This is the third of three lectures that Dr. Cady did in Sao Paulo, Brazil, for Laboratorio Great Plains. Dr. Cady dispenses with the "Dopamine hypothesis of schizophrenia" quickly, and notes that the most powerful drug for schizophrenia, clozapine, is actually only a weak blocker at that receptor. Using the concepts of Dale Bredesen, MD, Dr. Cady advances the idea that there is no "one magic bullet" approach to the treatment of schizophrenia, but that, rather, multiple possibile causes of schizophrenia exist, multiple nutritional laboratory values exist, multiple other physiological perturbations exist (including gluten sensitivyt), and that the thoughtful practitioner's approach should be to attempt to identify, integrate, and address all possible causes and exacerbating influences on the causes, and treatments of schizophrenia. Obviously, this is not a comprehensive treatment on the subject - which would take days - but does scratch the surface at other ways to look at schizophrenia and approach its treatment.
1. The document outlines guidelines for treating schizophrenia in three phases: acute, stabilization, and stable.
2. During the acute phase, treatment focuses on ensuring safety, comprehensive assessment, and prompt treatment of psychotic symptoms. Antipsychotics are the primary treatment.
3. The stabilization phase aims to achieve sustained symptom remission and transition patients successfully into the community with continued support.
4. During the stable phase, treatment focuses on managing side effects, monitoring adherence, and identifying relapse risk factors to prevent recurrence of psychosis. Continued medication is emphasized for long-term prevention of relapse.
This case involves an 85-year-old woman who was hospitalized for increased psychosis and agitation. She was diagnosed with delirium caused by multiple factors including infections, medications, and medical issues. Her delirium improved with treatment of the underlying causes. She was also found to have recurrent major depressive disorder with psychosis and late-onset Alzheimer's dementia. Her psychiatric conditions were managed with medications and non-pharmacological therapies. She was discharged to a nursing facility in a stabilized condition.
Nursing Case Study Paranaoid Schizophreniapinoy nurze
The document describes paranoid schizophrenia. Key points include:
- Paranoid schizophrenia is characterized by stable delusions and auditory hallucinations.
- Symptoms include suspiciousness and paranoia. The condition is lifelong but can be managed with treatment.
- The case study involves a 40-year-old male patient who was admitted after stabbing his cousin, experiencing auditory hallucinations and paranoid delusions.
An interactive case presentation during the monthly meeting of Early-career psychiatrists in Jeddah, SA. Basically, a case managed and supervised clinically by Dr Shokry Alemam, MD
OCD is an anxiety disorder characterized by obsessive thoughts and compulsive behaviors that interfere with daily life. It is caused by abnormalities in brain circuits involving serotonin, dopamine, and glutamate. Treatment involves SSRIs, cognitive-behavioral therapy, and exposure therapy. OCD is part of a spectrum of related disorders involving similar obsessions and compulsions.
1. Schizophrenia is a chronic and severe mental disorder characterized by distortions in thinking, perception, emotions, language, sense of self and behavior.
2. It affects about 1% of the population and is one of the most challenging diseases for psychiatrists to treat.
3. The causes are unknown but likely involve a combination of genetic, biological, environmental, and psychological factors. Management involves antipsychotic medications along with psychosocial therapies.
This document discusses different types of anxiety disorders including generalized anxiety disorder, social phobia, panic disorder, agoraphobia, specific phobias, post-traumatic stress disorder, and obsessive-compulsive disorder. It describes the symptoms, causes, and common treatments for each disorder which typically involve medication, cognitive behavioral therapy, and exposure therapy.
Dr. Irfan Ahmad Khan discusses the management of schizophrenia. Some key points:
- Schizophrenia is a mental disorder characterized by breakdown of thought processes and poor emotional responsiveness. It typically begins in early adulthood.
- Symptoms include positive symptoms like hallucinations and delusions, as well as negative symptoms like affective flattening and anhedonia.
- The dopamine hypothesis suggests dopamine excess in the mesolimbic pathway contributes to symptoms. Current antipsychotics target dopamine and serotonin receptors.
- Treatment involves antipsychotic drugs, including classical antipsychotics that mainly target D2 receptors, and atypical antipsychotics that have multi-receptor profiles and cause
1. The document outlines guidelines for treating schizophrenia in three phases: acute, stabilization, and stable.
2. During the acute phase, treatment focuses on ensuring safety, comprehensive assessment, and prompt treatment of psychotic symptoms. Antipsychotics are the primary treatment.
3. The stabilization phase aims to achieve sustained symptom remission and transition patients successfully into the community with continued support.
