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

By Trudy Scott 14 Comments

anxiety case study

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.

DIY moisturizer recipes to lower inflammation and reduce anxiety, panic, PTSD, phobias and social anxiety?

By Trudy Scott 16 Comments

Could daily use of a good quality moisturizer help to reduce anxiety, panic, PTSD, phobias and social anxiety by reducing inflammation? Last week I blogged about a new pilot study on how a skin moisturizer reduced inflammation in older adults and extrapolated these results suggesting this may well be applicable for you if you suffer from anxiety because of the reduced inflammation. The benefits of touch, the oxytocin boost and slowing down for some self-care most likely play a role too. I promised to share some DIY home-made moisturizer recipes so here goes. You’ll see that many of these include ingredients that are helpful for anxiety when used stand-alone, so you get that benefit too.

Dr. Mariza shares Lavender-Cocoa Body Lotion Bars and a Soothing Skin Roller Blend

Dr. Mariza Snyder, author of The Essential Oils Hormone Solution (my Amazon link) and Smart Mom’s Guide to Essential Oils (my Amazon link), has a lovely recipe for DIY lotion bars on her site which she gave me permission to share here. She describes these bars as a “luxurious chocolaty-lavender post-shave moisturizer.” She adds that “Lavender and Geranium essential oils are the perfect combination when it comes to softening the skin while helping you to relax in the process.”

Lavender-Cocoa Body Lotion Bars

Ingredients:

1 cup beeswax pastilles
1 cup cocoa butter
1 cup coconut oil
2 teaspoons vitamin E
10 drops lavender essential oil
10 drops geranium essential oil

Directions: Combine all ingredients except essential oils in a double boiler or a glass bowl over a smaller sauce pan with 1 inch of water in it. Bring to a boil. Stir ingredients until they are completely melted and smooth. Remove from heat and then add essential oils and stir. Pour mixture into silicone bake cup molds for the lotion to solidify, allowing them to completely dry before removing them from the molds. Store lotion bars in a clean container and apply to body after a shower. The heat from your body will melt the lotion! Yield: 10-12 bars (depending on molds).

Check out her blog for other self-care recipes like a salt scrub, a cooling peppermint shaving cream and a razor burn serum (with versions for both women and men).

When I reached out to her for recipes, Dr. Mariza also shared a soothing skin healing blend recipe saying: “I’ve used this blend to reduce inflammation and redness on irritated skin with incredible success! I’ve treated a lot of acute eczema and psoriasis with this blend flare ups.” 

Soothing Skin Roller Blend 

Ingredients:

5 drops Melaleuca/Tea Tree essential oil
5 drops Geranium essential oil
6 drops Rose essential oil (optional)
6 drops Lavender essential oil
6 drops Frankincense essential oil
Fractionated Coconut Oil or Carrier Oil of choice

Directions:  Add essential oils to 10ml roller bottle and top off with Fractionated Coconut oil, or carrier oil of your choice.  Apply directly over the area of concern to reduce red, irritated skin.  Use as needed.

You can read my review of her book here): The Essential Oils Hormone Solution.

Dr. Z and Mama Z share their most used recipe: DIY Healing Skin Serum

Dr. Eric Zielinski, author of The Healing Power of Essential Oils (my Amazon link), and known affectionately as Dr. Z, and his wonderful wife, Mama Z, gave me permission to share this DIY Healing Skin Serum recipe. They run the Natural Living Family site.

Mama Z’s DIY Healing Skin Serum

Ingredients:

1 tablespoon cold fresh frozen aloe, or aloe vera gel
1 tablespoon organic coconut oil (softened or melted)
5 drops lavender essential oil
2 drops frankincense essential oil

Directions:

  1. Blend the aloe gel, coconut oil and essential oils in a Magic Bullet or food processor until smooth.
  2. Once well mixed, store in a class jar or glass salve container in a cool place so the coconut oil remains hardened.
  3. Store in fridge or cool place and enjoy at least once per day. Make fresh each week.

Notes: No matter what allergies you may have, there’s a carrier oil that’s right for you. You can use any, or a combination of these: Avocado, Fractionated Coconut, Grapeseed, Jojoba, Sweet Almond.

Be sure to read the entire blog post to get the back story on how Mama Z used this to heal her face after experiencing some chemical burns from store bought facial cleansers and creams when she was a teen, how it helped her dad with some skin cancer on his hands, some tips on aloe and some recipe variations.

Dr. Z gives it this glowing endorsement: “This is by far the most proven and most used DIY recipe that we have. It helps people with everything with skin cancer to sun burn, eczema to acne to psoriasis to you name it.”

