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Sundowning in Alzheimer’s and dementia: melatonin/tryptophan for the agitation, restlessness, anxiety, disturbed sleep and aggression

March 3, 2023 By Trudy Scott 8 Comments

The terms “sundown syndrome” or “sundowning” are used to describe a wide range of neuropsychiatric symptoms occurring in individuals with dementia in the late afternoon, evening, or night. These symptoms include confusion, restlessness, anxiety, agitation, aggression, pacing, wandering, screaming, yelling, and hallucinations. The treatment of sundown syndrome is challenging, and pharmacological therapies are not particularly effective.

This definition is from a very encouraging case study published as a letter to the editor of the Journal of the American Geriatrics Society – Melatonin for Sundown Syndrome and Delirium in Dementia: Is It Effective?

This case study is very typical in terms of symptoms and a pharmacological approach:

An 81-year-old man with Alzheimer’s disease diagnosed 4 years previously was admitted to the elderly department because of behavioral disturbances, sleep disorders, and wandering. His wife said that his cognitive and functional impairments had gradually worsened over the past 4 years and that, in the last 6 months, her husband had become verbally aggressive, agitated, and restless; wandered; and paced. He did not sleep for long and had difficulty falling asleep. The symptoms increased in the late afternoon and at night. He had no hallucinations or delusions. One month before admission, delirium was suspected, and his general practitioner prescribed haloperidol, but it was not effective.

During admission, sundown syndrome was diagnosed, and he received pharmacological and nonpharmacological interventions for behavioral and sleep disturbances, but none was effective, and some aggravated symptoms. The pharmacological interventions consisted of benzodiazepines, antipsychotics, cholinesterase inhibitors, mood stabilizers, and antidepressants, all given in an optimal dosing schedule.

Melatonin led to much improved symptoms within a few hours

None of the medications were effective and some made his symptoms worse. This case study is atypical in that his doctors were open to the use of melatonin. This led to much improved symptoms within a few hours and complete resolution in 2 weeks with a second dose:

After extensive review of his history, the effect of past treatments, and the published literature, melatonin was started at a dose of 2 mg at 8:00 p.m. for sleep disorders. Not only did his sleep quality improve within a week, but there was also significant improvement in his behavior within 2 hours of initiation of melatonin. A therapeutic trial with an additional dose of 2 mg given at 3:00 p.m. was started, and his symptoms gradually improved over the subsequent 2 weeks (NPI score 20). No behavioral changes were observed in the 2-month follow-up.

These results are powerful and mirror what a number of other studies are showing, for sundowning and to also slow “down the progression of cognitive impairment”). We also see melatonin working clinically for this population.

I share this case study so if you are a carer or have a parent or loved one with Alzheimer’s or dementia, you have a resource to share with the medical team. There is growing awareness of this research and some neurologists are prescribing melatonin with success. Typically 0.5 mg to 5 mg melatonin is used once or twice a day.

My hope is that this becomes the standard of care instead of prescribing psychiatric medications which the authors acknowledge are not particularly effective. And they don’t get to the root cause that is triggering these symptoms: low melatonin and low serotonin (more on low serotonin below).

Melatonin and anxiety

Melatonin also improves sleep quality and reduces anxiety after a TBI (traumatic brain injury). I blogged about a study that used timed-release melatonin here. The study participants used 2 mg of timed-release/prolonged-release melatonin for 4 weeks. This improved sleep quality and melatonin was also associated with a small decrease in self-reported anxiety.

As outlined in this paper, Melatonin as a Potential Approach to Anxiety Treatment, “melatonin’s benefit in anxiety may reside in its sympatholytic action, interaction with the renin-angiotensin and glucocorticoid systems, modulation of interneuronal signaling and its extraordinary antioxidant and radical scavenging nature.”

The serotonin connection and using tryptophan or 5-HTP

Keep in mind the strong serotonin connection: these sundowning symptoms start late afternoon and evening (hence the name sundowning) and serotonin is a precursor to melatonin production.

I look forward to seeing research on the use of tryptophan or 5-HTP for sundowning symptoms too. Until then, based on the above, and the fact that many of these symptoms are classic signs of low serotonin, I feel comfortable recommending either of these amino acids.

