ADHD

The marketing of Risperdal and how atypical antipsychotics became a multi-billion-dollar industry – a shockingly eye-opening article!

August 22, 2025 By Trudy Scott 2 Comments

Even though I’m very aware this happens, this shockingly eye-opening article by Lydia Green is the best explanation I’ve heard….

I didn’t set out to shape the field of psychiatry. I was just a copywriter working in pharmaceutical advertising. But over time, I found myself at the center of a campaign that would help transform how mental illness—and its treatment—are understood in the U.S. This is the story of how we marketed one drug, Risperdal, and how that effort helped turn atypical antipsychotics into a multi-billion-dollar industry.

If you’ve ever wondered how this powerful class of drugs ended up being prescribed for everything from adolescent mood swings to agitated nursing home patients, you’re not alone. The rise of atypical antipsychotics was a business and marketing phenomenon—driven in part by a wave of pharmaceutical mergers in the 1990s. First introduced for schizophrenia, atypical antipsychotics were promoted as more effective and safer than older drugs like Haldol or Thorazine.

While journalists and regulators have addressed this issue, I want to share my memories of marketing Risperdal—the first widely prescribed atypical antipsychotic. This is the story of how we promoted Risperdal not just as a medication, but as a revolution in psychiatric care. It’s also the story of how we redefined schizophrenia, rewrote the safety narrative of antipsychotics, and helped drive one of the most successful (and concerning) pharmaceutical launches in history.

It was also my first realization of the immense power marketers have to shape their version of the truth—and how I eventually came to question the very system I helped build.

This is an excerpt from the excellent article recently published on the Mad in America site. We all need to be aware what happened with this medication and is still happening. It’s so wrong and is just heart-breaking to think how individuals and their families were manipulated and impacted. Unfortunately it’s very likely also happening with many other block-buster medications too – like Ozempic (for weight-loss), Evenity (for osteoporosis) and more.

In this blog, I share stories from social workers and psychologists who were working in the field at time, the overprescribing of atypical antipsychotics to children and teens in the mid-1990s and now, and the powerful effects of tryptophan, GABA, other nutrients and diet for anxiety, agitation, rage and sleep issues in autism, dementia and ADHD.

You can read the full article here – Confessions of an Ad Writer: How I Helped Turn Atypical Antipsychotics into a Billion-Dollar Industry.

Be sure to read some of the many comments from individuals and families who bore the brunt of this. It’s heartbreaking.

Stories from individuals who were working in the trenches at the time

I shared this article on Facebook and here is some of the feedback I received from the community. Laura Ann’s response:

Thank you for sharing this article. I can remember when I was fresh out of my grad social work program and was working in child psychiatry at the University of Maryland, our docs were pushing this drug for young children with ADHD and conduct disorder. Unbelievable! These companies and their executives should be criminally prosecuted.

We tend to think of these scandals as something that happened but aren’t currently happening. I think we will be reading similar articles about GLP-1’s.

I appreciate her for sharing what she was seeing as a social worker at the time. This is so sad and so wrong. I agree that these companies should be prosecuted. Instead they pay massive fines which are part of their marketing and just-doing-business budget, and continue as before.

Unfortunately Laura Ann is spot on, as much of this continues with Risperdal and other psychiatric meds and it’s already happening with GLP-1s. I share more on this below.

Elizabeth Mary’s response:

Just reading your post gave me chills and made my stomach turn. I worked with folks with developmental disabilities during this time period, I had for years! I watched as the antipsychotics and various psych meds infiltrated the group homes and joined a team of co-workers to fight it. We lost. It was disgusting. And I had no idea all this was happening in the background

My heart breaks for these individuals and their families. Bravo to her for trying to fight it and I appreciate her for sharing what she saw happening.

And this feedback from someone else in the community:

This drug was pushed on individuals with ASD (autism spectrum disorder)! Probably still is! Very sad!

I am a retired psychologist who worked primarily with individuals with developmental disabilities. I saw it all the time. The “medical model” was used a lot, meaning many saw psychiatrists and/or PCPs (primary care providers) who prescribed these meds. It has a long history.

Overprescribing of atypical antipsychotics and other psychiatric medications to children and teens – then and now

As mentioned above, I’ve been aware for some time that there is overprescribing of psychiatric medications to children and teens. In one of my interviews on an Anxiety Summit, “Psychiatric Medications in Children and Teens” with Dr. Nicole Beurkens, we discuss these results from this 2019 paper, Current Pattern of Psychiatric Comorbidity and Psychotropic Drug Prescription in Child and Adolescent Patients:

Our study indicates that the rate of presentation to child and adolescent psychiatry outpatient clinics is increasing, and rates of diagnosis and initiation of psychiatry drugs are high among the presented children.
The prevalence of ADHD shows an increase in males and females in our country, and psychiatric polypharmacy (multiple medications) has reached significant rates.

Keep in mind that Lydia Green shared her marketing work began in the mid-1990s, about 25 years before the above paper was published.

Unfortunately not much has changed. This 2025 paper from Swedish authors reports that the “number of prescriptions to children aged 5-17 years has increased” and that “most prescribed drugs were risperidone [Risperdal] and aripiprazole.”

This 2025 paper report that in a group of Australian children with intellectual disability, autism spectrum disorder and cerebral palsy, “risperidone was the most prescribed antipsychotic medication” and it was often prescribed off-label.

Similar increases in antipsychotic prescriptions are also reported in children and teens in Israel in 2025. The list of papers goes on and on and there are similar papers for dementia and other conditions.

There are versions of this story about a lot of diseases: osteoporosis is another one

Melissa’s response to the Risperdal article was this: “Makes you wonder about therapies they are pushing today.” It’s creating awareness which is what we need and she is asking a great question. Yes – there are many versions of this story about other medications.

Here is a perfect quote from this 2009 article: How A Bone Disease Grew To Fit The Prescription

There’s a powerful economic incentive for pharmaceutical firms to expand the boundaries of the use of different therapies. So whether you consider treatments for osteoporosis or treatments for depression or treatments for high cholesterol — in all of these settings — pharmaceutical firms stand to benefit if the therapies for these diseases are broadly used, even if they’re used among people who have very mild forms of these diseases.

