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Integrative Psychiatry

Nutritional Supplements for Child and Adolescent Mental Health by Noshene Ranjbar, MD & Amelia Villagomez, MD

By August 31, 2020December 3rd, 2020No Comments

Many of the issues present in the conventional field are in supplements and the use of it. As discussed, data although small and underpowered has shown small but significant benefits. There are range of what can be helpful to patients it is up to the family of what they are looking for and the energy they want to invest in this type of treatment.

The use of nutraceuticals in youth is relatively high between the ages of 7-17 who have suffered in a form of mental health condition. Upon monitoring always check for calcium levels before starting with Vitamin D intake when looking at depression. More often an abnormal elevated calcium concentration in a patient with Vitamin D deficiency could be an underlying cause of hyperparathyroidism.

Unfortunately, there have not been any studies examining the effect of B12 in adolescent depression. L-theanine however, have had studies in kids particularly boys with ADHD showed significant improvement with sleep efficiency.

FULL TRANSCRIPT:

Many of the issues that are present in the conventional field as far as the evidence and the safety and how to know what to do and where to bring that in, really takes time with supplements and it can be quite overwhelming to try to get good at too many things at once. One of the things we would recommend is to get good at using one thing at a time, even more important than that, is building that initial relationship of trust with the person in front of you.

As we discuss the data, many of the studies are small and underpowered and have shown small but significant benefits. It’s not that we can’t be effective with using nutraceuticals, but more so that there are a range of what can be helpful for patients and depending on what the families are looking for, and how much energy they have to invest in this. For some families, they just want one thing to help the kids sleep along with all traditional or conventional medications and other families don’t want any of that. And so, we’re going to be addressing that as well how to look at what level of intervention to apply.

Many youth use nutraceuticals. The statistics having 28.9% used one or more types of cam therapies. And this figure is twice that of those without mental health concerns. So many people are looking for nutraceuticals and this was a survey done for youth between the ages of seven and 17.

When we’re looking at vitamin D in children, only in data that we have when looking at depression. As far as monitoring, anytime we check a vitamin D level, we also want to check a calcium level because an abnormally elevated calcium concentration and a patient with vitamin D deficiency could be because of hypercalcemic disorder with primary hyperparathyroidism being the most common so you don’t want to give somebody with hyperthyroidism, more vitamin D. Rather, you would want to address that. Kids who are taking antidepressants we’d like to know their vitamin D level, because studies in adults suggest a negative association between SSRI use and bone mineral density and during adolescence is when a huge amount of bone is being placed in consolidated so there’s a greater rate of bone loss with SSRI use and increased risk of fractures in adults studies.

We really don’t have a lot of studies looking at adolescent depression using Vitamin B12. We do check it and it’s rarely low. But I do supplement and again with the broad spectrum of micronutrients, it’s an easy, easier way to get a lot of this addressed without having to look at each little thing and trying to replace it.

Essentially, L-theanine is a great one. The only study that’s really been done in kids is looking for at boys with ADHD, showing that their sleep efficiency improved. L-theanine is one of those easy things to use when you see someone with anxiety and you don’t have time to figure out exactly what’s going to be the best thing and they have a little bit of sleep trouble. It is something pretty safe to start while you’re doing your workup and getting labs etc. A lot of times they come back in two or three weeks and they’re like, Oh, he’s already you know, a little bit better with anxiety sleeping a little better, so it tends to be an easy thing to add on early on.

Frederick Barrett is a cognitive neuroscientist with training in behavioral pharmacology, and the Associate Director of the Johns Hopkins Center for Psychedelic and Consciousness Research. Dr. Barrett has been conducting psychedelic research at Johns Hopkins University since 2013, and his research in healthy participants and in patients with mood and substance use disorders focuses on the psychological and neurological mechanisms underlying the enduring therapeutic and other effects of psychedelic drugs. In 2017, he received an NIH “R03” grant as Principal Investigator to investigate biological mechanisms of psilocybin effects, the first federally funded research since the 1970s administering a classic psychedelic to people with psychedelic effects as the primary focus. He has developed measures of subjective effects of psychedelic drugs, and has also published first-in-human studies characterizing the acute and enduring effects of psilocybin on the brain. He is currently leading clinical trials to investigate the use of psilocybin to treat patients with major depressive disorder and co-occurring alcohol use disorder, and he is leading a number of ongoing studies aimed at better understanding the psychological, biological, and neural mechanisms underlying therapeutic efficacy of psychedelic drugs.

Will Van Derveer, MD is co-founder of Integrative Psychiatry Institute (IPI), along with friend and colleague Keith Kurlander, MA. He co-created IPI as an expression of what he stands for. First, that anyone can heal, and second that we medical providers must embrace our own healing journeys in order to fully command our potency as healers.

Dr. Van Derveer spent the last 20 years innovating and testing a comprehensive approach to addressing psychiatric challenges which transcends the conventional model he learned in medical school at Vanderbilt University and residency at University of Colorado, while deeply engaging his own healing path.

He founded the Integrative Psychiatric Healing Center in in 2001 in Boulder, CO, where he currently practices. Dr. Van Derveer regards unresolved emotional trauma as the most significant root cause of psychiatric symptoms in integrative psychiatry practice, along with gut issues, hormone imbalances, inflammation, mitochondrial dysfunction, and other functional medicine challenges. He is trained in Somatic Experiencing, EMDR, Internal Family Systems, and other psychotherapy techniques. His current clinical passion is psychedelic-assisted psychotherapy, which he mentors interested doctors in providing. An avid meditator, he has been a meditation instructor since 2004.

For the past several years Dr. Van Derveer has taught psychiatrists and other psychiatric providers integrative psychiatry in a number of settings, including course directing the CU psychiatry residents’ course as well as with Scott Shannon and Janet Settle at the Psychiatry MasterClass. In addition to his clinical work and teaching, he was co-investigator in 2016 a Phase II randomized clinical trial, sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS). He continues to support this protocol, now in a Phase III clinical trial under break-through designation by FDA.

Dr. Van Derveer is a diplomate of the American Board of Integrative and Holistic Medicine (ABoIHM) since 2013, and he was board certified in the first wave of diplomates of the new American Board of Integrative Medicine (ABIM) in 2016.