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Integrative Medicine for Mental Health conference

Psychedelics: is MDMA assisted therapy effective and safe?

September 6, 2019 By Trudy Scott 5 Comments

psychedelics

Dr. Dan Engle, MD, did one of the keynote presentations at the recent IMMH conference. The topic was “Psychiatry Meets Psychedelics: Treating Psycho-Emotional Conditions with Ayahuasca, Psilocybin and more.”

psychedelics

This was not about recreational use of psychedelics but rather Psychedelic Assisted Psychotherapy or PAP, which is “professionally supervised use of ketamine, MDMA, psilocybin, LSD and ibogaine as part of elaborated psychotherapy programs.” Dr. Engle also talked about peyote, cannabis, ayahuasca, San Pedro and DMT.

psychedelics

psychedelics

I had the pleasure of meeting Dr. Engle the day before during the speaker panel we were both part of and shared that I was coming to his presentation because I have a curious mind and love to learn but to be honest “I’m not yet sure if I’m on board with pyschedelics because I’m concerned about the adverse effects AND that too many folks will rush into this approach before exhausting all other nutritional and functional medicine options.” He appreciated my honesty, saying the fact that I was going to come to his talk was a great first step.

psychedelics

He highlighted the epidemics of suicide (22-23/day in veterans), anxiety and depression in youth (40% increase in teens and 200% increase in suicide in girls 10-14 years old, and a 50% increase in boys, opioids (115 overdoses/day and a 400% increase from 1999-206) and loneliness (where rates have doubled since the 1980s).

This is all very horrifying and calls for drastic interventions. Is Psychedelic Assisted Psychotherapy the solution and is it safe and effective?

Let’s take MDMA as one example. In case you’re new to the term, MDMA is the abbreviation for 3,4-Methyl​enedioxy​methamphetamine. This 2018 article, Is psychiatry ready for medical MDMA? shares this:

Advocates for MDMA-assisted psychotherapy have been at pains to distinguish the street drug ecstasy from MDMA, the medicine. Ecstasy can contain a range of substances as well as varying doses of MDMA.

psychedelics

Dr. Engle shared some of the psychedelic science, with impressive results for MDMA.

The study by Mithoefer in 2010 reported that 83% of patients with severe treatment-resistant PTSD saw their symptoms resolve after 2-3 sessions of MDMA assisted therapy. These are very encouraging results, however the patients were described as having treatment-resistant PTSD as a result of not seeing resolution of their symptoms with either psychotherapy or psychopharmacology (i.e. medications). They had not been offered a functional medicine/nutritional approach. This is all good and well if there were no adverse reactions with the MDMA assisted therapy.

According to the above paper: There were no drug-related serious adverse events, adverse neurocognitive effects or clinically significant blood pressure increases.

However, what wasn’t mentioned in Dr. Engle’s presentation is that some studies do show adverse effects of MDMA. For me, this is an area of concern as far as psychedelic use goes, and I would have liked to hear more about what kinds of problems we need to be aware of.

This 2014 paper: The potential dangers of using MDMA for psychotherapy lists a number of very concerning potential dangers:

  • Early studies from the 1980s noted that MDMA was an entactogen, engendering feelings of love and warmth. However, negative experiences can also occur with MDMA since it is not selective in the thoughts or emotions it releases. This unpredictability in the psychological material released is similar to another serotonergic drug, LSD.
  • Acute MDMA has powerful neurohormonal effects, increasing cortisol, oxytocin, testosterone, and other hormone levels. The release of oxytocin may facilitate psychotherapy, whereas cortisol may increase stress and be counterproductive.
  • MDMA administration is followed by a period of neurochemical recovery, when low serotonin levels are often accompanied by lethargy and depression.
  • MDMA could increase the likelihood of suicide in those individuals with strong post-recovery feelings of depression.
  • Regular usage can also lead to serotonergic neurotoxicity, memory problems, and other psychobiological problems.
  • Proponents of MDMA-assisted therapy state that it should only be used for reactive disorders (such as PTSD) since it can exacerbate distress in those with a prior psychiatric history.

The author ends by saying: My own position is that it will always be far safer to undertake psychotherapy without using co-drugs. In selected cases MDMA might provide an initial boost, but it also has far too many potentially damaging effects for safe general usage.

There are many practitioners who, like me, are not yet on board with Psychedelic Assisted Psychotherapy, because adverse effects appear to be under-reported and not discussed. A more recent 2018 paper calls for more research about the safety of MDMA assisted therapy: an immediate need for more research directly examining its safe usage in the therapeutic context.