As always, we start low, use afternoon and evening doses and increase based on symptom resolution. The typical adult dose of tryptophan is 500 mg and 50 mg of 5-HTP. I recommend starting with 100 mg tryptophan and 10mg of 5-HTP. The amino acid precautions are always reviewed. I would not recommend either tryptophan or 5-HTP if the individual is currently prescribed an antidepressant, unless you are working with a knowledgeable practitioner and always with the approval and monitoring of the prescribing doctor. This is because of the possibility of serotonin syndrome.

Dr. Dale Bredesen recommends tryptophan and melatonin

Dr. Dale Bredesen is the author of The End of Alzheimer’s (my Amazon link) and a number of other books on Alzheimer’s. He is an authority on Alzheimer’s and recommends both tryptophan and melatonin. In this paper, Reversal of cognitive decline: A novel therapeutic program, he reports the use of 0.5 mg melatonin and 500 mg tryptophan used (3 x week) for sleep issues.

Interestingly and surprisingly, he doesn’t mention sundowning in his books or papers. However, if you are new to his work, I encourage you to look into his functional medicine approach, which is extensive and offers results and hope for many.

Low GABA in Alzheimer’s disease and dementia

This paper, Implications of GABAergic Neurotransmission in Alzheimer’s Disease, shares that “of the two major types of synapses in the central nervous system (CNS): glutamatergic and GABAergic, which provide excitatory and inhibitory outputs respectively, abundant data implicate an impaired glutamatergic system during disease progression.”

The amino acid GABA may also help anxiety, disturbed sleep and restlessness. And it’s common to have both low serotonin and low GABA.

This case study illustrates how using the amino acid GABA can help ease the anxiety often experienced in those with Alzheimer’s disease.

It’s too entrenched in our thinking that there is nothing to be done

It saddens me that it’s too entrenched in our thinking that there is nothing to be done. Unfortunately, many family members and medical professionals consider sundowning a normal part of the disease progression and question whether it’s worth doing anything.

My feedback is this: please don’t discount the power of the amino acids, melatonin and other nutritional approaches to offer some relief and improved quality of life for the patient. And when they are calmer, less aggressive and sleeping better it’s so much easier for the caregivers too.

Resources if you are new to using tryptophan or GABA as supplements

If you are new to using tryptophan or GABA 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).

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, sugar cravings, self-medicating with alcohol and more.

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. You can find them all in my online store. The above oral lavender products are available in my online store too.

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.

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.

Have you used melatonin to help with sundowning symptoms with your loved one and if yes how much helps?

Was melatonin prescribed or did you research it and bring the information to the doctor?

Have you used melatonin to help with sundowning symptoms in your clients/patients? What ranges have you seen to help?

Have you also found tryptophan, 5-HTP and/or GABA to help?

If you have questions and other feedback please share it here too.

DLPA (DL-Phenylalanine) eases PMDD/PMS symptoms in women who experience declining endorphin levels in the second half of their cycles

March 18, 2022 By Trudy Scott 23 Comments

Mood swings, intense sugar cravings, comfort/binge eating, sadness, anxiety, crying, cramps and increased pain, irritability, anger, fatigue, cognitive dysfunction, overwhelm, feelings of unease and dissatisfaction, aggression, heartache, and/or insomnia are common for many women during the second half of the menstrual cycle i.e. in the luteal phase. You may relate to all or some of these symptoms. And you may have been diagnosed with or may identify with PMS (premenstrual syndrome) or PMDD (premenstrual dysphoric disorder – similar to PMS but more serious).

Research shows improvements of these symptoms with the amino acids tryptophan (which provides serotonin support) and GABA (which supports GABA levels). Although there is no research that the pyroluria protocol improves symptoms it’s something I see clinically all the time. (I’ve written about this extensively and share more on this below)

A really interesting study published in 1989 identified low endorphins and low catecholamines as a probable cause for some women – Prevention of Late Luteal Phase Dysphoric Disorder Symptoms with DL-Phenylalanine in Women with Abrupt β-Endorphin Decline: A Pilot Study

I recently came across the above paper and prior to this, had not considered this as a primary root cause. Here is the excerpt from the abstract:

Twenty-two women with late luteal phase dysphoric disorder were treated with DL-phenylalanine during the 15 days prior to menses in a double-blind crossover study.