In this same article, Caleb Alexander, a pharmaco-epidemiologist at the University of Chicago, is writing about the marketing of osteoporosis medications and says “the dynamic is well understood.” But all this applies equally to the marketing of all medications i.e. “There are versions of this story about a lot of diseases.”

Dubious marketing by the makers of Ozempic and Wegovy (GLP-1s for weight loss)

This is happening right now for GLP-1s. There were already reports in 2023 about dubious marketing by Novo Nordisk, the makers of Ozempic and Wegovy:

In Great Britain, the company has paid within three years a total of around 21.7 million pounds (24.7 million euros) to experts and organisations including important opinion leaders who have since touted semaglutide as a “game changer” in obesity in a campaign described as an “orchestrated PR campaign.

Sadly I expect their marketing campaigns to run unchecked and get more and more sophisticated, with unsuspecting consumers being taken advantage of and harmed.

Families are not aware of the powerful effects of tryptophan, GABA, other nutrients and diet

My goal is to try and change this lack of awareness so families and individuals can explore other options when they are faced with decisions about some of these medications.

Instead of using antipsychotics for a family member with dementia or Alzheimer’s who is experiencing agitation, aggression and anxiety, consider tryptophan and melatonin, and GABA:

Instead of using antipsychotics, explore the use of 5-HTP/tryptophan and/or GABA for kids with ADHD:

Instead of antipsychotics and other psychotropic medications in autism, explore tryptophan and GABA:

This is by no means a conclusive approach to addressing these symptoms in dementia/Alzheimer’s, ADHD and autism. We also need to consider and address diet, other nutritional imbalances, infections, gut health, toxins and much more.

Additional resources when you are new to using GABA and tryptophan as supplements

As always, I use the symptoms questionnaire to figure out if low GABA or low serotonin or other neurotransmitter imbalances may be an issue.

If you suspect low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids on your own so you are knowledgeable. And be sure to share it with the practitioner/health team you or your loved one is working with.

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control (this is covered in an entire chapter too), sugar cravings, anxiety and mood issues.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acids that I use with my individual clients and those in my group programs.

If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), a good place to get help is the GABA QuickStart Program (if you have low GABA symptoms). This is a paid online/virtual group program where you get my guidance and community support. You can sign up to be notified when the next live launch is happening.

If you need serotonin support, the Serotonin QuickStart Program is a good place to get help. This is also a paid online/virtual group program where you get my guidance on using tryptophan and 5-HTP safely, and community support during 5 LIVE Q&A calls. You can sign up to be notified when the next live launch of this program is happening.

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. This is also a paid online/virtual program with an opportunity to interact with me and other practitioners who are also using the amino acids.

Wrapping up and your feedback

I appreciate Lydia for sharing this and enlightening us, and Mad in Arica for inviting her to do the article. And I appreciate community members for sharing and allowing me to share on this blog

Have you or a family member been the victim of the overprescribing of atypical antipsychotics ?

Have you seen this overprescribing of atypical antipsychotics happening in the work you do as a social worker, psychologist, doctor or other health professional?

Are you surprised to learn about similar strategies being used for marketing osteoporosis and GLP-1 medications?

Feel free to share and ask your questions below.

Calming GABA, tryptophan to relinquish the evening bottle of red wine, theanine for focus and the pyroluria protocol

November 29, 2024 By Trudy Scott 5 Comments

gaba tryptophan theanine

I’m 61 years old postmenopausal. 2 GABA Calm under my tongue the second my eyes open in the morning. I keep it at the bedside. So that’s 250mg.

In the beginning I would also use two if I woke up at 2AM with a panic attack. That doesn’t happen as much anymore. I keep a bottle in my purse for panic attacks during the day. I haven’t had one of those in a couple of years. When I have a low stress week ahead, such as no social interaction scheduled, I go several days without any, but then that clutch in my chest reminds me to start back.

I also am diligent in treating my Pyroluria (diagnosed with a urine test)…it makes a difference. Daily zinc, B vitamins (especially 15mg methylfolate/day – check out the research papers on that dose being as effective as most antidepressants, I’m heterozygous not homozygous, MTHFR), Magnesium Threonate.

I am having good results with 1000 mg L-Tryptophan/day. I’ve just started adding another 1000mg/day in a bid to relinquish my evening bottle of red wine.

I keep a bottle of L-theanine on hand if I have a day ahead that I need to focus. ADHD does not improve with age!! I seriously liked it better in my day when my third-grade teacher labeled me a “dreamer”. Fortunately, I live on a farm and the cows don’t seem to mind that it takes me a bit to focus long enough to get the chores done.

I also have a regular yoga practice and I do physical work outside and in the winter use a SAD light.

I will also add that the last 8 months I have been in a very stressful family situation at home and the above regimen is holding.

If anyone has stuck with this wandering post to the end, don’t give up. Keep fighting to find what works for you.

Jennifer responded with the above in response to my question on Facebook about your starting GABA dose and if it’s changed over the years based on stress levels, hormone changes and life events.

I thanked her for sharing and for her encouraging words for others in the community and asked if I could share her feedback as a blog. She said yes saying “I have learned so very much from the stories of others on the page” – so here we are …

Stories offer hope, motivation and inspiration and we do learn so much from them.

I also told her that she is a poster child for how we want to use GABA and share more about that and her desire to relinquish her bottle of wine (and how amino acids make it easier) below.

She is a poster child for how we want to use GABA

Initially a higher dose of GABA may be needed and then as GABA levels increase and we also start to address other underlying root causes, less GABA is needed on a regular basis.

Initially Jennifer needed 4 x GABA Calm (for a total of 400mg/day) and then just 250mg GABA per day once she addressed pyroluria and B vitamin deficiencies. Yoga also supports GABA production.