Here is my review of Dr. Z’s book: The Healing Power of Essential Oils. You’ll find additional recipes here.

If you’re looking to learn how to use essential oils, I highly recommend their Essential Oils for Abundant Living 10-Part Video Masterclass.

Rachael, herbal skincare formulator, shares a lovely Skin Repair Souffle recipe

Rachael Pontillo, Licensed Aesthetician, herbal skincare formulator, educator and author of Love Your Skin, Love Yourself (my Amazon link) shares this lovely Skin Repair Souffle recipe.

Skin Repair Souffle Recipe

Supplies needed:

A glass jar–4 oz is preferred
A small double boiler/bain marie
Heat element (stove, cooktop, hot plate)
Kitchen scale
A small whisk
Small hand mixer, milk frother, or immersion blender

Ingredients:

30 g shea butter
30 g jojoba oil
15 drops total essential oils (Frankincense, Helichrysum, Geranium, and Lavender are the essential oils Rachael likes best for barrier support. She says either choose one or create a blend).

Instructions:

  1. Heat your double boiler until the water is boiling, then reduce to a simmer.
  2. Add the shea and jojoba and whisk gently until completely melted.
  3. Remove the vessel from the heat (careful not to get water into the mixture), and cool to room temperature in an ice bath while stirring gently.
  4. Add your essential oils, one by one, stirring gently.
  5. Blend gently with your milk frother or blender until the mixture begins to rise with a meringue-like texture (usually about 60 seconds)
  6. Pour into your jar. Close the jar immediately. Refrigerate overnight.

Dr. Keira, The Skin Whisperer, shares Lavender Bath Oil and Rejuvenating Serum

Dr. Keira L. Barr, MD, Founder and Chief Wellness Officer of Resilient Health Institute and author of The Skin Whisperer: A Dermatologist Reveals How to Look Younger, Radiate Beauty and Create the Life you Crave (my Amazon link), shares two wonderful recipes.

Lavender Bath Oil

Ingredients:

30 ml Almond Oil (or other carrier oil)
3 drops lavender essential oil
1 drop jasmine essential oil
1 drop myrrh essential oil

Instructions:

Mix all oils together in a bottle and shake well. This oil can be applied to skin in the shower, added to bath water or used after bathing or showering (while skin is damp but not completely dry to aid in absorption). Note: essential oil is 1% dilution.

Rejuvenating Serum 

Ingredients:

4ml Rosehip Seed Oil
3 ml Argan Oil
1 ml Pomegranate seed Oil
1 ml Sea Buckthorn Oil
1 drop carrot seed essential oil
Pour into 10 ml amber or dark colored glass bottle and label

Instructions:

Blend all the oils together adding the carrot seed essential oil last. Shake thoroughly and store in the refrigerator. Apply 3 to 5 drops after cleansing the skin nightly. Can be used on the face, neck and back of hands.

Calming essential oils and the original blog

As I mentioned above many of these recipes include ingredients that are calming and helpful for anxiety when used stand-alone, so you get that benefit too:

If you missed the original blog with the research or would like a recap here it is: Could a daily moisturizer help to lower markers of inflammation and reduce anxiety, panic, PTSD, phobias and social anxiety?

You can learn more about the study; why poor skin health leads to inflammation; the role of inflammation on anxiety and other mental health conditions; the many nutritional approaches for reducing cytokines and inflammation; some studies on the benefit of touch and a boost of oxytocin; and tips for adding skin moisturizing to your daily self-care routine.

Skin moisturizing, diet and calming nutrients

As I said in the original blog, I feel very comfortable saying you now have a new tool – daily skin moisturizing – to add to your toolbox to help lower inflammation and reduce anxiety, panic, PTSD, phobias and social anxiety. Let’s use this – together with dietary changes and key calming nutrients – to eliminate anxiety and feel your absolute best.

These recipes provide safe and fun options for you to try. Have fun with these recipes and be sure to share which ones you try and like or if you have your own favorite. Also share what your moisturizing self-care routine is like.

I have more to share – all the feedback from a recent Facebook post on favorite home-made and store-bought moisturizers and will share this in the next installment. Do let me know what else you’d like me to cover.

Could a daily moisturizer help to lower markers of inflammation and reduce anxiety, panic, PTSD, phobias and social anxiety?

By Trudy Scott 43 Comments

Could using a good quality moisturizer on a daily basis help to lower markers of inflammation (proinflammatory markers) and actually help reduce anxiety, panic, PTSD, phobias, social anxiety and other mental health symptoms, plus other chronic health conditions at the same time? Based on a new pilot study, I’m going out on a limb and saying this may well pan out to be true. And there is certainly no harm in making this a daily self-care routine until further research confirms this, certainly because of the other benefits of using a moisturizer.

