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Natural Medications in Psychiatry

 

* Natural options cannot be patented and as result almost always have limited clinical trials due to lack of financial incentives to do more expensive, more rigorous studies. The following is a list of options that I and other psychiatrists have found helpful and have some clinical positive trials though too small and limited for official FDA approval. 

Depression:

1.    S-Adenosyl Methionine (SAMe): Dose range usually 400 – 3200 mg/day. Fairly expensive. Cost $27 - $40/month for 800mg/day. 

Dosage Start 400 mg/day, raise by 200–400 mg every three to seven days to a target dose of 800–1600 mg daily; take on an empty stomach for better absorption

Side Effects: Nausea, vomiting, abdominal discomfort, diarrhea, constipation, dry mouth, sweating, dizziness, anxiety

Caution in patients with history of bipolar disorder, with cardiac arrythmia, or who are pregnant

Reliable brands: Doctor’s Best, Nature’s Trove, NOW, Swanson, Vitacost, and The Vitamin Depot

2.    L-Methylfolate: 7.5mg for a week then 7.5 – 15mg. Generally well tolerated

3.    Omega -3 Fatty Acid from fish oil (not flax seed): 

In brain Omega-3 fatty acids coat nerve cell membranes and provides neuroprotective and anti-inflammatory effects. They have also shown some efficacy as augmenting agent for bipolar depression. 

Side effects: Nausea, fishy taste, belching. Recommend enteric coated formulation or refrigerate the capsules. 

Reliable brands: Carlson Elite EPA Gems (1000/16.5 mg), GNC Triple Strength (734/266 mg), Nature Made 1400 (683/252mg), NutriGold Triple Strength (725/275 mg)

Dose usually 1,000mg a day (total EPA+DHA) for a month. If no benefit in 3 weeks, increase to 2,000mg for another 3 – 4 weeks. 
 
4.    5-HTP

Anxiety:

1.    Chamomile 300 -700mg capsules 1 – 3 times a day. Suggest Natures Way brand


2.    Lavender extract tablets:  Recommend "Calm-Aid" made by Nature’s Way and take 1 - 2 a day. SE of lavender burping. Might try refrigerating if that happens. 

3.    Ashwagandha: Prefer "Cortisol Manager" made by Integrative Therapeutics. Take 1 at night.

 

4.    Rhodiola Rosea (see below) 


 

Sleep: Please also see Insomnia Guide on this website. 

 

1.    Melatonin: Dose 0.25 – 5mg. 


2.    Magnesium 

3.    Various natural concoctions that combines several ingredients like Theonine, Tryptophan, Valerian, chamomile, lavender, others... One suggestion is ZzzQuil Pure Zzzs. 

ADHD:

 

Rhodiola Rosea. Usually does not cause anxiety and less frequent crash at end of day. Recommend "Rosavin Plus" 1 pill in morning for few days and if no effect, try 2 pill in morning. Stop if get more anxious. 

Poor Memory:

 

American Gingseng (Panax quinquefolius) with 10% ginsenoside 500mg twice a day. Well tolerated but caution in patients with anticoagulants or undergoing surgery. 

 

Skin/Hair Pulling:

N-Acetylcysteine 600mg twice a day for couple of weeks. Then 1200mg twice a day for 2 more weeks and up to 1800mg twice a day. Data suggests taking for 2 months before deciding does not help. 

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