On some low-stress days she doesn’t need any GABA at all, but she wisely keeps some in her purse for “panic attacks during the day” (but hasn’t had one in a couple of years).

She had struggled with perimenopause: “I must say that postmenopausal is a hell of a lot better, even with the paper thin skin and wrinkles, than the hell that was perimenopause!!!!”

And she did mention her phenyl-GABA mistake/ignorance and the fact that I helped her identify this issue 5 years ago. If you’re not aware, phenyl-GABA or phenibut can cause similar tolerance, dependence and discontinuation issues to benzodiazepines. More on phenibut here.

All of the above very likely contributed to her higher need for GABA initially.

Additional serotonin support to relinquish her evening bottle of red wine

Jennifer is already supporting her serotonin with 1000mg tryptophan per day, a SAD light in winter and physical exercise on the farm.

Afternoon and evening cravings are common when serotonin isn’t optimal – this can be carb/sugar cravings and/or also a need to self-medicate with wine. The first step is to recognize and acknowledge that a bottle of wine each evening is too much.

This amount of alcohol affects the liver, contributes to leaky gut, can cause blood sugar swings and reduces B vitamins, especially thiamine/vitamin B3. And it could also be considered an added “stress” if you have pyroluria.

Most of us are aware of these harmful effects and yet cannot easily quit. Her use of the word relinquish is a clue as to how she feels about this i.e. some common synonyms of relinquish are “abandon, resign, surrender” which “may suggest some regret, reluctance, or weakness.”

But because she understands the power of amino acids, she plans to increase her tryptophan from 1000mg to 2000mg to address this addiction without the need for willpower or with no feelings of regret or surrender.

If you are new to using this tryptophan for this purpose, this blog is worth reading: Tryptophan had the added benefit of turning me completely off alcohol when I took it to improve mood and sleep during perimenopause

Theanine for when she needs additional focus

Theanine provides a feeling of calm focus, offering support for the following neurotransmitters: GABA, serotonin and dopamine.

Jennifer also uses 400mg of theanine (Suntheanine) for her focus issues, using it only on days she needs it. She says “I rarely have a day when I would need more than 3-4 hours of paperwork concentration as my life on the farm and keeping up with grandchildren is more physical than mental focus.”

Now that she has used GABA, tryptophan and theanine with success, she has these amino acids in her toolbox whenever she needs them in the future and when she needs to increase the dose if the situation requires a change.

A few GABA product options – a sublingual and a powder

Jennifer used Source Naturals GABA Calm lozenges, a product I recommend. It’s a good low dose of 125 mg and is convenient and effective because it’s a sublingual lozenge.

Now GABA Powder is another product I use and recommend. It does need to be measured out to provide a 125 mg typical starting dose. I have clients use a handy mini measuring spoon like this one (my Amazon link) and share more about how to measure out GABA powder on this blog).

For Source Naturals GABA Calm lozenges and Now GABA Powder:

You can purchase these from my online store (Fullscript – only available to US customers – use this link to set up an account).
If you’re not in the US, you can purchase these at iherb (use this link to save 5%).

Additional resources when you are new to using GABA, tryptophan and other amino acids as supplements

As always, I use the symptoms questionnaire to figure out if low GABA, low serotonin or other neurotransmitter imbalances may be an issue.

Wrapping up and your feedback

I appreciate Jennifer for sharing and giving me permission to share her story on the blog. Despite the wine and her very stressful family situation I am thrilled she says she is doing well. I also love that she ends with this: “… don’t give up. Keep fighting to find what works for you.”

I’d love to hear from you – has any of this worked for you?

Feel free to share about your GABA success and how much it helps you and if this has changed over time. And let us know what you feel has contributed to the need for less or more GABA i.e. which other root causes have you addressed?

Feel free to share if tryptophan (or another amino acid) has helped with quitting wine or another alcoholic beverage.

And do share if you use theanine for calm focus.

Feel free to share and ask your questions below.

Vitamin B6 and magnesium on neurobehavioral status of autism spectrum disorder with hyperactivity and irritability (research)

May 24, 2024 By Trudy Scott 7 Comments

Today I’m sharing new research that supports some of the original findings about vitamin B6 and magnesium published by autism biomedical pioneer Bernie Rimland.

Despite the small population size, this study demonstrated neurobehavioural improvement among children with ASD [autism spectrum disorder] with hyperactivity and irritability. Consequently, it can be expected that future studies conducted on a larger scale might help to establish the beneficial role of Vitamin B6 and Magnesium as a complementary treatment for autism with hyperactivity and irritability.

The above comes from the conclusion of this 2021 paper, Vitamin B6 and Magnesium on Neurobehavioral Status of Autism Spectrum Disorder: A Randomized, Double-Blind, Placebo Controlled Study.

There were 50 children in the study, with a random assignment of 27 to the study group (vitamin B6 and magnesium) and 23 to the control group (placebo). All the children were autism patients from a pediatric autism and neurodevelopmental disorder outpatient clinic in India.

One of the primary aims over the 3 month study period was to investigate “any improvement among the six domains of ASD: general observation, cognition, emotion, social behavior, communication, and sensory deficits.”

Read on for learning more about the study outcomes, and dosing and forms of magnesium and vitamin B6 (and how this compares to P5P). I also share more about autism biomedical pioneer Bernie Rimland’s earlier research and the autism/B6/pyroluria connections. And end with some of the many possible mechanisms, GABA and vitamin B6, and other applications for vitamin B6.

More about the study outcomes

The improvement observed in the study/intervention group was 81% compared to only 47% in the placebo group.
Both the study group and control group had a mixture of patients rated as having mild, low moderate, high moderate and severe symptoms of ASD. At the conclusion of the study, there were fewer patients in high moderate and severe categories.
There was “an overall improvement in the symptoms of autism along with improvements in specific domains e.g. Emotion and Cognition.” The Emotion domain includes hyperactivity, aggressiveness, emotional lability (or instability) and stress.