Hopefully the phase 3 MDMA trial Dr. Engle mentioned on this slide will provide further insights about potential safety issues.

psychedelics

Dr. Engle did also share this interesting slide: Active/Lethal Dose Ratio and Dependence Potential of Psychoactive Drugs, Drugs and Society, US Public Policy, 2006. It’s apparently from this paper published by Gable, RS (I’ll confirm once I find out). You can see MDMA on the far right indicating a rather high potential for acute lethality (bottom scale), with a moderate/low risk for dependence (the scale on the left).

Dr. Engle stopped by my booth after his presentation to see if he’d been able to change my mind. I shared my concerns about the potential risks. I also said that it would be helpful to see a study comparing MDMA assisted therapy with a functional medicine/nutritional approach. I also said I’ll keep reading and learning and will keep an open mind but right now I’m still very much on the fence. This approach does seem to be very effective but I have concerns about safety.

I blogged about some of my concerns last year: MDMA-Assisted Psychotherapy for Treating Chronic PTSD: Why I feel we can do better and the role of nutrition and amino acids like GABA

I agree there is an immense need for successful treatment approaches, but jumping to MDMA from psychotherapy and/or psychiatric medications is skipping out the entire nutritional and biochemical step which is SO powerful and doesn’t have the above adverse effects. I’m concerned too many who have not seen benefits from therapy or medications are seeing MDMA as THE solution and are going to be harmed even further.

One other big reason is that I’m very much on the fence is that I see so much success with the nutritional approach that I use with clients.

In addition to psychotherapy, there are also so many nutritional and biochemical factors we can consider when it comes to PTSD. These don’t have any of the above harmful effects seen with MDMA.

Here are a few to consider:

  • In this blog post, PTSD from 3 tours in Afghanistan: Can GABA help with the anxiety? how low GABA can lead to physical anxiety, muscle tension and the need to self-medicate with alcohol or sugary foods in order to calm down and relax. We also have research supporting the use of GABA for helping with unwanted obtrusive thoughts which are common with PTSD. When low GABA is suspected we do an amino acid trial with GABA, one of the calming amino acids.
  • A 2016 reports that blueberries boost serotonin and may help with PTSD and anxiety. This was an animal study where the traumatized rats were fed a blueberry-enriched diet. The study authors report an increase in serotonin levels, suggesting that “non-pharmacological approaches might modulate neurotransmitters in PTSD.”
  • A recent meta-analysis, Association between posttraumatic stress disorder and lack of exercise, poor diet, obesity, and co-occuring smoking, confirms the diet and lifestyle connection to being more impacted by trauma when health is not optimal.
  • Depression, hostility, anger, and aggression and common in returning veterans with PTSD. These are classic signs of low serotonin and a trial of tryptophan may be warranted given that insomnia and anxiety are so common too.

I feel it is these kinds of interventions that should be considered for PTSD, rather than subjecting individuals who are already suffering to treatments that have adverse reactions AND are not addressing underlying nutritional deficiencies of low GABA, low serotonin, out of balance endocannabinoid system, dysbiosis and overall health, to name a few of the many possible underlying biochemical factors.

Real whole food, exercise, GABA, tryptophan, zinc, berries, probiotics etc. wouldn’t even feature on a chart such as the one above! They are effective approaches and they are safe!

In case you missed the previous IMMH blogs:

  • Last week I shared some highlights on mold, oxalates, anxiety, panic attacks and depersonalization
  • Here are a few highlights from my IMMH presentation: “GABA for Anxiety, Insomnia, ADHD, Autism and Addictions: Research and Practical Applications” – benzodiazepines are not the solution, some new 2019 research on the far-reaching benefits of GABA, and the role of GABA in ADHD.
  • A few weeks before IMMH I wrote this blog post on one of the new studies in my presentation: how a combination of GABA and theanine improves sleep and reduces anxiety.

Have you been part of a Psychedelic Assisted Psychotherapy program with MDMA or one of the other psychedelics? What benefits did you experience? Did you have any adverse effects?

Would you consider Psychedelic Assisted Psychotherapy with MDMA or one of the other psychedelics?

Have you see benefits and/or adverse effects with your patients or clients?