DL-Phenylalanine was shown to be more effective than placebo in attenuating many symptoms characteristic of luteal phase dysphoric disorder. This amino acid was chosen because of its hypothesized actions in attenuating the symptoms associated with the sharp decline in central β-endorphin levels during the late luteal phase in women with luteal phase dysphoric disorder.

Let’s review a few terms… Late luteal phase dysphoric disorder is a synonym for PMDD. The luteal phase is one stage of the menstrual cycle and occurs after ovulation and before your period. When you feel dysphoric you feel very unhappy, uneasy, or dissatisfied. With the downward endorphin shift at this time, period pain and other pain can be worse, and weepiness and emotional symptoms increase. The need for comfort or reward eating also increases. The study authors suggest these PMDD symptoms may “closely resemble those seen during morphine or heroin withdrawal.”

Based on my experience I do feel comfortable extrapolating these findings to PMS and even peri and post-menopausal women who experience some or all of these symptoms (other than actual periods and period issues in post-menopausal women).

Study participants, dosing and timing of DLPA and improvements

The participants in the study were white, middle-class, and between 24 and 29. Each woman took one 750 mg of DLPA at breakfast and lunch for the 15 days prior to the expected onset of their periods.

In the study groups, it was found that “initial improvement started at the end of the first month of DLPA therapy. Continued therapy brought increased relief from symptoms by the end of the second month. Interestingly, the greatest period of improvement occurred during the washout period” at the end of the third month possibly due to a delayed action of DL-phenylalanine.

The authors make the following conclusion:

DL-phenylalanine was found to be safe, well-accepted, and without significant side effects. The significant improvement it produced with many of the symptoms characteristic of Late Luteal Phase Dysphoric Disorder [PMDD] suggests that it may prove a useful addition to the therapeutic armamentarium for this syndrome.

Keep in mind that a typical starting dose of DLPA is 500mg used 2-3 x per day and it’s typically used between meals for best effects. Ideal is also to customize dosing to your unique needs. In this study, everyone received the same dose at the same time. For these reasons it’s even more impressive to see results like they did.

It makes sense but I have just not used DPLA alone and only in the second half of the cycle

It’s a very small pilot study but given my experience with the amino acids DLPA, DPA and tyrosine, and the vast number of women I have worked with who had symptoms like the above, it makes sense. Using the above three amino acids in combination with dietary changes, tryptophan, GABA and the pyroluria protocol, this approach has offered relief for many of my clients. I have just not used DPLA alone and only in the second half of the cycle.

In case you’re wondering why I mention the three amino acids DLPA, DPA and tyrosine above, it’s because:

DLPA (the amino acid used in this study) supports both endorphins and catecholamines (dopamine is one of them)
Or DPA (supports endorphins only) can be used with tyrosine (supports catecholamines only) instead of DLPA which does both

I blog about the differences between DLPA and DPA here, together with all the symptoms we look at when considering doing a trial.

In this study, they used DLPA which boosts endorphins and catecholamines. As I share in my DPA vs DLPA blog, I prefer DPA (d-phenylalanine) for endorphin support when symptoms are severe. But DPA is not always available so DLPA is a good alternative, assuming the person can handle the catecholamine support. Some people can’t and there are some contraindications too.

I’d love to see follow-on research covering the following:

A larger group of women using DLPA
Individualizing the dosing of DLPA to each person’s unique needs
Correlating results with the low endorphin and low catecholamine symptoms questionnaire
Comparing DLPA alone with a combination of DPA + tyrosine (with each individualized based on unique needs)

Serotonin and GABA support for PMS/PMDD, and the pyroluria protocol

In this paper, Premenstrual Dysphoric Disorder the authors share that PMDD

comprises emotional and physical symptoms and functional impairment that lie on the severe end of the continuum of premenstrual symptoms. Women with PMDD have a differential response to normal hormonal fluctuations.

It’s recognized that serotonin and GABA play a role:

This susceptibility may involve the serotonin system, altered sensitivity of the GABAA receptor to the neurosteroid allopregnanalone [a naturally occurring neurosteroid which is made from the hormone progesterone], and altered brain circuitry involving emotional and cognitive functions.

They share SSRIs that are considered as the first-line treatment. Second-line treatments include oral contraceptives, calcium, chasteberry, and cognitive-behavioral therapy.