4. During the stable phase, treatment focuses on managing side effects, monitoring adherence, and identifying relapse risk factors to prevent recurrence of psychosis. Continued medication is emphasized for long-term prevention of relapse.
This case involves an 85-year-old woman who was hospitalized for increased psychosis and agitation. She was diagnosed with delirium caused by multiple factors including infections, medications, and medical issues. Her delirium improved with treatment of the underlying causes. She was also found to have recurrent major depressive disorder with psychosis and late-onset Alzheimer's dementia. Her psychiatric conditions were managed with medications and non-pharmacological therapies. She was discharged to a nursing facility in a stabilized condition.
Nursing Case Study Paranaoid Schizophreniapinoy nurze
The document describes paranoid schizophrenia. Key points include:
- Paranoid schizophrenia is characterized by stable delusions and auditory hallucinations.
- Symptoms include suspiciousness and paranoia. The condition is lifelong but can be managed with treatment.
- The case study involves a 40-year-old male patient who was admitted after stabbing his cousin, experiencing auditory hallucinations and paranoid delusions.
An interactive case presentation during the monthly meeting of Early-career psychiatrists in Jeddah, SA. Basically, a case managed and supervised clinically by Dr Shokry Alemam, MD
OCD is an anxiety disorder characterized by obsessive thoughts and compulsive behaviors that interfere with daily life. It is caused by abnormalities in brain circuits involving serotonin, dopamine, and glutamate. Treatment involves SSRIs, cognitive-behavioral therapy, and exposure therapy. OCD is part of a spectrum of related disorders involving similar obsessions and compulsions.
1. Schizophrenia is a chronic and severe mental disorder characterized by distortions in thinking, perception, emotions, language, sense of self and behavior.
2. It affects about 1% of the population and is one of the most challenging diseases for psychiatrists to treat.
3. The causes are unknown but likely involve a combination of genetic, biological, environmental, and psychological factors. Management involves antipsychotic medications along with psychosocial therapies.
This document discusses different types of anxiety disorders including generalized anxiety disorder, social phobia, panic disorder, agoraphobia, specific phobias, post-traumatic stress disorder, and obsessive-compulsive disorder. It describes the symptoms, causes, and common treatments for each disorder which typically involve medication, cognitive behavioral therapy, and exposure therapy.
Dr. Irfan Ahmad Khan discusses the management of schizophrenia. Some key points:
- Schizophrenia is a mental disorder characterized by breakdown of thought processes and poor emotional responsiveness. It typically begins in early adulthood.
- Symptoms include positive symptoms like hallucinations and delusions, as well as negative symptoms like affective flattening and anhedonia.
- The dopamine hypothesis suggests dopamine excess in the mesolimbic pathway contributes to symptoms. Current antipsychotics target dopamine and serotonin receptors.
- Treatment involves antipsychotic drugs, including classical antipsychotics that mainly target D2 receptors, and atypical antipsychotics that have multi-receptor profiles and cause
1. Schizophrenia is a chronic neuropsychiatric disorder affecting about 1% of the world's population that imposes a large economic burden.
2. While the exact causes remain unclear, current research suggests schizophrenia involves alterations in brain development and circuits during early development. Genetics also play a role as risk factors.
3. Recent advances in treatment include new atypical antipsychotic medications that target both dopamine and serotonin receptors, as well as research into alternative treatments targeting negative symptoms, cognitive impairments, and underlying neuropathology and metabolic abnormalities.
The document discusses schizophrenia, including its characteristic symptoms, subtypes, treatments, and theories about its causes. Some key points include:
- The main symptoms of schizophrenia are delusions, hallucinations, and disorganized speech.
- There are several subtypes of schizophrenia including paranoid, catatonic, and undifferentiated.
- Both older "conventional" and newer "atypical" antipsychotic medications are used to treat schizophrenia by reducing positive symptoms.
- The dopamine hypothesis suggests psychotic symptoms are related to excess dopamine activity in the brain, which newer theories have expanded on to include other neurotransmitters.
Ms. RS is a 35-year-old female patient with schizophrenia and hypothyroidism who presents with auditory and visual hallucinations, disturbed sleep, and suspicious thoughts. She exhibits both positive symptoms like delusions and hallucinations as well as negative symptoms like lack of activeness. She was initially prescribed typical antipsychotics like haloperidol and fluphenazine but developed resistance, so she was switched to clozapine and olanzepine, both atypical antipsychotics. Depot injections of antipsychotics are beneficial for schizophrenia management as they ensure medication adherence and more stable drug levels over time, reducing relapse risk compared to oral medications.
Depression is a common and serious mental disorder characterized by depressed mood, loss of interest, feelings of guilt and low self-worth, and poor concentration. It is the leading cause of disability worldwide. Depression can be reliably diagnosed and treated, although currently less than 25% of those affected have access to effective treatments. Treatment options include antidepressant medications like SSRIs and psychotherapy.