Dosing varied by age and forms of magnesium and vitamin B6

The dosage of magnesium and vitamin B6 for the 27 children in the intervention/study group was pre-determined by the age of the subjects: “Patients aged 2-3 years received 50 mg Magnesium and 25mg Vitamin B6 daily, aged 4-8 years received 100 mg Magnesium and 50mg Vitamin B6 daily, and patients aged 9-12 years were given 200 mg Magnesium and 100mg Vitamin B6 daily.”

Patients in both groups received Risperidone for hyperactivity and irritability.

The form of magnesium used in the study was glycinate and the form of vitamin B6 was pyridoxine.

Vitamin B6 and magnesium research by autism biomedical pioneer Bernie Rimland

The authors share that of the many autism studies with nutrients, studies using vitamin B6 and magnesium “given by parents to ASD children have been observed to produce improvement for about 30 years.”

As I mentioned above, this new research builds on some of the original findings about vitamin B6 and magnesium published by autism biomedical pioneer Bernie Rimland. The study authors share this: “Rimland found significant improvement with the use of high doses of pyridoxine, however high doses of pyridoxine showed side effects which could be negated by co-administering magnesium.”

This 1988 paper by B. Rimland is referenced: Controversies in the treatment of autistic children: vitamin and drug therapy, and states that “Among the biomedical treatments, the use of high-dosage vitamin B6 and magnesium received the highest ratings”

Also referenced is this vitamin B6 paper, co-authored by B. Rimland and published 46 years ago: The effect of high doses of vitamin B6 on autistic children: a double-blind crossover study. It states that “Behavior was rated as deteriorating significantly during the B6 withdrawal.”

Vitamin B6, autism and pyroluria

My experience when it comes to vitamin B6 and P5P is primarily with the many individuals in my community who have pyroluria or suspect they do based on their symptoms (here is the pyroluria symptoms questionnaire). This is about 80% of the anxious folks in my community.

I share this because pyroluria is common in autism spectrum disorder:

children with learning disorders and behavioral disorders: 25% (Abram Hoffer)
autism spectrum disorders: 46% (Woody McGinnis)

(more on prevalence and associated conditions here)

And this study found emotional instability – a key aspect of pyroluria and autism – improved with vitamin B6 and magnesium.

For adults with pyroluria, vitamin B6 is used in the range of 100 mg to 500 mg, starting low and increasing as needed. We use dream recall and increased ability to socialize without feeling anxious as a clue that the correct dose is being used.

Keep in mind that 25 mg P5P (pyridoxal-5-phosphate) or the active form of vitamin B6 is approximately equivalent to 100 mg pyridoxine.

I have found that some folks do better on one form of vitamin B6 than the other i.e. not everyone needs P5P and some folks do better with a combination of P5P and pyridoxine. As with all supplements there is no one–size fits all and so the protocol and form of vitamin B6 used in this study group really only serves as a guideline.

The possible mechanisms

The authors mention this as one possible mechanism under these circumstances: “Magnesium inhibits the excitatory channel glutamate N-methyl-D-aspartate (NMDA) and reduces hyperactivity – a part of the emotional domain.” They also mention the fact that “magnesium increases presynaptic releases” enhancing “both short term and long term synaptic facilitation and long-term potentiation, improving learning and other memory functions.”

I’m adding these as possible mechanisms to consider too:

Vitamin B6 is a potent anti inflammatory compound
Vitamin B6 and magnesium are co-factors needed to make serotonin (which is calming and helps with emotional stability) and dopamine (which helps with focus and motivation)
“GABA is formed from glutamate via the addition of glutamate decarboxylase and vitamin B6”
Vitamin B6 offers neuroprotection in situations of excess glutamate release (together with vitamin B12 and B2)
Vitamin B6 is key (together with zinc, evening primrose oil and others) for addressing social anxiety/pyroluria which is common in autism (as mentioned above)
Vitamin B6 and magnesium improve hormonal health
Oxalate issues are common in autism, leading to depleted levels of vitamin B6 and magnesium. Supplementation can help counter some of the adverse effects.

Also vitamin B6 (and other B vitamins) and magnesium are depleted by sugar, stress, dysbiosis, food allergies, certain medications and caffeine. And it’s common to find deficiencies of both.

A comprehensive dietary and functional medicine / biomedical approach, targeted individual amino acids such as GABA and tryptophan, in addition to vitamin B6 and magnesium is imperative in ASD.

Many other applications for vitamin B6

It’s wonderful to be able to share yet another application for vitamin B6, which, in some circles, is receiving an unfavorable reputation about causing toxicity.

Here are a few other related vitamin B6 blog posts that may be of interest:

Because of the role of vitamin B6 when it comes to calming GABA, it’s worth sharing this blog too – Half a crushed GABA Calm for my autistic child: sleep, anxiety and sensorimotor skills (writing, horse riding and swimming) improve. Both vitamin B6 and GABA are commonly beneficial.

And sometimes, vitamin B6 on it’s own provides results – Anxiety and vomit phobia in an 8-year-old: within a week of starting vitamin B6 she made a complete turnaround.

Additional resources when you are new to using amino acids as supplements

As always, I use the symptoms questionnaire to figure out if low GABA or other neurotransmitter imbalances may be an issue.

There is also an entire chapter on pyroluria and in-depth sections on vitamin B6 and zinc.

If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), a good place to get help is the GABA QuickStart Program (if you have low GABA symptoms too). This is a paid online/virtual group program where you get my guidance and community support.

Wrapping up and your feedback

I’d love to hear from you – have you had success with vitamin B6 and magnesium – personally or with your child? How much has helped and which products? (feel free to share the diagnosis and what symptoms have improved)

Have dietary changes and/or addressing pyroluria helped too?

If you’re a practitioner have you seen these nutrients to help in situations like this?

I’m also curious to hear if you’re familiar with the vitamin B6 and magnesium research and work done by Bernie Rimland?

Feel free to share and ask your questions below.

My 12 year old son has ADHD, is impulsive, is a loner, craves carbs, and doesn’t do well or care about school – should he be on GABA?