New study: a skin moisturizer reduces markers of inflammation

Let’s take a look at this new study which reports how using a skin moisturizer actually reduces markers of inflammation in the body: Topical Applications of an Emollient Reduce Circulating Pro-Inflammatory Cytokine Levels in Chronically Aged Humans: A Pilot Clinical Study

Emollients are moisturizers that help keep the skin moist and supple by reducing water loss from the epidermis, the outer layer of the skin.

The study set out to mirror an animal study where skin problems in older/aged mice was tied to elevated markers of inflammation called cytokines. When epidermal function/skin health in the mice was improved, the circulating cytokine levels were reduced:

Thirty‐three aged humans were treated twice‐daily for 30 days, with ≈3 ml of an emollient, previously shown to improve epidermal [i.e. skin] function

Changes in epidermal function and levels of three key, age‐related, plasma cytokines (IL‐1β, IL‐6 and TNFα) were measured at baseline and after treatment.

Circulating levels of proinflammatory cytokines in the body, IL‐1β, IL‐6 and TNFα, were higher in the older adults before the use of the emollient. After topical use, i.e, using the cream on their skin twice a day for 30 days:

circulating levels of IL‐1β and IL‐6 normalized, while TNFα levels declined substantially.

The authors suggest larger clinical trials to confirm this connection between high levels of proinflammatory cytokines and chronic inflammatory disorders and to show how improving skin health by moisturizing may prevent chronic inflammatory disorders such as heart disease, type II diabetes, osteoporosis and Alzheimer’s disease in older adults.

The University of California explains the mechanism:

Our skin starts to deteriorate around age 50 with changes to epidermal pH, hydration, and the permeability barrier, which keeps water in and bacteria and other potential pathogens out. A loss of moisture and breaks in the permeability barrier cause the skin to release inflammatory cytokines. Ordinarily, these cytokines help to repair defects in the barrier, but in aging skin the barrier can’t be fixed as easily, so the inflammatory signals continue to be released, eventually reaching the blood.

This article and the study authors are suggesting this is an issue to be addressed with older adults and with respect to the above chronic diseases, but there is enough research on the role of inflammation on anxiety and other mental health conditions at any age, that this study had me perk up and take notice. Also, if you’re young and not moisturizing or living in a dry climate or have other factors contributing to inflammation (more on that below), could this be happening too? I believe it’s highly likely.

The role of inflammation on anxiety and other mental health conditions

Here is one of the many anxiety-inflammation studies: Inflammation in Fear- and Anxiety-Based Disorders: PTSD, GAD, and Beyond, reporting that:

heightened concentrations of inflammatory signals, including cytokines and C-reactive protein, have been described in posttraumatic stress disorder (PTSD), generalized anxiety disorder (GAD), panic disorder (PD), and phobias (agoraphobia, social phobia), etc.

And concludes that:

targeting inflammation may serve as a potential therapeutic target for treating these fear- and anxiety-based disorders in the future

Inflammation plays a role in depression too. This paper, Role of Inflammation in Depression and Treatment Implications reports that:

Numerous studies (including meta-analyses) have found elevated peripheral and central inflammatory cytokines and acute phase proteins in depression.

The ongoing inflammation affects neurotransmitters and makes antidepressants less effective:

Chronic exposure to increased inflammation is thought to drive changes in neurotransmitters and neurocircuits that lead to depressive symptoms and that may also interfere with or circumvent the efficacy of antidepressants.

Many approaches for reducing cytokines and inflammation

I do want to address the one statement in the emollient study where they say that “approaches that reduce circulating cytokines are not yet available.” There are, in fact, many approaches for reducing cytokines and inflammation.

In one study vitamin D supplementation improved mood, reduced anxiety and lowered markers of inflammation (CRP and IL-10) in female diabetics who had low levels of vitamin D.

In another study looking at anxiety in women with PCOS (polycystic ovary syndrome), probiotics and selenium improved their mental health and hormonal profiles, lowered markers of inflammation and reduced oxidative stress.

This paper lists a number of underling root causes that cause systemic inflammation and depression: psychosocial or life stressors, poor diet, physical inactivity, obesity, smoking, altered gut permeability (i.e. leaky gut), atopy (a genetic tendency to allergies – this could include gluten sensitivity), poor dental health, sleep issues and vitamin D deficiency.

Of course, these factors may also play a role in anxiety and using a functional medicine and nutritional approach, you can reduce the inflammation and eliminate the anxiety/depression. It’s a matter of finding your root cause/s and addressing them.