As a practitioner, do you want to learn more about how to incorporate GABA and the other targeted individual amino acids, tryptophan/5-HTP, DPA, glutamine and tyrosine, into your work to help your clients/patients with anxiety and PTSD? I invite you to check out my new online practitioner training here: Balancing Neurotransmitters – The Fundamentals. I’m extending the $100 discount offered at IMMH for a few weeks (use coupon code immh2019).

Filed Under: Events Tagged With: amino acids, anxiety, Dan Engle, depression, GABA, IMMH, Integrative Medicine for Mental Health conference, MDMA, MDMA assisted therapy, Psychedelics, PTSD

IMMH highlights: mold, oxalates, anxiety, panic attacks and depersonalization

August 30, 2019 By Trudy Scott Leave a Comment

IMMH highlights

Today I’m sharing some highlights from three different presentations at the recent IMMH/Integrative Medicine for Mental Health Conference – on mold and the connection to oxalate issues, as well as a major trigger of anxiety, panic attacks, depression and depersonalization.

Matthew Pratt-Hyatt, PhD: “The Hidden Threats of Mycotoxins.”

Matthew Pratt-Hyatt, PhD presented on “The Hidden Threats of Mycotoxins.” He shared medically significant mycotoxins and that ochratoxin affects the kidneys and my first thought was: “I wonder if this plays a role in oxalate issues?”

I asked Dr. Pratt-Hyatt after his presentation and he said yes, the mycotoxins produce oxalates and then dietary oxalates can be the tipping point. He wasn’t aware of any research on the mycotoxin-oxalate connection but sees the connection on the Great Plains MycoTOX lab test and Organic Acids test

Matthew Pratt-Hyatt

Matthew Pratt-Hyatt

Matthew Pratt-Hyatt

Matthew Pratt-Hyatt

Dr. Neil Nathan: “Mold Toxicity as an Unrecognized Cause of Mental Health issues.”

One of my favorite presentations was the one delivered by Dr. Neil Nathan on “Mold Toxicity.” He defines mold toxicity and how it can directly trigger anxiety, panic attacks, depression, depersonalization and hallucinations, as well as some of the common complications which can exacerbate mental health symptoms. These include mast cell activation, multiple chemical sensitivities, secondary porphyrias, methylation dysfunction and pyroluria.

I do appreciate the fact that he addressed that there can be PTSD caused by physicians when someone knows they are sick – especially with mold toxicity – and yet they do not feel heard or validated. This can even lead to their families being less supportive.

Dr. Nathan is a brilliant and compassionate practitioner, and the author of the excellent book – Toxic: Heal Your Body from Mold Toxicity, Lyme Disease, Multiple Chemical Sensitivities, and Chronic Environmental Illness (my Amazon link)

Neil Nathan

Neil Nathan

Neil Nathan

Neil Nathan

Neil Nathan

Dr. Kurt Woeller: “Metabolic Products in Mental Health – How Fungal, Bacterial, Mitochondrial and Other Compounds Influence the Brain.”

Dr. Kurt Woeller shared more about oxalates and mold in his presentation: “Metabolic Products in Mental Health.” I really like the Oxalate Metabolism diagram that shows the role of low vitamin B6, dietary oxalates including ascorbic acid, collagen and gelatin, mold, yeast and genetics in someone with high oxalates.

On a side note, low serotonin is often a factor with collagen and gelatin but it can be a source of oxalates.

He mentions various health problems associated with high oxalates – pain issues are common and so is fatigue and behavioral issues. Dr. Woeller works primarily with children but I have seen anxiety and depression in adults with oxalate issues too.   If mold is one of the triggers then the mental health issues can be further impacted.

 

In case you missed the previous two IMMH blogs:

  • Last week I shared a few highlights from my IMMH presentation: “GABA for Anxiety, Insomnia, ADHD, Autism and Addictions: Research and Practical Applications” – benzodiazepines are not the solution, some new 2019 research on the far-reaching benefits of GABA, and the role of GABA in ADHD.
  • The previous week I wrote this blog post on one of the new studies in my presentation: how a combination of GABA and theanine improves sleep and reduces anxiety.

What wasn’t discussed were some of the other mechanisms that may be causing the increased anxiety – such as the impacts of toxic mold on neurotransmitters and low levels of zinc.

Have you been exposed to toxic mold and was this a trigger for your anxiety, panic attacks and other mood issues?

Did GABA, tryptophan and zinc (and other nutritional support approaches) help ease some of the anxiety symptoms while you were remediating your home and detoxing from the mold toxicity?