July 21, 2023 By Trudy Scott 17 Comments

I’ve been reading your blogs and I’m trying to decide if my 12 year old son should be on GABA? He has ADHD, is impulsive, is a loner, craves carbs, and doesn’t do well or care about school.

Can you tell me what supplement he could be deficient and where to purchase? He is currently on ADHD medication (Focalin) during the school year.

Janice asked the above question about her 12 year old son. I wish it was as simple as just using the calming amino acid GABA but it’s seldom one amino acid that is the answer. GABA is often one of many supplements that may help and in this instance I suspect a combination of neurotransmitter imbalances (low GABA, low dopamine and low serotonin), pyroluria, other possible nutritional deficiencies and dietary factors are at play. Read on to hear my approach for working through what may help this young man improve his focus, reduce his carbs, actually care about school and doing well, reduce his impulsivity and help him fit in socially – and ultimately lead to him being a happier, calmer and healthier child.

GABA with preteens who have ADHD and spinning-type symptoms

I always start with one of the amino acids because we get quick results and immediate feedback. Since Janice asked about GABA, this is the GABA feedback I shared with her: I’ve had good results with GABA with preteens who have ADHD and spinning-type symptoms. One clue is when the craving of carbs is driven by stress i.e. stress eating. I always start with the symptoms questionnaire and have the parent rate each low GABA symptom on a scale of 1-10, with 10 being most severe, ideally in conjunction with their child.

I then have the child do a one-off trial of GABA and we observe improvements in the next 5-30 minutes. If the child reports any improvement in any of the symptoms – in this case focus and spinning driven by anxiety – the child continues with GABA and increases over the next few weeks to find the ideal dose for their needs.

Sometimes focus issues are so severe that it’s too challenging to rate symptoms before, doing a one-off trial of GABA and then rating symptoms afterwards. In cases like this, mom makes the decision to have their child use GABA before school, when they get home and possibly early evening too. Mom can observe their focus and spinning: like getting dressed and ready for school, settling down to homework in the afternoon and settling down for bed.

Relying on feedback from school is invaluable too. Stress related carb cravings are also assessed i.e. does he seek out sugar when stressed and anxious.

A mom shares how GABA helps her 11 year old daughter – GABA for children: ADHD, focus issues, irritability, anxiety and tantrums

My daughter hasn’t been diagnosed with ADHD but has a lot of ADHD qualities. We were having a huge amount of behavior problems as she is getting older (she’s 11). She has had amazing behavior at school and at home since giving it to her. She’s almost like a different child. GABA has truly changed our life.

…before the GABA she was irritable, she was fighting with her teacher and schoolmates, she couldn’t focus and was distracted by anything and everything, she was constantly disrupting the class and she was throwing major tantrums over ridiculous stuff (like her hair didn’t do what she wanted), she was mouthy and everything was a fight.

We are not seeing 99% of those behaviors at all anymore. She of course is still your typical pre-teen but if I say “no you can’t have that” our “no you can’t go there” her reaction is OK. Before it would have been a major fight or meltdown. Her teacher is reporting to me every day about her wonderful days.

Tyrosine for focus issues, low motivation and low energy type carb cravings

With focus issues I would also consider the role of low dopamine and do a trial of tyrosine. Other clues: are his carb cravings related to low energy and is there also low motivation tied to the fact that he doesn’t care about school? Are there also signs of depression or low mood?

We go back to the symptoms questionnaire and have the parent rate each low dopamine/low catecholamine symptom on a scale of 1-10, with 10 being most severe. Again, do this in conjunction with the child if possible.

We only do a trial of one amino acid at a time so we know what is working. Assuming the GABA has been helping, we’d do a trial of tyrosine next and look for improvements in focus, carb cravings (all neurotransmitter imbalances can lead to carb cravings), motivation and mood.

If the one-off trial approach is not an option, tyrosine is also used before school and right after school but no later than 3pm so as not to affect sleep. Again, the above symptoms are tracked.

In this blog both GABA and tyrosine help this teen: GABA helps 14-year-old with Tourette’s Syndrome (the tics and sleep), and tyrosine makes him happier and his mind sharper

Tryptophan or 5-HTP for ADHD/hyperactivity and afternoon cravings

Hyperactivity can also show up with low serotonin, and so can something like not caring about school i.e. a low mood. A clue here is when his carb cravings are more intense – with low serotonin it’s typically afternoon or evening.

We go back to the symptoms questionnaire and have the parent rate each low serotonin symptom on a scale of 1-10, with 10 being most severe. And again, it’s best to do this in conjunction with the child if possible and do a one-off trial of tryptophan or 5-HTP.

If that’s not possible, tryptophan or 5-HTP is used mid-afternoon and evening and symptoms are tracked. This can be layered in on top of the GABA and tyrosine if they are offering some relief.

Here is a blog post where a mom shares how 5-HTP helps her child – ADHD: 5-HTP melts have been a miracle for one of my adopted kids

5-HTP melts have been a miracle for one of my adopted kids. He had lots of trauma and off the charts ADHD. 5-HTP is better than methylphenidate (Ritalin) and we are now weaning off the non-stimulants.

Just 80 mg 5-HTP in the morning is all he needs. He was super ADHD, he had a para (teacher’s aide) in public school for years to keep him on track and this year at a school for ADHD the teachers were complaining that he was never on task. Now after a week it has changed his life.

Addressing pyroluria, low lithium, low zinc, low blood sugar and diet

Janice mentions her son is a loner so we’d look into pyroluria/social anxiety and add zinc, vitamin B6 and evening primrose oil (and other key nutrients). Keep in mind that zinc deficiency is common and is often low with ADHD.

She also mentions that he is impulsive. Impulsivity and ADHD is common with low levels of lithium. A big clue is a child having a roller-coaster of emotions. I use this low lithium questionnaire to assess for a need for low dose lithium (a nutritional supplement).

I consider low blood sugar with all my clients and with this young man low blood sugar may be contributing to his focus issues, low mood and desire for carbs. The amino acid glutamine helps as does breakfast and meals with quality animal protein and healthy fats.