However, as I share in this blog, research supports the use of tryptophan – Tryptophan for PMS: premenstrual dysphoria, mood swings, tension, and irritability

A study published in 1999, A placebo-controlled clinical trial of L-tryptophan in premenstrual dysphoria, tryptophan was found to reduce symptoms of PMS when used in the luteal phase or second half of the cycle (i.e. after ovulation).

I mention GABA in this blog and the fact that many anxious women I work with also have pyroluria or signs of low zinc and low vitamin B6 and adding these nutrients, together with evening primrose oil, provide additional hormonal and neurotransmitter support, and help with the social anxiety.

Resources if you are new to using DLPA (or other amino acids) as supplements

If you are new to using DLPA or the other amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low endorphin and low catecholamine symptoms.)

If you suspect low levels of endorphins and/or low levels of catecholamine 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 team you or your loved one is working with. Blog posts like this are intended to add value to the chapter on amino acids, which contains detailed information on doses and time of the day for dosing.

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 acid products that I use with my individual clients and those in my group programs.

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. It’s an opportunity to interact with me and other practitioners who are also using the amino acids.

Have you considered that there may be different types of PMS (premenstrual syndrome) or PMDD (premenstrual dysphoric disorder) i.e. a different combination of root causes and therefore different solutions?

And have you had success with DLPA alone (providing both endorphin and dopamine support) or by using a combination of DPA (endorphin support only) and tyrosine (catecholamine support only).

If you’re peri or post menopausal have you also seen success with any of these amino acids?

Have the other amino acids, tryptophan and GABA or the pyroluria protocol helped too?

If you’re a practitioner please share what you’ve seen with clients/patients.

Feel free to ask your questions here too.

Christmas tree phenols as a trigger for anger, meltdowns, anxiety, hyperactivity, insomnia, aggression, self-injury and autistic symptoms?

December 18, 2020 By Trudy Scott 16 Comments

Are you aware that the aromatic oils that give pine trees their wonderful smell are phenols and that these phenols may be a trigger for anger and meltdowns, anxiety, hyperactivity, irritability insomnia, self-injurious behavior, digestive issues and autistic symptoms (such as stimming, swinging and hand-flapping)? All this can be caused by an indoor Christmas tree in susceptible individuals.

My colleague Julie Matthews writes about this here: Avoiding Holiday Havoc: Healthy solutions to avoid meltdowns and keep the holidays happy

“When phenols are not able to be broken-down and detoxified by a process called sulfation, which is low in many children with autism and ADHD”, they can cause these symptoms and also red cheeks and ears. She shares that “phenolic compounds come in many forms including artificial petroleum-based food additives, and salicylates (a type of phenol) found in plants and foods like strawberries and spices, as well as pine trees.”

In the above blog, Julie shares this story about a client with a 10-year old son with autism. He severely regressed during the holidays and it was because of the Christmas tree. This is what the mom shared:

During the Holidays our son regressed severely. He became anxious, aggressive, and self-abusive. He cried and had tantrums regularly throughout the day. He couldn’t sleep anymore and was up for hours at a time, night after night. He was hand-flapping like crazy. We have a swing in the house for him and he now wanted to swing all day long, constantly, and do nothing else. He lost eye contact and he stopped responding to his name.

Once the Christmas tree was removed the improvements were dramatic:

The next day, he was much calmer. He seemed to have “exhaled.” Within 48 hours, our son was completely back to normal.

I shared Julie’s blog on my Facebook page and a father in my community shared a similar experience about his autistic son’s severe reactions to phenols:

Yes! My autistic son who is sensitive to phenols, would completely meltdown during the holidays. We thought it was just the change in routine and his environment, but quite by accident we discovered fragrances seemed to make him worse. We got rid of the fragrances and holiday tree/decor and the improvement in our son was dramatic! We now realize it was the phenols.

My son’s reaction to phenols/fragrances are bright red cheeks/ears, dark under eye circles, headaches, inappropriate manic laughter, aggression/self injurious behavior, marathon meltdowns/screaming, incontinence, insomnia/less than 3 hrs sleep a night, bumpy rashes, GI issues/diarrhea, excessive sensory stimming (hand flapping, lip licking, running around and body slamming into things.) During the holidays, the intensity of these reactions shot through the roof.

