Turmeric (curcumin) may be a new, inexpensive depression and anxiety treatment. It’s early days on this one, but it’s worth noting because it is so available and inexpensive. Here is where the research is on turmeric as a treatment for depression and anxiety.
Those of you who follow me know that I’m not a big fan of Truehope/EMPowerplus, in spite of having tried EMPowerplus myself. And one of the things I complained about is the lack of double-blind, controlled studies of the supplement. Well, one scientific study has now been published and I figured I should mention it to be fair. This new study indicates preliminary evidence for Truehope/EMPowerplus (a micronutrient formula) in the treatment of attention-deficit/hyperactivity disorder (ADHD).
It’s been quite a while since I’ve done a Truehope/EMPowerplus update. I had planned on more of them, initially, but when nothing major happened, I didn’t have much to report. I have come to some conclusions about my Truehope/EMPowerplus (what is Truehope/EMPowerplus) experience at five weeks, however, so I’ll share them below.
I was really nervous to have to tell my doctor that I had decided to take the Truehope product EMPowerplus. I was pretty sure he was going to either laugh or chastise me out of his office. My anxiety about it was so bad that I didn’t want to mention it at all. Of course, that would have been a poor decision. Allowing anxiety to override your logic is never the right call.
So I told him and surprisingly, he was nonplussed. He just sort of said, “Alright then.”
- I started on half a dose – that’s two pills in the morning and two in the evening.
- Pretty much as soon as I started taking the EMPowerplus I started feeling giddy. Not quite hypomanic but notably elevated and different, although not better.
- On day five I experienced an official rapid cycle from hypomania one day to serious debilitating depression the next day.
(Preread: What is EMPowerplus by Truehope?)
I’m not doing well. I haven’t been doing well for a long time. It’s quite simple really, every day I fight the bipolar and at the moment, the bipolar is winning.
And when this happens I know what I have to do. I know I have to find an effective treatment. In my 15 years of being treated for bipolar disorder, I can tell you what pulls me out of a depression: medication. Nothing else ever has. Ever. I’ve done everything (believe me) and nothing works except finding the right bipolar medication. I know people don’t want to believe this, but it’s true.
But unfortunately for me, we’re out of bipolar meds. My doctor is out of ideas. I have no good ideas either. If I wanted a drug, my doctor would give it to me, but there’s simply nothing to want because there’s nothing with any evidence behind it that I haven’t tried. And there’s no combination (or combination of combinations) that I haven’t been on. Really.
And the other night I was in my apartment, suicidal as you please, and I desperately decided to try this EMPowerplus stuff. Because, according to some anecdotal evidence and case studies, it appears to have worked for a few people.
I have been wanting to write about the Truehope people (makers of EMPowerplus) for years but I haven’t because, well, I didn’t have anything nice to say, so I didn’t say anything at all. I knew that any critique I made of these people would be met with a slew of hate mail and, really, I get enough of that already.
But now I’m ready to go and at the bottom I’ll tell you why.
I have been known to lament that there’s nothing new under the sun when it comes to depression treatment, and thus, there is little hope for people with true treatment-resistant depression. (And by treatment-resistant depression I mean people who really have tried everything, and there are few in this category.)
But I forget how far we’ve come and how fast. It isn’t fair to say there aren’t new approaches to treatment-resistant depression because there are new approaches being researched and approved every year. Here are a few noted by Current Psychiatry article Innovative approaches to treatment-resistant depression:
Many people complain about overmedication. They lament that the first thing doctors do is prescribe a medication for depression or another mental illness rather than suggest lifestyle changes like exercise and meditation.
This is often true. Doctors, including psychiatrists, often prescribe medication over suggesting lifestyle changes when a mental illness like depression is diagnosed.
And that’s a completely reasonable thing to do.
Mental Illness Diagnosis
When someone gets a mental illness diagnosis, it’s because they are very ill. No one goes to the doctor when they’re not ill. No one goes to the doctor because they’re having a bad day. People go to the doctor because they need help. Not need-help-in-a-little-while, but need help now.
Yup, I know people don’t want to believe that, but for a severe mental illness, we know that’s what works. Or, at least, we know it works better than anything else of which we know.
The Mentally Ill and Major Lifestyle Changes
Typically when people are mentally ill, they are not capable of making major life changes. People with severe depression can’t even get themselves out of bed to take a shower let alone ensure a quality diet and exercise program – if that could even help, were they capable of doing it. In fact, going to the doctor, getting a prescription filled and taking medication is enough of a battle for severely ill people.
It’s not reasonable for them to leave a doctor’s office with a “prescription” for kale, sunshine and park-walking. Because it just won’t happen. And it probably won’t work.
And then that severely ill person? They could die. Yes. Die.
In fact, most people who attempt suicide have seen their doctor within seven days of their suicide attempt. Many people within 24 hours of their suicide attempt. Doctors are aware of these statistics. They know the dangers of letting a severely ill person out of their office without offering them real help.