Research is also finding that GABA, one of the main calming neurotransmitters, may also have a possible role in “neuroimmune interaction, being involved in the modulation of immune cell activity associated with different systemic and enteric inflammatory conditions.”

Low zinc and low vitamin B6 are also factors in inflammation, and addressing low levels reduces inflammation and eases anxiety such as pyroluria (a social anxiety condition) and low GABA and low serotonin anxiety because zinc and vitamin B6 are co-factors for making these brain chemicals.

The benefit of touch and a boost of oxytocin

I’d like to mention other benefits of using a daily moisturizer – the benefits of touch, massage and a boost of oxytocin:

  • Hand massage and therapeutic touch has been shown to decrease anxiety and make the elderly in a nursing home feel more comforted. If you’re a caregiver to a parent, make daily moisturizing part of your routine.
  • Swedish massage reduces anxiety in ICU patients and improves vital signs.
  • Touch increases the release of oxytocin improving well-being and may also have “applications in neuropsychiatric disorders especially those characterized by persistent fear, repetitive behavior, reduced trust and avoidance of social interactions.”

Adding skin moisturizing to your daily self-care routine

I feel very comfortable saying you now we have a new tool – daily skin moisturizing – to add to your toolbox to help lower your markers of inflammation and reduce anxiety, panic, PTSD, phobias and social anxiety. Let’s use everything at your disposal to heal and feel your absolute best.

It’s something most women (and a few men) are already doing, and this information can give you more reason to continue to do it.

It’s a lovely self-care routine if you’ve not been doing it for some time or have never regularly used a moisturizer. This information can be an incentive to add it back to your daily routine or start doing it.

The biggest problem I see with moisturizing is using toxic chemicals and less than ideal creams on your skin so I reached out to colleagues and my community on Facebook to get input on their favorite home-made and store-bought moisturizers:

In the meanwhile, feel free to share your favorites and what your moisturizing self-care routine is like, and if you get regular massages and use moisturizing creams with love ones. Simply comment below.

Phenibut for anxiety and insomnia: FDA warns 3 companies to cease distribution of their products

By Trudy Scott 71 Comments

Earlier this week, on April 16, 2019, the FDA issued warning letters to 3 companies have products that are marketed as dietary supplements with a label saying they contain Phenibut. These companies have been told to stop distribution of the current products and to let the FDA know within 15 days what they plan to do to be compliant with the law.

Quite frankly, I’m surprised it’s taken this long, and I actually agree with the decision. However, there are some major problems that are being overlooked with a decision like this, such as the dire consequences for susceptible individuals currently tapering from Phenibut or needing to do a slow taper once they no longer have access to Phenibut (more on that below).

The good news is that GABA, when used correctly i.e. used sublingually as part of a trial process to find the ideal amount for each person, is as effective and with none of the dependence and withdrawal issues.

Here is the announcement on the FDA site:

Phenibut has been found in products labeled as dietary supplements, sometimes marketed for uses such as a sleep aid. Phenibut does not meet the definition of a dietary ingredient Under the Federal Food, Drug, and Cosmetic Act (FD&C Act). Products labeled as dietary supplements that list phenibut as a dietary ingredient are misbranded.

Phenibut is also known as:

  • fenibut
  • phenigam
  • PhGaba
  • Phenigamma
  • Phenygam
  • 4-Amino-3-phenylbutanoic acid
  • β-(aminomethyl)benzenepropanoic acid
  • beta-(Aminomethyl)hydrocinnamic acid
  • β-phenyl-γ-aminobutyric acid

The companies have 15 business days from the date of receipt of the letter to communicate to the agency the specific steps they will take to bring their products into compliance with the law. The warning letters also caution the companies that the FDA may take enforcement action without further notice if they do not immediately cease distribution of the products.

A reaffirmed commitment to traditional advisory and enforcement actions, such as warning letters, in combination with the newly launched rapid-response tool, the Dietary Supplement Ingredient Advisory List, are integral parts of the FDA’s overall effort to strengthen the agency’s regulation and oversight of dietary supplements. We continue to look for ways to modernize our approach to protecting consumers from misbranded, unsafe, or otherwise unlawful dietary supplements.