They found out by chance that it was the Christmas tree that was causing his son’s issues each year. It started when he was a toddler and they figured it was the stress and changes of the holidays that was the issue. One year they didn’t put up a tree and they could not believe the difference. It was then they made the connection and learned more about phenols and made the necessary changes.

By reducing phenols in his diet and environment, and giving him Epsom Salt baths and enzymes (No-Fenol), most of the above symptoms were significantly reduced.

I suspect there are many families who are seeing similar meltdowns and have no idea it could be the Christmas tree. Keep in mind that the reactions may not be as severe as these two cases I’ve shared here. If you are seeing any increase in anxiety, irritability, sleep problems, digestive issues or other unusual behavior changes in your child, keep an open mind that it may be more than just the holiday changes.

Julie’s advice is this:

Since so many children with autism and ADHD react to salicylates/phenols – in her nutrition practice she finds an overwhelming majority react negatively – she suggests a cautious approach to holiday decorating for all families of a child with autism or ADHD. Simply avoid the pine Christmas tree.
If you are unsure about their sensitivity to salicylates/phenols you might ask yourself if your child is often hyper, irritable, or has red cheeks, and other common salicylate symptoms, or whether they crave salicylate-rich foods such as berries, grapes, apples, and ketchup. If so, explore salicylates further.

I encourage you to read Julie’s blog to gain a better understanding of salicylates and phenols. If you are a practitioner and want to learn more about low salicylates/phenols and other special diets her practitioner training is excellent.

I appreciate this mom and dad for sharing their experiences with their sons so we can all learn and help other families. I also so appreciate Julie’s expertise in this area and really look forward to digging further into the research and picking her brain so I can share more.

Could your holiday anxiety and/or insomnia be phenol issues too?

Julie works with children with autism and ADHD but as someone who works primarily with adults with anxiety, I’m going to be exploring sensitivity to salicylates/phenols further. Julie recently shared this with me: “if you start looking you’ll probably see a lot of your clients with anxiety have phenol issues.”

If you also notice any increase in anxiety, anger, irritability, sleep problems, digestive issues or other unusual behavior changes, keep an open mind that it may be more than just the holiday stress or winter blues/winter anxiety. It may well be phenol issues too.

Serotonin connection to phenol issues

I’ll be blogging more about this and the fascinating serotonin connection to phenol issues. You may have noticed that many of the symptoms these 2 boys experienced sound a lot like either low serotonin or high serotonin (both of which can occur in autism). Serotonin is an endogenous phenol compound and this phenol issue is likely causing high serotonin.

When I asked Julie about this she shared this with me: “Yes, serotonin and dopamine are phenolic. And sulfation is important for the inactivation of dopamine and serotonin. So poor sulfation can lead to neurotransmitter imbalances.”

Using collagen to lower high serotonin?

I’ve blogged about how collagen can lower serotonin in susceptible folks and increase anxiety. It is also used by some folks to lower their high serotonin and make them calm. Misty reports using collagen ‘therapeutically’:

I use it to reduce tryptophan because I have a tendency toward high serotonin. I have suffered my entire life with ADD, tics as a child, grinding teeth, general anxiety, lack of motivation and later, IBS. In my 53 years I’ve never been as calm as I am now.

I don’t know if Misty has a phenol issue but I’m going to be exploring if collagen or gelatin could possibly be used to help lower the high serotonin and ease some of these severe phenol reactions quickly, in conjunction with other approaches like avoiding the foods and environmental exposures, enzymes and other nutrients, and Epsom salt baths.

Christmas tree syndrome, mold issues and toxic plastic trees

I hate to spoil the Christmas fun but here are a few other things to consider:

Christmas tree syndrome is also a real issue for many individuals
My friend and Enviornmental Toxins expert Lara Adler shares how mold from a real tree made her and her cat really sick “Within a few days of getting the tree, I broke out in a full-body rash that required a 10-day run of prednisone. I didn’t think it was the tree at first (it could have been something else), but then my cat, who was already dealing with GI inflammation and a gut issue developed asthma! Out of nowhere! She also ended up on prednisone. I got rid of the tree and both our symptoms never came back.”
She also shares some issues with plastic trees: they are often made from toxic PVC (polyvinyl chloride) with “softeners like lead and/or phthalates”, and often treated with endocrine-disrupting flame retardant chemicals. More about this on Lara’s blog here.