And how would you like death on your hands after suggesting a person take up jogging?
This is why I recommend that people try alternative treatment with medication (and therapy). Because if the person successfully stabilizes, they can taper off the medication if they so choose. If they feel whatever lifestyle changes they’ve made have helped their illness to the point where they no longer need the medication, they can get off of it. It’s not really rocket science.
American College of Physicians Recommendations
And for the record, the American College of Physicians (ACP)recommends the use of antidepressants in the treatment of depressive disorders. The ACP then recommends the treatment be altered if the patient does not show a positive response to therapy in 6-8 weeks. Further, once the patient shows an adequate response to antidepressants, the ACP recommends continuing the therapy for 4-9 months if it is the first episode of depression.
In other words, in those without a longstanding mental illness, antidepressants are a temporary treatment. And many people have had depression and used antidepressants in just this way.
A Note on Exercise for Depression
There was a study not too long ago that showed that an exercise program for depression could be as effective as an antidepressant in some cases of depression. This is still a questionable finding. It’s worth noting, however, that no long-term benefit was noted in exercise study participants upon follow-up.
It is for these reasons that exercise is not considered a treatment of depression.
Frontline Treatment of Depression is Medication for a Reason
So while lifestyle factors can impact depression, sometimes dramatically, they are not a frontline treatment because medication works better, overall, in the treatment of mental illness.
By erring on the side of medication, you run the risk of overmedicating people. By erring on the side of non-medication you run the risk of killing people. One of these things can be corrected, the other cannot.
*Technically, electroconvulsive therapy is the most effective treatment for depression; however, it is not a frontline treatment for a host of reasons.
**And psychotherapy but that is not the focus of this article. Therapy is also a frontline treatment but is often not chosen due to cost to the patient.
It’s a bit of a short week what with the holiday and all, but still, there is time for three new things about mental health. Today’s three new things are:
- A safety warning on the atypical antipsychotic drug asenapine maleate (Saphris)
- Saffron and depression
- Multi-drug (polypharmacy) treatment of mental illness
Serious Allergic Reactions Reported with Asenapine Maleate (Saphris)
Asenapine maleate (Saphris) is an atypical antipsychotic drug recently approved for use in the treatment of bipolar type 1 mania and mixed episodes (as well as schizophrenia).
In slightly less than two years of approval, about 87,000 people have been prescribed asenapine maleate. The FDA’s Adverse Event Reporting System (AERS) has had a significant number of serious allergic (hypersensitivity) reactions reported. These serious allergic reactions were reported in 52 cases and are considered Type 1 hypersensitivity. From the FDA:
“Signs and symptoms of Type I hypersensitivity reactions may include anaphylaxis (a life-threatening allergic reaction), angioedema (swelling of the deeper layers of the skin), low blood pressure, rapid heart rate, swollen tongue, difficulty breathing, wheezing, or rash . . . Several cases reported multiple hypersensitivity reactions occurring at the same time, with some of these reactions occurring after the first dose of Saphris.”
Any such reactions require immediate medical attention.
You can report serious allergic reactions to the FDA’s MedWatch program here.
FYI, asenapine maleate’s label has been changed and updated with this new information.
Saffron (crocus sativus) is the most expensive spice by weight and is integral in French bouillabaisse. And someone asked me this week, “Can saffron help with depression?” Initially, I did a search on the Alternative Medicine Index at the University of Maryland Medical Center and turned up nothing. This alternative index lists most everything so my immediate answer to “can saffron help with depression,” was no.
However, I may have spoken slightly too soon.
Upon closer inspection I did find one study that asserts, in treating mild-to-moderate depression:
“Saffron petal was significantly more effective than placebo and was found to be equally efficacious compared to fluoxetine and saffron stigma.”
Now, hold on a minute. This is not a good, particularly scientific, study. This is just a review of studies, some of which are very questionable in nature. The above statement is premature at best. All that can really be said (in my opinion) is that saffron deserves further study and that some formulation of it might work.
Good question. This is called polypharmacy and most doctors agree it’s a bad thing. The reason polypharmacy is bad is because it greatly increases the chance, and severity, of side effects. (There are other reasons too.) People who have been through rounds of polypharmacy will tell you this is true.
However, doctors continue to prescribe many drugs simultaneously for a condition. This article explores why polypharmacy is so common.
The article may make you take a look at your drug regimen and talk to your doctor about reducing some of your medication. This isn’t always possible, but a good idea if you can get away with it.
Note on Polypharmacy
It’s worth noting some conditions do warrant polypharmacy.
According to the Psychiatric Times article, the best indications for polypharmacy are few and well established:
- Bipolar depression
- Psychotic or agitated depression
- Co-morbid conditions that require independent medications (e.g., ADD and major depression)
- When partial response to the first medication requires adding another adjunctively
- When there is a combination of psychiatric and pain problems