And it goes without saying that dietary factors must always be addressed. My book is a great resource when are looking for a comprehensive dietary approach, which is needed with ADHD and the symptoms Janice describes – The Antianxiety Food Solution. There is also a chapter on low blood sugar, pyroluria and the amino acids.

If you are an adult and can relate to any of these symptoms and feelings, the same process applies. Just remember this: there is no one-size fits all since we all have unique biochemistry.

Side effects and longer term effects of stimulant medications

I appreciate Janice for reaching out and asking this question. Hopefully, implementing some or all of these changes, will allow her son to stop his stimulant medication, Focalin. This medication is similar to Ritalin (methylphenidate), which can cause the following side-effects: feeling sad or empty, irritability, loss of interest or pleasure, trouble concentrating, trouble sleeping (and many more).

These stimulant medications can also play a role in longer term health effects that include heart disease and the possibility of it being a gateway drug to other stimulants. The research on the latter is hotly debated but it is often seen clinically.

Resources if you are new to using amino acids as supplements

To recap, if you are new to using amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the symptoms of neurotransmitter imbalances, including low GABA, low serotonin, low dopamine, low blood sugar and low endorphins).

As mentioned, there is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, anxiety and mood issues.

If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), a good place to get help is the GABA QuickStart Program (if you have low GABA symptoms too). This is a paid online/virtual group program where you get my guidance and community support.

Have any of the above amino acids helped your child or you with the following symptoms: ADHD and poor focus, carb cravings and low mood/low motivation (doesn’t care)?

Has the pyroluria protocol helped your child or you be less of a loner?

Has low dose lithium helped your child or you with impulsivity and focus issues?

Have dietary changes helped too?

If you are a practitioner, are you using amino acids, the pyroluria protocol, low dose lithium and dietary changes with success in cases like this?

Feel free to post your questions and feedback here in the comments.

GABA is not the same as gabapentin. GABA (gamma-aminobutyric acid) is an amino acid supplement; gabapentin is a prescription medication

December 23, 2022 By Trudy Scott 53 Comments

One common question I hear from folks who are new to my work is this: “is GABA the same as gabapentin?” Quite frankly it has always surprised me to get this question since they are different words – why would you think they are the same? But I’d carefully explain the difference, educate the person and move on. A few months ago I shared a blog post on how the amino acid GABA was effective for an 11 year old with ADHD, irritability, anxiety and tantrums and someone asked this question again: “GABA sold at health store or prescription Gabapentin?”

I decided it was finally time to ask why she thought they may be the same thing. I first explained what GABA is (an amino acid supplement), shared some links to products and said “no, not prescription Gabapentin – I’m curious why you’d think that?”

She replied that “some people refer to GABA the same as Gabapentin” and thanked me for the clarification.

I appreciate her response but it did still concern me that the amino acid GABA is lumped together with prescription gabapentin. My next step was a facebook post sharing the above dialogue and asking my community there for feedback: “Have you heard GABA and gabapentin used interchangeably? Did you think they were the same thing at one stage?”

The response was enlightening, hence this blog post to provide clarification if you’re not sure either or if you know exactly what GABA is but have had confused conversations with your practitioner, family members, friends and/or colleagues. And to also get your feedback on this topic.

GABA is not the same as gabapentin. GABA (gamma-aminobutyric acid) is an amino acid supplement and neurotransmitter; gabapentin is a prescription medication. They are often used interchangeably (as you’ll read below) and should not be!

GABA and gabapentin is used interchangeably by a variety of practitioners

Here are some of the many responses showing how GABA and gabapentin is used interchangeably by a variety of practitioners:

Jennifer shared this: Yes in the vet world, gabapentin is often called gaba. Not surprising since western medicine likes to pretend that supplements don’t exist. I didn’t know GABA existed as a supplement for many years. I always explain what it is when I talk about it, to make sure there’s no confusion.

Val shared this: I was just at the dentist and I shared that I take Gaba to help me sleep. She said “Gabapentin?” I said “no I don’t take a synthetic medication, instead I take Gaba which is an amino acid.” It’s good to share with all who are willing to listen.

Katie shared this: I have never heard them used interchangeably but, whenever I talk about GABA, I say “GABA otc amino acid, not gabapentin the prescription” to be extra clear and educational.

Heather said: I was wondering this earlier in the week. My husband’s [nurse practitioner] suggested gabapentin temporarily for a back injury but she used the term “gaba”. I quickly got clarification. Hopefully she won’t do that again. But I understand it. Her field is all pain management.

Theresa shared this: Nurses who don’t know medicine often do that. I’ve found that [gaba] is listed in my med list when they don’t seem to know the difference.

Laura shared this: I always knew that they were different but I have had psychiatrists use them interchangeably.

Bonnie shared this: I mentioned GABA to my dad’s nurse and she got all upset, thinking I meant Gabapentin. At the time I didn’t know it was two different things. Dad was in the hospital and I suggested gaba to calm him. She said, no, no, no! I didn’t realize we were speaking of two different things.

Lisa shared this: When I told my primary doctor [an MD] that I was taking Gaba instead of prescription drugs she asked “gabapentin?” I said “no, Gaba which is a supplement”. She looked confused.

Lindy shared this: It’s a common assumption. I think some GPs (general practitioners) shorten gapapentin to gaba.

Jane shared this: “Yes – I am very careful to say the “supplement GABA.” I mentioned it to an Anesthesiologist when I had surgery. I normally don’t tell the medical profession my supplements – they have no idea what they are. I do specify the “supplement GABA” to holistic providers – I don’t want any misunderstanding. I was on Gabapentin and Lyrica for a long time. Horrific medications with severe consequences

If you relate to any of this feedback, keep sharing in order to educate, explain the difference and clarify to make sure there is no confusion.

What is GABA?

If you are new to the amino acid GABA, it’s a supplement that is used to raise low GABA (the neurotransmitter) levels and ease the physical-tension and stiff-and-tense-muscles type of anxiety.