Do you have oxalate issues and have you ruled out the fact that toxic mold may be a trigger? I personally have oxalate issues (I share more about this here) and plan to do the MycoTOX test to learn more. I’ll keep you posted on what I find.

As a practitioner, do you want to learn more about how to incorporate GABA and the other targeted individual amino acids, tryptophan/5-HTP, DPA, glutamine and tyrosine, into your work to help your clients/patients with anxiety triggered by toxic mold? I invite you to check out my new online practitioner training here: Balancing Neurotransmitters – The Fundamentals. I’m extending the $100 discount offered at IMMH for a few weeks (use coupon code immh2019).

Filed Under: Anxiety, Depression, Environment, Events, GABA, Mold Tagged With: ADHD and addictions, anxiety, autism, benzodiazepines, depersonalization, depression, GABA, IMMH, insomnia, Integrative Medicine for Mental Health conference, mold, oxalates, panic attacks

IMMH highlights: GABA for anxiety, insomnia, ADHD, autism and addictions

August 23, 2019 By Trudy Scott 6 Comments

immh highlights

I’m back from 2 weeks in the USA, first attending the Mindshare Summit (a collaborative community of like-minded practitioners) and then speaking at the IMMH/Integrative Medicine for Mental Health Conference – my favorite mental health conference – on “GABA for Anxiety, Insomnia, ADHD, Autism and Addictions: Research and Practical Applications.”

Last week I shared a blog on one of the new studies in my presentation: how a combination of GABA and theanine improves sleep and reduces anxiety. Today I’m sharing some other highlights from my presentation: benzodiazepines are not the solution, some new 2019 research on the far-reaching benefits of GABA, and the role of GABA in ADHD.

immh slide

immh slide

immh slide

It was great to meet so many of you from my community and to make new connections! I’m thrilled there is so much interest in using the individual amino acids for anxiety and insomnia, and for those with ADHD, autism and addictions.

trudy at immh
trudy at immh

It was also wonderful to get the support of my colleagues at my booth, for my talk, and to hang out with them, laugh and eat good food. There was plenty of sardines, sauerkraut and grass-fed beef in the place we all shared!

immh booth

Pictured here, on the left is is Annie and Julie; on the right is Elissa, Jessica and Dr. Zendi

Let me share a little about these wonderful practitioners who are doing life-changing work:

  • Julie Matthews, is the author of Nourishing Hope for Autism (my Amazon link), co-author of a new study, Nutritional and Dietary Intervention for Autism Spectrum Disorder and creator/founder of the Bioindividual Nutrition Institute, offering practitioner training on special diets and bioindividual nutrition. Julie also presented at IMMH this year: “Effective Nutrition and Diet Intervention for Autism Spectrum Disorder: Newly Published Research.”
  • Elissa Arnheim is a health coach and a certified fermentationist. She is the creator of “Healthy Gut Happy Child”, “8 Days to Freedom from Picky Eating!” and the “Gut Health Mamas” group coaching programs.
  • Jessica Sherman’s work is all about raising resilient healthy kids and she teaches about nutrition for the brain, mood, behavior and better overall health. She is the author of Raising Resilience: Take the Stress out of Feeding Your Family and Love Your Life.
  • Zendi Molderhauer, works with children, adolescents and young adults, integrating her conventional medical background in pediatrics and psychiatry with more natural, holistic, and functional healing modalities.

Once the conference was over, we also got to lie on the warm sand chatting about what we had just learned, walk along the beach, jump for joy and play, and even have a quick swim in the ocean (it was chilly but invigorating).

san diego beach

san diego beach

san diego beach

san diego beach

Has GABA helped you with your anxiety, insomnia or addictions (carbs or alcohol or even drugs)? Do you have a child with autism or ADHD and have they benefited from GABA?

Do you have questions about using GABA for anxiety, insomnia, autism, ADHD and addictions?

If you’re a practitioner and want to learn more about how to incorporate GABA and the other targeted individual amino acids (tryptophan/5-HTP, DPA, glutamine and tyrosine) into your work to help your clients/patients with anxiety/insomnia/addictions/ADHD/autism, I invite you to check out my new online practitioner training here: Balancing Neurotransmitters – The Fundamentals. I’m extending the $100 discount offered at IMMH through the end of August (use coupon code immh2019).

And be sure to save the date for IMMH 2020:  August 20-23 in Chicago!