I have always been very open with my warnings and have never recommended Phenibut because of the dependence issues and the fact that withdrawal can be similar to benzodiazepines. I blogged about my concerns back in 2016: Why I recommend GABA for anxiety instead of Phenibut

Here are a few highlights from this blog:

  • I have concerns with Phenibut and I don’t feel anyone should be using it
  • It is widely used in Russia as a prescription medication for anxiety, tension, fear, to improve sleep, pre- or post-operatively, depression, post-traumatic stress, stuttering and vestibular disorders
  • It’s available over-the-counter and as a supplement in the USA and the UK. It’s no longer available in Australia as a supplement
  • It’s very effective for anxiety and insomnia and this is why anxious individuals really love it and many practitioners recommend it before they start to see problems
  • One of the reasons Phenibut seems to work so well is because it is so similar to benzodiazepines.
  • The adverse effects can be similar to those experienced with benzos. This case study is one of many that report physical dependence can develop, including tolerance and withdrawal

Here are a few more recent case studies, reviews and papers on Phenibut:

Over the last several years, multiple case reports have highlighted phenibut’s potential to produce the conditions of physical dependence, withdrawal, and addiction. In cases involving intoxication, patients have presented with a varying degree of mental status changes, from being minimally responsive to manifesting symptoms of an agitated delirium. Phenibut is a potent psychoactive substance with GABAB agonist properties, which is emerging as a drug of misuse through growing internet sales. Its marketing as a “dietary supplement” is inaccurate and misleading, given its pharmacological profile and ability to induce the physiological changes associated with withdrawal and physical dependence

I see no reason to use a product like Phenibut given the potential to cause harm and because GABA (when used correctly i.e. used sublingually as part of a trial process to find the ideal amount for each person) is as effective and with none of the dependence and withdrawal issues.

Phenibut: initially very promising results and then rebound anxiety, panic and insomnia

I’d like to share a story from someone in my community who posted on the 2016 blog above. He shared this about the addictive aspects he observed when he used a Phenibut product called GABA Wave, saying his initial reaction was very positive and quite extreme compared to his previous trials of GABA:

The initial response in the first couple of weeks was great, especially a couple of hours after taking it. The effects were a marked elevation in mood to the point of euphoria, enhanced appreciation for music, improved focus and cognition initially (but that became memory difficulty), marked relief of anxiety, increased motivation, renewed interest in things, being more talkative, a significant calming/relaxation effect, generally a deep and great night’s sleep the night of the morning it is taken.

He then shares how this changed after a few weeks with rebound insomnia, panic and anxiety, and other adverse symptoms:

However, after a few weeks it was the reaction on the following day of taking it that kicked me in the butt, literally. On the following day I began to feel very low, groggy and spaced out, almost like a hangover and then during the following night I began having brutal insomnia – a complete turn-around from the night before. A kind of rebound response. I imagine that’s when the tolerance and addiction begins to develop because one craves the next dose to provide the good night’s sleep after the bad sleep on the second night. Other side effects included mood swings, irritability, rebound anxiety, panic, loss of short-term memory, total and utter loss of any form of libido and constipation!

He shared that his diet and self-care are excellent, but he is dealing with and working past emotional and psychological traumas – and this may make him more susceptible to the adverse effects.

And this is one of the problems with Phenibut – you’ll hear excellent initial reports and for some people this continues. Not everyone is adversely affected but you just don’t know in advance if you will be someone who is adversely affected or just how badly you’ll be affected.

Merry has had very severe ongoing adverse effects from Phenibut.

Merry Citoli shares her warnings about benzodiazepine, lunesta and Phenibut withdrawal

Merry Citoli shares her warnings about benzodiazepine, lunesta and Phenibut withdrawal. Lunesta and then Phenibut were recommended to help her taper from the benzodiazepine she was prescribed for perimenopausal anxiety. At the time of this recording, she had tapered off the benzo and lunesta, but was having great difficulties tapering off Phenibut – almost as bad as her benzo taper.

You can learn more about Merry on Follow Your Bliss. She shares how cathartic it is to share her story and the desire to help stop others going through what she has been through. I’d like to acknowledge Merry for doing this (and all of you for sharing your stories and posting encouraging messages here on the blog for each other).

I’d also like to give a shout out to the Benzodiazepine Information Coalition who is doing amazing advocacy and educational work about these awful medications.

The comments in my 2016 blog: Why I recommend GABA for anxiety instead of Phenibut are worth a read if this affects you. You’ll see there are some very different thoughts on Phenibut safety and folks saying GABA won’t work. This is typical of what you can expect to hear elsewhere online.

I don’t have all the answers

I know many Phenibut users are going to be very concerned about this and we’ll be dealing with many withdrawal issues and folks looking for an alternative. I recognize that this is not going to be easy if there is no Phenibut available for tapering. There are also very serious concerns for those who can’t go cold-turkey off Phenibut and won’t have the time to taper. Abrupt discontinuation of Phenibut may result in withdrawal which can be severe and require hospitalization.