Have you observed a salicylate/phenol reaction with your child or client/patient? What about a less severe reaction with your child or with you personally?

Have the following helped you: avoiding the foods and environmental exposures like a Christmas tree, using enzymes like No-Fenol and other nutrients, and Epsom salt baths? In the midst of a very severe reaction has collagen or gelatin helped reduce symptoms quickly?

What about mold issues or allergies with a Christmas tree?

Feel free to post your questions here on the blog too.

Anxiety case study: a very very slow SSRI taper with tryptophan and other nutritional support

August 28, 2020 By Trudy Scott 14 Comments

Today I’m sharing an update from someone in my community who is tapering from an SSRI (Cipralex/lexapro) in the best way possible – very methodically and doing a very very slow taper, using compounded medication and nutritional support. It is a team approach with a supportive doctor monitoring for serotonin syndrome, her pharmacist compounding her medication and input from me.

She has an excellent diet that contains enough healthy protein and fats, plenty of vegetables, and no sugar or caffeine. She has the basic nutrients covered and is on the pyroluria protocol (these nutrients help make serotonin). She is using the amino acid tryptophan for serotonin support as she tapers. And she is out walking in nature and practicing mindfulness.

All of this sets her up for success and being able to avoid antidepressant discontinuation syndrome.

Here is her story:

I began tapering off 10 mg of Cipralex in November 2017. I have my little “Support Team” that includes a compounding pharmacist and my GP. Feeling very fortunate that I have these people as my taper has not exactly gone as planned (although far better than my last two attempts)

Originally, the plan was to go down by 10% of the dose and stay at that dose for 4 weeks. That didn’t work for me. I was fine when I dropped from 10mg to 9, but after my next 10% drop I experienced that familiar withdrawal hell. I got a little scared, but stuck with it, and decided to stay at that dose for a bit longer. While I leveled out, I did a lot of reading about how SSRIs work. I learned about the 1/2 life of Cipralex (all SSRIs have a different 1/2 life) and what was actually happening physiologically as my body adjusts to the lower dose. It’s a recovery process.

With that new knowledge, I decided to try another approach. I knew I couldn’t handle a drop of 10%. So, I started to taper at a rate of 0.1mg once a week (far less than 10%!). By day three at the new dose, I could feel the withdrawal, but it was far less severe. Small drops=small “withdrawal wave”. I discovered that I am able to manage a 2% drop of the current dose and I have been able to drop that % each week. So, I’m still reducing by 8% a month, which means I am close to the original plan of dropping by 10% a month. At this time I am at 6.24mg.

Yes, it is a very slow process and I have a long way to go, but it’s working. I have read that some people have to reduce by 1% of their current dose and remain at that dose for 4 weeks to allow their body the time to heal and adjust to life on the lower dose. Having the liquid compound has made such a difference! You sure would have difficulty accurately shaving off a pill by 2%!! If anyone is trying to come off of this drug, do your best to find a compounding pharmacist!

I find that I must stick to a very healthy diet. I eat a lot of fresh, raw and cooked vegetables. I mean a LOT of vegetables. I eat good sources of protein and walk for at least 45 min almost every day. I steer clear of sugar and caffeine. Both make my withdrawal much worse.

Every day I take omega 3, vitamin C, vitamin D, vitamin B complex. I take the supplements for pyroluria, vitamin B6, evening primrose oil and zinc. I take magnesium at night. I took Trudy’s amino acids course online and did all of the amino acid trials. I discovered all I really need is tryptophan. It has made a huge difference for me. Yes, I take Lidke tryptophan. For us Canadians, it can be ordered online.

I practice mindfulness. I’ve read a lot about the anxious brain (the reason I took Cipralex in the first place) so I understand what is happening now, what is real and what is just noise in my head.

Antidepressant discontinuation syndrome

This is the best way to taper SSRI medications in order to avoid withdrawal effects, also known as discontinuation syndrome which can be very severe for some folks.

Accordingly to this paper, Antidepressant discontinuation syndrome occurs in about 20% of patients who reduce the dose or abruptly stop an antidepressant that they have been taking for one month. This paper states that “symptoms are usually mild….occur within two to four days after drug cessation and usually last one to two weeks.”

It also states that occasionally symptoms “may persist up to one year…and if the same or a similar drug is started, the symptoms will resolve within one to three days.”