The other symptoms we see with low GABA are panic attacks, physical tension in certain settings like public speaking or driving, and the need to self-medicate to calm down, often with alcohol but sometimes with carbs and sugary foods. Insomnia can also be due to low GABA and you’ll experience physical tension (rather than the ruminating thoughts which is the low serotonin type of insomnia – although it’s not uncommon to experience both). GABA also helps with muscle spasms and pain relief when muscles are tight.

You can read this blog, GABA for the physical-tension and stiff-and-tense-muscles type of anxiety for my biggest takeaways for using GABA effectively. I also share a number of GABA products and some feedback from folks who have experienced the benefits. One example is this:

I have used GABA (several brands, just open a capsule and sprinkle a small amount under the tongue) for years now, with calming results within minutes.

With regards to the question about GABA being available in health stores: there are amino acid supplements that are available over the counter at a health store and also via my online health store here (these are products I have vetted and use with clients).

Here is the blog I referred to above: GABA for children: ADHD, focus issues, irritability, anxiety and tantrums. My blog is a wealth of information when it comes to GABA so be sure to use the search feature.

What is gabapentin?

Per the Cleveland Clinic site:

Gabapentin is a prescription medication known as a gamma aminobutyric acid (GABA) analogue. GABA reduces the excitability of nerve cells (neurons) in the brain, which play a role in seizures and the transmission of pain signals. Gabapentin mirrors the effects of GABA calming excited neurons. Gabapentin is in a class of medications called anticonvulsants.

It’s been approved for seizures and nerve pain caused by shingles, however, off-label use is common when it comes to other types of pain, anxiety and depression. This paper, Outpatient Off-Label Gabapentin Use for Psychiatric Indications Among U.S. Adults, 2011-2016 warns of

risks associated with gabapentin combined with central nervous system depressant (CNS-D) drugs, which are commonly prescribed in psychiatric treatment….Over 6 years, 58.4% of off-label gabapentin visits listed one or more concomitant CNS-D medications, most frequently antidepressants (24.3%), opioids (22.9%), and benzodiazepines (17.3%).

The above Cleveland Clinic site lists some brand names – Horizant®, Gralise® and Neurontin® – but it is known by many different names in other countries. You can look it up in your country here.

You’ll also see all the side effects and the fact that dependence and withdrawal is downplayed despite the growing evidence that these are very real issues. More on that below.

There are many issues with gabapentin dependence and withdrawal

This blog post is really about terminology and the interchangeable use of GABA and gabapentin, but if you’re new to gabapentin, it’s important to be aware that there are many issues with dependence and withdrawal (often similar to benzodiazepines):

Withdrawal symptoms after gabapentin discontinuation

On day 3 of hospitalization, she developed restlessness, disorientation, confusion, agitation, and anxiety. She was presumed to be suffering from ethanol withdrawal and was treated with benzodiazepines but had no improvement in symptoms. During days 4 and 5, the patient became increasingly confused, agitated, and anxious, with complaints of headache, light sensitivity, and increasing nervousness. On day 5, gabapentin was reinitiated, and the patient’s confusion and agitation improved that evening. The next morning, the patient was calm, alert, and cooperative.

Akathisia induced by gabapentin withdrawal

To our knowledge, this is the first reported cases of akathisia induced by gabapentin withdrawal. Available case reports suggest that gabapentin withdrawal can occur at doses ranging from 400-8000 mg/day. Patients experienced symptoms similar to those that develop with benzodiazepine withdrawal and were taking gabapentin for as little as 3 weeks to as long as 5 years.

Gabapentin dependence and withdrawal requiring an 18-month taper in a patient with alcohol use disorder: a case report

This case highlights the need for patient-centered slow tapers in patients with severe gabapentin dependence and withdrawal.

The withdrawal took 18 months.

There is one case report of macular edema after gabapentin use and gabapentinoid (pregabalin/Lyrica) more so than gabapentin/Neurontin) prescriptions increased risk of suicidal behavior and unintentional overdose.

This 2017 paper, Gabapentin and pregabalin: do the benefits outweigh the harms? summarizes as follows: “Prescribers should be aware of the very limited clinical evidence for use of gabapentin and pregabalin outside their licensed indications, as well as their capacity to do harm.”

The amino acid GABA has none of these issues.

Why it may be confusing for practitioners

Other than the fact that gabapentin is described as a GABA analogue, I can see why it may be confusing for practitioners who don’t yet know about my work and the amino acid GABA.

The fact that GABA is an amino acid supplement and also a neurotransmitter may also be contributing to some of the confusion.

The other fact that I believe is adding to the confusion is because of how gabapentin is often referred to in the research. Let’s take this 2020 paper as an example: γ-Aminobutyric Acid and Derivatives Reduce the Incidence of Acute Pain after Herpes Zoster – A Systematic Review and Meta-analysis

It has γ-aminobutyric acid and derivatives in the paper title and as part of the aim, is mentioned in the results and elsewhere too:

The aim of the present study was to investigate the effectiveness of GABA and its derivatives in reducing acute pain incidence in patients having HZ.
The results showed that the treatment with GABA and its derivatives significantly reduced the number of patients with acute zoster pain.
There is no guideline for using and dosing GABA and its derivatives to prevent acute HZ pain.

And elsewhere they refer to GABA-like compounds:

The optimal dosage of GABA-like compounds is still to be determined.
Nevertheless, the presently available data indicate that the application of GABA-like compounds in this respect is very promising.

The entire review is about gabapentin/neurontin and is not about the amino acid GABA at all, even though the search terms used for this paper included: gamma-aminobutyric acid and gaba.

This is just one example of many such papers. I know what the amino acid GABA is and I was initially confused when reading the title and abstract, and even when reading the full paper (initially hopeful the paper would also be discussing the amino acid GABA).

Resources if you are new to using GABA and other amino acids as supplements

If you are new to using GABA or any of the other amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the symptoms of neurotransmitter imbalances, including low GABA and low serotonin).

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, self-medicating with alcohol and more.