What I don’t know:

  • if other companies and products will be targeted too?
  • if Phenibut will be made available as prescription in some form or another?
  • what resources are in place or going to be put in place for individuals who are in the process for trying to taper from Phenibut right now (or if there is even the awareness that this is an issue and very needed? For people like Merry, cold-turkeying off Phenibut could be life-threatening)
  • what advocacy groups and benzo support groups know and what advice do they have?
  • what my colleagues know and are planning to do?
  • why so many practitioners recommended it and why so many companies made it available as a supplement, given the research/case studies and the issues so many individuals report?
  • if there will be a place to submit concerns and complaints?

What I do know – GABA and the foundations

Give GABA serious consideration for safe and comfortable tapering (assuming there is enough Phenibut to do slow tapers) and for ongoing support of the low GABA symptoms of physical anxiety and tension.

It’s really best that you work with your practitioner. As with a benzodiazepine, before starting a Phenibut taper, I’ve always found it’s best to get nutritionally stable as possible first and address all root causes of anxiety before starting to taper and then tapering Phenibut very very very slowly. For some folks it’s just very uncomfortable for a few weeks and for others it’s a long-term ordeal.

I use GABA sublingually after an initial trial to find the ideal amount for each person. I have found that for both a benzo and Phenibut taper, very very tiny amounts (like a pinch or dab) will be enough for some folks.

Other nutrients are used based on each person’s need – such as theanine, tryptophan, melatonin, niacinamide, zinc and vitamin B6 and others. Light therapy, exercise, yoga, meditation, getting out in nature and essential oils like lavender, citrus and jasmine are also wonderful to incorporate. Of course, diet, blood sugar control and gut health are the foundation.

These are various GABA products I use. You can find some examples on my supplements blog here:

  • Source Naturals GABA Calm (with additional information here)
  • Nutritional Fundamentals for Health GABA-T SAP: gamma-aminobutyric acid (GABA) 300 mg, l-theanine 150 mg. This is pleasant-tasting when opened on to the tongue and works very well when GABA Calm can’t be used.  I find best results when it is used opened on to the tongue.
  • Enzymatic Therapy GABA: gamma-aminobutyric acid (GABA) 250 mg. This is also pleasant-tasting when opened on to the tongue and works very well when GABA Calm can’t be used.  As with all GABA products, I find best results when it is used opened on to the tongue.
  • ProThera 500mg GABA: gamma-aminobutyric acid (GABA) 500 mg.  You will likely need to open this up and start with less than a full capsule during the day. A full capsule may be fine at night for some individuals.

They can all be purchased from my online store here.

As you can see, I don’t have all the answers about this FDA announcement, but I wanted to share what I do know so you are aware of what’s going on.

In the next few weeks I’m going to be reaching out to benzodiazepine groups, colleagues, the companies affected and individuals who are in the process for trying to taper from Phenibut. As I learn more, I’ll share what I learn.

In the meantime, please post questions you may have, and I’ll do my best to either answer them now or find answers for you.

And please do share your Phenibut stories (both good and bad), your concerns, and any resources you may have.

And do share if GABA has help you taper from Phenibut.

Source Naturals GABA Calm™: Why I recommend it for anxiety

By Trudy Scott 185 Comments

source naturals gaba calm

When you have low GABA levels you will have physical anxiety with stiff and tense muscles as well as feelings of stress, overwhelm and may even have panic attacks.

The amino acid GABA helps to raise GABA levels and ease these symptoms very quickly. I find that all GABA products are most effective when taken sublingually or opened on to the tongue. This is why I recommend the Source Naturals GABA Calm™ product.

It is a pleasant-tasting sublingual product that you can buy at your local health-store and in my online supplement store. It is a lozenge that contains 125mg GABA, 5mg magnesium, 50mg glycine, 25mg tyrosine and 20 mg taurine.

[Note: this product is a lozenge with 125mg GABA and is not to be confused with the Source Naturals, GABA Calm Mind, 750 mg tablets]

This is my most popular and most effective form of GABA I use with my clients. Here is the product description from the Source Naturals site:

GABA Calm™ combines two of the main inhibitory neurotransmitters, GABA and glycine, with N-acetyl L-tyrosine, which is a precursor to the neurotransmitters dopamine and norepinephrine. In addition, taurine supports the calming effects of GABA. The lozenge form dissolves in the mouth for quick and convenient delivery.

gaba-calm-supplement-facts 

The GABA, glycine and taurine are calming and the N-acetyl L-tyrosine (which boosts the catecholamines and can be more stimulating) counters some of the calming effects so you have a nice balance.

