not on mood-stabilising drugs did. The average decline in depression rating on the Hamilton Scale was almost 50 per cent in the fish oil group as compared to an increase of 25 per cent in the control group. The Harvard researchers urge further trials of fish oils in the treatment of depression and manic-depressive illness.
Cigarette smoking has been shown to contribute to heart disease, stroke, obstructive pulmonary disease, peripheral vascular disease, peptic ulcers and many forms of cancer. But researchers suggest that ingesting substantially greater amounts of antioxidant nutrients such as Vitamin E, Vitamin C, beta-carotene and selenium can compensate for many of the detrimental effects of smoking. Cadmium, which is a toxin that occurs naturally in tobacco, decreases the bioavailability of selenium and acts antagonistically to zinc, a cofactor for the antioxidant enzyme, superoxide dismutase.
Researchers have shown that smokers can benefit from taking additional quantities of cysteine and glutathione, which can help metabolise some of the toxins from smoking. The herb milk thistle (Silybum marianum) helps protect the liver and aids in detoxifying excess toxins generated from smoking. A dose of 80 mg to 160 mg three times daily is recommended.
Nicotine addiction is reported to stimulate the dopaminergic system in the brain. It is suggested that smokers also take 1,000 mg of DL-phenylalanine three times daily since it is the precursor for the synthesis of dopamine. Phenylalanine also stimulates the production of cholecystokinin, which is the hormone that signals satiety. The use of phenylalanine may also help to prevent weight gain as smokers attempt to quit. Doctors warn that individuals with high blood pressure should not use phenylalanine without medical supervision.
Alcohol intoxication has been shown to cause liver toxicity and the death of brain cells. Overindulgence with alcohol overwhelms the body's normal pathways for the detoxification of alcohol and its metabolites.
The following doses of amino acids are recommended to be taken three times daily about 20 to 30 minutes before meals: tamine, 1,000 mg; L-glutamine, 1,000 mg; and DL-phenylalanine, 500 mg.
Glutamine is an alternative source of fuel for the brain, which makes the brain less sensitive to episodes of hypoglycaemia. During alcohol withdrawal, there is an increased turnover of norepinephrine.
Phenylalanine, the precursor to norepinephrine, has been shown to help satisfy an individual's biochemical need for this neurotransmitter during the withdrawal time period. Taurine is also used because a dose of three grams daily for one week was reported to be effective in the treatment and prevention of alcohol withdrawal symptoms.
The herb kudzu root (Pueraria loboba) has reportedly been used successfully to treat alcohol addiction in China for hundreds of years. At Indiana University School of Medicine, animals given the active ingredients in kudzu along with ethanol had lower blood alcohol concentrations than controls.
In further experiments, each of the three flavonoid components of kudzu (Puerarin, daidzin and daidzein) suppressed voluntary alcohol consumption in alcohol-preferring rats. Although human studies are lacking, kudzu may be a unique addition to alcohol treatment programs.
Cocaine does not produce a physiological addiction, but it can create a psychological addiction. Cocaine is a stimulant that acts on the central nervous system by inhibiting the re-uptake of the neurotransmitter norepinephrine, which regulates vasoconstriction in the heart, lungs and blood vessels.
Researchers found that sudden increase in blood pressure from a dose of cocaine can cause a stroke and sometimes sudden death. Cocaine also inhibits the re-uptake of dopamine, a neurotransmitter that controls the pleasure centres in the central nervous system, resulting in euphoria, reduced anxiety and social inhibitions, and heightened sexuality. Dopamine is the neurotransmitter that is primarily responsible for cocaine's pleasurable effects.
Amino acids recommended for people with a history of cocaine use include the following, each to be taken three times daily, 20 minutes to 30 minutes before meals: DL-phenylalanine, 1,000 mg; L-glutamine, 500 mg; and L-tyrosine, 500 mg. Phenylalanine has also been reported to be an effective antidepressant.