I typically hear from individuals who fall into the category of severe symptoms that are persisting past 2 weeks. It’s not uncommon to see symptoms continue for a year and often longer in some cases.

Also from the above paper, is the mnemonic FINISH which summarizes these symptoms:

Flu-like symptoms (lethargy, fatigue, headache, achiness, sweating)
Insomnia (with vivid dreams or nightmares)
Nausea (sometimes vomiting)
Imbalance (dizziness, vertigo, light-headedness)
Sensory disturbances (“burning,” “tingling,” “electric-like” or “shock-like” sensations) and
Hyperarousal (anxiety, irritability, agitation, aggression, mania, jerkiness).”

How you will feel if your serotonin is low and how to learn more

With low serotonin you will have the worry-in-your-head and ruminating type of anxiety, panic attacks and phobias, lack of confidence, depression, negativity, imposter syndrome, PMS, irritability, anger issues, insomnia and afternoon/evening cravings.

If you suspect low serotonin symptoms and are new to using the amino acids and do not have my book I highly recommend getting it and reading it before jumping in to taking supplements and navigating this with your prescribing physician: The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings. You may need to lend him/her a copy of my book too.

There is a complete chapter on the amino acids and one for pyroluria, plus information on real whole food, sugar and blood sugar, gluten, digestion and much more. If you’re not a reader there is now also an audible version.

Here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution and additional information on Anxiety and targeted individual amino acid supplements: a summary

Please also read and follow these Amino Acid Precautions.

This lists The Antianxiety Food Solution Amino Acid and Pyroluria Supplements that I use with my individual clients and those in my group programs – you will find the Lidtke Tryptophan here. You can also read more about why I prefer the Lidtke tryptophan on this blog.

I would like to end off by saying how much I appreciate this woman and others sharing their stories like this so we can all learn!

Please also share your taper story and what you did to make it easier. If you had challenges share those too. Let us know if you can relate to any of the above FINISH symptoms and how long they lasted.

Feel free to post your questions here too.

Intoxicating fragrance: Jasmine as valium substitute? New 2019 research confirms this

March 29, 2019 By Trudy Scott 11 Comments

A study from the University of the Ruhr, in Bochum, Germany, resulted in a press-release with a very provocative and enticing title – Intoxicating fragrance: Jasmine as valium substitute and a slew of articles which generated much interest. When I came across this 2010 press release recently, I was of course, intrigued and started digging deeper. Despite the fact that some folks felt it was a long stretch to extrapolate to humans, new research published this year confirms this headline may well have some merit.

Here are some highlights from the 2010 press release:

Instead of a sleeping pill or a mood enhancer, a nose full of jasmine from Gardenia jasminoides could also help, according to researchers in Germany. They have discovered that the two fragrances Vertacetal-coeur (VC) and the chemical variation (PI24513) have the same molecular mechanism of action and are as strong as the commonly prescribed barbiturates or propofol. They soothe, relieve anxiety and promote sleep.

The press release also shares that sedatives, sleeping pills and relaxants which increase the effect of GABA, are the most frequently prescribed psychotropic drugs. Also, “the benzodiazepines, which are now among the world’s most widely prescribed drugs” are “not only potentially addictive, but can also cause serious side effects, e.g. depression, dizziness, hypotension, muscle weakness and impaired coordination.” Valium, Xanax, Ativan and Klonopin are all benzodiazepines and I write more about these medications and why they are so problematic here.

Here are some really interesting facts from the press release/study:

The two fragrances vertacetal-coeur (VC) and the chemical variation (PI24513) were … able to increase the GABA effect by more than five times and thus act as strongly as the known drugs.
Injected or inhaled, the fragrances generated a calming effect.
Applications in sedation, anxiety, excitement and aggression relieving treatment and sleep induction therapy are all imaginable. The results can also be seen as evidence of a scientific basis for aromatherapy.

Here is a link to the 2010 paper: Fragrant dioxane derivatives identify beta1-subunit-containing GABAA receptors. I’ll be honest, it was challenging read for me and when I read the press release and actual paper at first, I wasn’t even sure they were talking about the same thing. You won’t find any mention of jasmine in the study, but instead will find vertacetal-coeur.