A typical starting dose could look like this:

  • 1 x GABA Calm on waking
  • 1 x GABA Calm mid-morning
  • 1 x GABA Calm mid-afternoon

If this works well but you still have some anxiety, then you could try 2 each time and even 3 each time.

I have all my clients do an amino acid trial to determine what will work best for their own needs.

As with all of the amino acids we review the Amino Acid Precautions before starting GABA Calm. The only precaution for using GABA is low blood pressure. I have yet to see it be an issue but it’s something to watch.

Since GABA Calm does contain tyrosine please be aware of these precautions. I don’t have my clients use it in these instances:

  • Overactive thyroid/Grave’s disease
  • Melanoma
  • Phenylketonuria (PKU)
  • Bipolar disorder

The amount of tyrosine in GABA Calm is so low it’s typically not an issue but I have my clients monitor their use of GABA Calm if they have

  • High Blood pressure
  • Migraine headaches

Some of my clients do fine taking this product at night and it calms them and helps them sleep. Here is feedback I recently received from someone:

I’ve been getting good results with taking 2 x Source Naturals GABA Calm lozenges of late, especially at night if I can’t get to sleep. I have tried several GABA supplements but this one seems to be the only one that works for me

Others find it affects their sleep and can only use it for easing their anxiety in the day time.

When I was experiencing my anxiety and panic attacks I used to take GABA Calm™ during the day (1-3, 3 times day) and it completely stopped the panic attacks and eased my anxiety while I dug deeper looking for the other contributing factors (like gluten issues, low progesterone, heavy metals and more). I took 2 of the Country Life GABA Relaxer at night. This product contains GABA, glycine, taurine, inositol, vitamin B6 and niacinamide.

It’s a great product to use with children. Trish Soderstrom shared how she used this product with her daughter’s Lyme anxiety.

We’ve used Source Naturals GABA Calm sublinguals with good results. I learned about GABA helping anxiety and because I was treating my young daughter I purchased this because it was easy for her to take.

She’ll be sharing more during her interview on the Anxiety Summit: How We Used GABA for Lyme Anxiety.

Dr. Zendi Moldenhauer, PhD, NP, RN will also be talking about how she uses this product in her interview: Anxiety in children, adolescents and young adults: an integrative psychiatric approach.

I recently received this comment on another blog post where I mentioned GABA Calm™:

Checked out gaba calm. Sounded great until I looked at the ingredients: sorbitol and mannitol are listed as first ingredients. These fake sugars can wreak havoc on your system. Also natural orange flavor… Heaven knows what that is. Too bad, sounded great. Any other suggestions?

Here is my response to this: I agree we could do better but it’s still a very effective product since sublingual GABA is best for most people. Sorbitol and mannitol are not fake sugars but sugar alcohols that don’t affect blood sugar. Very large amounts of sugar alcohols can sometimes cause lose stool but none of my clients have reported this effect from GABA Calm since it contains a very small amount.

If you choose not to use this product, I list other GABA products here on my supplements blog. Opening the capsule seems to be the best way to take GABA.

We are all different and many people do well with other types of GABA products as you can read here – GABA, the calming amino acid: products and results.

The blood brain barrier question comes up at least once a week. In fact, I was just asked this question last week:

Does a GABA supplement have to cross the blood brain barrier to be effective? A nutrition seminar I have been to, said it does not and GABA supplements are ineffective.

This is a myth and I am on a mission to change this thinking about GABA. GABA supplements are very effective for many anxious individuals.

I’d love to hear if you’ve used GABA Calm™ for anxiety, panic attacks, sleep and/or stress eating and how it’s worked for you. How often do you take it and how much do you take?

If you use it with clients I’d love to hear from you too.

If you use GABA Calm™ during the day and another GABA product at night please share that info too.

I’m sharing this information in preparation for my Anxiety Summit interview on GABA and dispelling the blood brain barrier myth. I’ll be sharing what we do know about how GABA works, what we don’t yet know and what we hope to learn through further research.

 

Tryptophan for anxiety, sleep and mood: in Put Anxiety Behind You

By Trudy Scott 98 Comments

put-anxiety-behind-you

Tryptophan is an amino acid I use with clients all the time. If you have the low serotonin symptoms of anxiety, worry, depression, insomnia, PMS, TMJ, anger issues, winter blues and afternoon/evening cravings, tryptophan can provide relief very quickly, provided you use a quality tryptophan product and find the right amount for your unique needs. I do a trial of each amino acid with my clients.