I appreciate these women for sharing their interactions with practitioners so we can all be enlightened.

Have you heard GABA and gabapentin used interchangeably? Did you think they were the same thing at one stage?

How do you refer to GABA and gabapentin in order to avoid confusion?

If you’ve been prescribed gabapentin what was/is it prescribed for? And did you/do you also have a prescription for an antidepressant, opioid or benzodiazepine?

Have you had/do you have any issues using gabapentin?

Have you had success using the amino acid GABA? If yes, what for?

Feel free to post your questions and feedback in the comments below.

GABA supplementation may offer a new approach for the prevention and treatment of asthma (and it helps anxiety, ADHD and insomnia)

December 16, 2022 By Trudy Scott 12 Comments

If you’re already taking the amino acid GABA for physical anxiety, have you noticed if it’s also helping to ease your asthma symptoms too? This may sound surprising but research shows GABA may reduce inflammation and spasms and help with asthma symptoms via these mechanisms. What’s encouraging is the fact that GABA supplementation also helps with anxiety, obesity, ADHD and insomnia which commonly occur with asthma and can be associated with inflammation too. It’s so important to be addressing the root causes of asthma because of the many neuropsychiatric side-effects of asthma medications. This blog addresses all of these topics.

We’ll start with the research first. In this study, Effect of gamma-aminobutyric acid treatment on plasma substance P and calcitonin gene-related peptide levels in children with asthma, of 75 children with asthma, 36 children were in the GABA treatment group and received oral GABA (25-30 mg/kg per day) in addition to standard asthma medications.

The authors propose that airway inflammation may be a factor in asthma and GABA helps because it reduces SP (substance P) and CGRP (calcitonin gene-related peptide), easing neurogenic inflammation and tracheal spasms.

The conclusion of the study is that oral GABA:

can significantly decrease plasma levels of SP and CGRP in children suffering from acute asthma.

It may offer a new approach for the prevention and treatment of asthma.

(this is my best translation from the Chinese paper).

Dosing of GABA for asthma

The children in the study group received oral GABA of 25-30 mg/kg per day. For a 100 lb /45 kg child this would equate to 1125 mg -1350 mg of GABA per day.

As I always share, I don’t recommend using GABA based on the weight of the person and I consider this a high dose. For adults, 125 mg GABA is a good starting dose with 125 mg often used 2-4 times a day. For a child, ¼ to ⅓ this dose is typically good to start with. All that said, many adults and children with asthma and anxiety need higher doses than what they initially start with.

It’s also worth noting that the oral dose of GABA was swallowed so it’s possible (and very likely) that more was needed than if it was used sublingually or with the capsule opened or a powder or a liposomal form.

GABA is seldom recommended for asthma – more recent research supports this approach

This is not new research – the paper was published in 2013 – but I seldom see it discussed or hear about practitioners recommending GABA for asthma.

A more recent paper, Neuroimmune Pathophysiology in Asthma (published in 2021) supports this and discusses the role of neurotransmitters (including GABA and serotonin) and neuropeptides (including SP, CGRP and others) in asthma. The authors suggest “that regulating the effects of neurotransmitters and neuropeptides represents a potential novel approach for the treatment of asthma.”

Why we need to consider GABA – the neuropsychiatric side effects of asthma medications

Exploring the use of GABA and these approaches is especially important given the neuropsychiatric side effects of asthma medications. In this study (published in March this year), Neuropsychiatric adverse drug reactions induced by montelukast impair the quality of life in children with asthma

Neuropsychiatric ADRs (adverse drug reactions) were reported in 78 (62.4%) of 125 patients, who recovered when the drug was discontinued.

These were children of 3-18 years taking montelukast for the first time. The good news is that they recovered when the drug was stopped.

The bad news is there is no information on how many kids who have been prescribed this class of medication are subsequently prescribed psychiatric medications.

This concern needs to be considered for all asthma medications: there are similar adverse effects with antihistamine and inhaled corticosteroid medications.

GABA helps with other conditions where spasms are common

The study results are very encouraging and support what I see clinically with asthma and other conditions where spasms are common. These include

GABA helps with all of the above and the non-allergic comorbidities seen with asthma.

Asthma in children and non-allergic comorbidities (obesity, depression and anxiety, ADHD and insomnia)

As stated in this paper, Paediatric asthma and non-allergic comorbidities: A review of current risk and proposed mechanisms “It is increasingly recognized that children with asthma are at a higher risk of other non-allergic concurrent diseases than the non-asthma population.” These include obesity, depression and anxiety, neurodevelopmental disorders (such as ADHD), sleep disorders and autoimmune diseases.

This paper looks at mechanisms and inflammation is a common theme except when it comes to anxiety and depression. Given that this paper was published this year and all that we now know about nutritional psychiatry and neuroinflammation and anxiety, it’s clearly lacking in this aspect.

Clinically, we see how GABA can help with obesity (and cravings or stress-eating), depression and anxiety, ADHD and insomnia, as illustrated by these case studies:

I see similar comorbidities (the occurrence of more than one disorder at the same time) in adults and GABA can be used safely with adults and children.

Asthma from a functional medicine approach

There is clearly more to asthma than only GABA. This this article on natural remedies for asthma covers diet (eat real good quality food and avoid junk food), nutrients like vitamin D, zinc and others, and allergens – and all this needs to be investigated and addressed with a functional medicine approach.

Dr. Axe does mention stress and anxiety being a trigger: “It’s well-known that stress increases the severity and frequency of asthmatic attacks because it hinders immune function and raises inflammation.” He mentions stress-reduction techniques and breathing. I say let’s add GABA to the mix too.

Resources if you are new to using GABA and other amino acids as supplements

Has GABA helped ease your physical anxiety and asthma symptoms too?

What about obesity/cravings, ADHD and insomnia as well?

Have you or one of your children been adversely impacted by asthma medications? If yes please share which medications and what symptoms were experienced.

What functional medicine and nutritional approaches have helped your asthma symptoms?

Feel free to post your questions and feedback in the comments below.