As I mentioned above, some organizations felt it was a long stretch to extrapolate to humans. The NHS in the UK was one example, publishing this:

Although some anti-anxiety medications are also known to interact with GABA receptors, it is far too soon to suggest that the effects of jasmine are similar to a recognised treatment for anxiety such as valium. People taking prescribed medication for anxiety should not change their treatment based on this study.

New 2019 research on jasmine for labor anxiety

However, a paper published just this month, A Systematic Review on the Anxiolytic Effect of Aromatherapy during the First Stage of Labor confirms the use of jasmine for reducing anxiety during the first stage of labor (in humans):

It is recommended that aromatherapy could be applied as a complementary therapy for reducing anxiety during the first stage of labor, but methodologically rigorous studies should be conducted in this area.

A total of 14 published papers and 2 unpublished papers were part of the review and other essential oils identified in the review for easing anxiety during labor include: rose, clary sage, geranium and frankincense, chamomile, bitter orange, sweet orange, peppermint, mandarin orange and clove.

Hopefully the NHS in the UK will update their article to include this new review.

Jasmine for other anxiety situations and feedback from real people

I feel very comfortable extrapolating this anxiety-reducing effect of jasmine during labor to other anxiety situations until we have more research.

I also asked folks on Facebook: “Do you use jasmine essential oil and love it? I’m working on a blog post on how jasmine impacts GABA levels and helps ease anxiety and I’d love to include some feedback (good or bad) in the blog. Care to share?” Here is some of the feedback –

Debra: “Never knew there was a Jasmine essential oil… love the smell of fresh Jasmine…will have to look out for it on days when I just need a bit more than what my antidepressant can do…”

Trish: “I use a blend from one of the companies called Joy that has Jasmine in it. It’s awesome, lightens the spirit, makes the day go happier. I use it as a perfume.”

Jessica: “I just started using it.. I really love it! I was using for facial purposes and then read it was good for anxiety and I do feel calm when using and just smelling it really.”

How to get some of the calming benefits of jasmine

There are many ways to enjoy the calming effects of jasmine. Here are some ideas for you:

Diffuse the jasmine essential oil alone in combination with other calming essential oils like lavender and one of the citrus oils like neroli or lemon. The Joy blend that Trish mentions above has bergamot, ylang ylang, geranium, lemon, coriander, tangerine, jasmine, roman chamomile, palmarosa and rose. Dr. Mariza, suggests this “Simply Soothing Diffuser Blend” in her new book The Essential Oils Hormone Solution (my review here)– 2 drops neroli, 2 drops jasmine and 2 drops ylang ylang essential oil
Use it topically with a carrier oil for a massage, alone or in a blend as above
Do what Trish suggests and use it as a perfume (I currently do this with neroli and am now going to try some jasmine)
Bring fresh jasmine flowers into your home or get a jasmine pot plant
Enjoy it in a tea. Organic India has a lovely tulsi tea that contains chamomile and jasmine. If you recall, tulsi or holy basil is an adaptogenic herb which has anti-stress effects
If you can tolerate caffeine, enjoy some Jasmine Oolong tea. Research suggests that the fragrant compounds in the tea “were absorbed by the brain and thereby potentiated the GABAA receptor response…and may therefore have a tranquillizing effect on the brain.”

Next steps: jasmine and GABA or jasmine alone?

It’s hard to know if jasmine used in any of the above ways will be enough to boost your GABA levels and ease your anxiety completely. The best way to find out is to try and see how you feel. It’s all very promising given that the 2010 study found that the compounds they used were able to increase the GABA effect by more than five times.

Until I’ve had clients use jasmine alone for this purpose, I’m still going to recommend the amino acid GABA (based on the questionnaire and a trial) and will suggest concurrent use of jasmine in some way. Once GABA levels have been boosted and all the other changes have been made (diet, blood sugar control, gut health, adrenals, low zinc, low vitamin B6 etc.), jasmine alone may be enough to keep GABA levels on an even keel.

However, right now I do see jasmine as a viable approach that is worth considering if you’re in the midst of tapering from a benzodiazepine and are not able to tolerate GABA and other oral supplements.

I’d love to get your feedback on jasmine and GABA and how you feel both help you (or have helped) with anxiety, depression, sleep or aggression? And if either has helped you taper off your benzodiazepine?

Please also share your favorite ways to use jasmine.

Feel free to post your questions here too.