Filed Under: Events Tagged With: ADHD and addictions, anxiety, autism, benzodiazepines, GABA, IMMH, insomnia, Integrative Medicine for Mental Health conference

Low zinc and low GABA contributing to anxiety in children and women

October 7, 2016 By Trudy Scott 18 Comments

low-zinc-gaba-video

Dr. Nicole Beurkens and I sit down together at the end of the recent Integrative Medicine for Mental Health conference to talk about anxiety and the impact of both low zinc and low GABA. Nicole shares her perspectives on working with children and I share what I see with the adult women I work with. We don’t specifically talk about older adults or men but it’s applicable to everyone.

Dr. Nicole Beurkens PhD, a special educator, clinical psychologist and nutritionist, is author of the new book Life Will Get Better: Simple Solutions for Parents of Children with Attention, Anxiety, Mood and Behavior Challenges

In case you’re new to my community, this is my book: The Antianxiety Food Solution: How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings

Here are some of the highlights from our conversation about zinc:

  • Zinc is a very common deficiency and can be a contributing factor in both anxiety and ADHD
  • Zinc is depleted by sugar consumption, stress and exercise
  • Zinc sulfate used as a zinc challenge is one way to determine your zinc status
  • Nicole’s response to the zinc challenge: fuzzy, strong yukky taste – which means good zinc levels
  • Most people coming to the booth had very little reaction to the zinc challenge – which means low zinc levels
  • Level 1, 2, 3 and 4 are used to figure out your zinc status (you can read about the zinc taste test here)
  • My response to the zinc challenge: metallic, gross, horrible and I got goosebumps – – which means good zinc levels
  • Nicole shares that most of kids and young adults at her clinic have level 1 or level 2 zinc status, and it’s an easy test to do with kids
  • Many people at the conference were on zinc and were surprised they were not tasting the zinc sulfate. Other than sugar consumption, stress and exercise, low HCl (stomach acid) can affect your absorption. I also found that many of these folks were on a gluten-free or Paleo or GAPs diet and eating a lot of nuts or using nut flours. Nuts are high in copper and this can counteract the zinc.
  • We talk about the importance of good quality zinc supplements and finding a zinc product and multi that is copper-free. Here are the products I recommend.

Then we talk about GABA Calm, a calming amino acid that we both love! Here are some of the highlights from this section:

  • It’s a lozenge/sublingual, is easy to take and helps in situations where the anxiety can quickly escalate into panic attacks. Nicole likes the peppermint flavor and finds many of the children and young adults she works with prefer the orange flavor. Personally I also prefer the orange flavor.
  • For adults, if you use wine at the end of the day to de-stress, you may be low in GABA and self-medicating, and using something like GABA-Calm often helps.
  • Moms will take their GABA Calm with them and use as needed and give to their kids if needed too.  
  • I share how effective it is for Lyme anxiety and how it can be used instead of benzodiazepines (I interviewed Trish about this on the recent Anxiety Summit)
  • GABA Calm can help when you’re on a benzodiazepine and even very severe anxiety or depression can be alleviated with diet and nutrients.
  • Nicole shares how common benzodiazepine prescriptions are in teens and young adults; and the issues with dependence and wanting to quit but not being able to. It can sometimes take years to reduce the medications.
  • I share about the first World Benzo Awareness Day on July 11 – so many people are in trouble and are not cautioned.

We were both so encouraged being at this conference and seeing so many physicians, psychiatrists, psychotherapists, psychiatric nurse practitioners and others practitioners who are really interested in learning more about these approaches. They are seeing the same issues we see with some of the medications (and not getting to the root cause of anxiety) and they are excited to expand their knowledge base. It’s just so exciting to see the pendulum swinging!

We both really appreciate the Integrative Medicine for Mental Health conference. If you’re a practitioner and haven’t attended it’s a must-attend event. If you were there you know what I mean. It was also super to meet so many of you after my talk and at my booth. If you’re not a practitioner do tell your doctor about it. Save the date for 2017: September 28 – October 1 in Orange County, California.

We did this as a live video feed on Facebook hence the references to posting questions and Facebook. It was also the end of the event and the people next to us were packing boxes and using a lot of tape so apologies for the weird noises.  

Feel free to share your results with zinc and GABA Calm and any questions you may have.

Filed Under: GABA Tagged With: anxiety, benzodiazepines, children, GABA, GABA Calm, Integrative Medicine for Mental Health conference, Nicole Beurkens, Trudy Scott, women, zinc

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