Dr. Peter Bongiorno, ND, a doctor of naturopathic medicine, also uses tryptophan with his patients. Here is an excerpt on tryptophan from his newest book Put Anxiety Behind You: The Complete Drug-Free Program:

Tryptophan (sometimes referred to as L-tryptophan) is a naturally derived amino acid that serves as a precursor to the neurotransmitter serotonin, which is needed to help you stay asleep. Low levels of tryptophan contribute to generalized anxiety and panic attacks. Back in the early 1990s, a laboratory I was associated with at Yale University performed “tryptophan depletion studies” and which volunteers who were already prone to anxiety were put on a tryptophan-free diet. Within days, these people were extremely anxious, panicky and unstable – and they had lots of trouble staying asleep.

I usually give people 500 – 1,000 mg of tryptophan at bedtime, but I may dose up to 2,500 mg. Take tryptophan at bedtime with a slice of simple carbohydrate (like an apple slice) – the carbohydrate will increase insulin levels and insulin will promote tryptophan absorption in the brain. In my clinic I use a supplement called Tryptophan Calmplete, which includes B vitamins.

Although most conventional psychiatrists are afraid to mix natural medicines like tryptophan with conventional medications studies suggest that they can be safely combined. One eight-week randomized controlled trial of thirty patients with major depression combined 20 mg of Prozac (an SSRI medication) with 2,000 mg of tryptophan as daily treatment for major depressive disorder. This study demonstrated that combining tryptophan and an SSRI improved mood and helped patients stay asleep.

If you look up tryptophan on websites like WebMD, they are going to tell you that tryptophan is unsafe. The reason for this is because in the early 1990s there was an incident of Eosinophilia Myalgia Syndrome, a condition contracted by thirty people who most unfortunately got sick (and some died) after ingesting tryptophan supplements. This tragic event occurred because the company making the supplement had no quality controls, and allowed the introduction of bacteria. These deaths had nothing to do with tryptophan itself. My sense is that the folks behind conventional websites WebMD, who should be doing their homework, let these ideas persist on purpose. The drug companies who advertise with these websites then benefit from continuing the misinformation. I have taken tryptophan myself, have used it with family members and countless patients with absolutely no problem save for the side benefit of better sleep and mood.

This book is an excellent resource for anxiety, where addressing nutritional imbalances with a supplement such as tryptophan is part of the bigger picture of addressing sleep, doing thought work and mind-body work, balancing hormones and blood sugar, exercising, adopting a healthy real foods diet, and making sure you have a healthy digestive system.

He uses the analogy of a stool – when one of the legs or supports is weak, your health suffers.

put-anxiety-behind-you-fig1

I’m a research-geek and love to be able to look at the studies so my only negative comment about the book is that all the studies mentioned in the text are not listed in the references and studies that are listed in the references are not numbered so they can be easily found in the text.

His other book Holistic Solutions for Anxiety and Depression: Combining Natural Remedies with Conventional Care is also excellent and is geared to therapists and other practitioners. You can read my review of that book here.

I had the pleasure of interviewing Dr. Bongiorno on The Anxiety Summit (season 3) – our topic: Serotonin and Anxiety, Happiness, Digestion and our Hormones. And I’m excited to share that he’ll be speaking on Season 4 of the Anxiety Summit. We’ll be taking a deeper dive into serotonin and tryptophan.

I also had the pleasure of meeting Dr. Bongiorno in person and hearing him present at the New York City Integrative Healthcare Symposium earlier this year.  

peter-trudy

Dr. Bongiorno is co-director of Inner Source Natural Health and Acupuncture in New York City. President of the New York Association of Naturopathic Physicians, he is a contributor to numerous blogs and online magazines, including DrOz.com and Sharecare.com, and is regularly interviewed as a natural medicine expert on national television and radio.

Dr. Bongiorno has been kind enough to offer a copy of Put Anxiety Behind You: The Complete Drug-Free Program as a giveaway. We’ll do a drawing and select one lucky reader and announce the winner next Friday. If you’d like to be entered in to the drawing simply comment below and share:

  • why you’d like to win the book
  • if you’ve used tryptophan and what results you saw/see
  • which section you’re most excited about reading and why (just go to the Amazon preview via this link and check out the table of contents and sections of the book)
  • which holistic approaches you already use personally or if you’re a practitioner, what you have used with your anxious patients/clients

5/12/16 UPDATE: Thanks for participating and commenting – the winner is Liz. We’ll contact you to get a mailing address and get a copy of the book to you! Enjoy it! 

If you missed out I encourage you to still check out the table of contents (with the look inside Amazon feature) and get the book if it feels like a fit for you. Check out the comments below to be inspired further.

Please share your feedback (and questions you may have) in the comments section below.