The document discusses the history and evolution of somatic symptom and related disorders. It describes how concepts like hysteria, hypochondriasis, and psychosomatic disorders developed before being categorized under somatic symptom disorder, illness anxiety disorder, conversion disorder, and other diagnoses in DSM-5. It provides details on the characteristic symptoms, thresholds, and specifiers for each DSM-5 disorder category. Theories on the causes of related conditions like pseudocyesis are also summarized.
This document summarizes key aspects of schizophrenia including its diagnosis, classification, biological and psychological approaches and therapies. It discusses two major diagnostic systems (DSM and ICD) that identify positive and negative symptoms. Issues with diagnosis include reliability between psychiatrists and validity given co-morbidity with other disorders. The biological approach emphasizes the dopamine hypothesis and genetic factors but environmental influences are also important. Biological therapies include drugs and electroconvulsive therapy that can reduce symptoms but have side effects and don't treat the underlying causes. Psychological approaches include behavioral, cognitive and therapies like CBT and token economies that can help some symptoms but also have limitations since cognition alone does not fully explain schizophrenia.
1. The patient, K. Ganga, was admitted to the psychiatry ward for bipolar disorder symptoms including excessive talking, reduced sleep, and indecent behavior observed for 2 months.
2. She was diagnosed with bipolar disorder based on her history of mood fluctuations and manic episodes over 2 years.
3. Her treatment included mood stabilizers, antipsychotics, benzodiazepines, antidepressants, psychotherapy, ECT, and monitoring to reduce her symptoms and prevent relapse. Her symptoms improved over her 3 week hospital stay before she was discharged.
1. Said Mohammad, an 18-year-old male from Peshawar, presented with suspiciousness, aggression, insomnia, lack of appetite, and social withdrawal over the past month.
2. His symptoms began one month ago when he started socially withdrawing and expressing beliefs that his family was plotting to kill him. Over the past three days, he became aggressive, refused to eat or sleep, and believed his family would poison him.
3. He was brought to the hospital by his family after attempts to treat him with spiritual healers were unsuccessful. His symptoms appeared to develop after recently relocating with his family due to security concerns.
This document describes the case of a 37-year-old man presenting with psychotic symptoms including delusions of poisoning, morbid jealousy, and unpredictable behavior. He has a history of schizophrenia and was non-compliant with medications. On admission, he was refusing food and water due to delusional beliefs. He was started on antipsychotic medications and monitored closely in the psychiatric ward. The specialist diagnosed him with schizophrenia exacerbated by borderline personality traits and medication non-adherence. Nurses focused on safety, monitoring for acute psychotic episodes, and establishing trust to effectively care for the patient.
Schizophrenia is a long-term mental disorder involving breakdowns in thought, emotion, and behavior. It has genetic and environmental causes and is associated with excessive dopamine in the brain. Symptoms include positive symptoms like hallucinations, negative symptoms like lack of pleasure, and cognitive symptoms like poor executive functioning. Diagnosis is clinical based on symptoms, and treatment involves antipsychotic medication as well as family and social support.
This document summarizes information presented about schizophrenia on World Mental Health Day. It discusses what schizophrenia is, including that it is a severe brain disorder causing abnormal interpretations of reality. It provides statistics on schizophrenia prevalence and disability rates. It also outlines causes of schizophrenia like genetics and environment, symptoms, treatment options including medication and psychosocial therapies, and living with the condition. The presentation aims to increase understanding of schizophrenia.
Generalized anxiety disorder (GAD) is characterized by excessive, uncontrollable worry about everyday things for at least six months. It is a common chronic disorder not focused on any single object or situation. Women are two to three times more likely than men to suffer from GAD, which typically develops between childhood and late adulthood, with median onset at age 31. Causes include genetics, abnormal brain chemistry, trauma, stressful life events, and environmental factors. Diagnosis requires excessive anxiety and worry for over six months that is difficult to control and associated with restlessness, fatigue, irritability, muscle tension, sleep issues, or difficulty concentrating. Treatment involves medication like benzodiazepines or antidepressants as well as cognitive
Depression is a common and treatable mental health condition that presents in various ways. It involves more than just sadness, and can include loss of interest, changes in appetite, sleep disturbances, fatigue, guilt, poor concentration, and sometimes psychosis or physical symptoms. Major depression affects about 1 in 6 people at some point in life. It is diagnosed using criteria from the DSM or ICD, and rating scales can aid assessment. Treatment involves medication, psychotherapy, and lifestyle changes. Proper diagnosis and treatment leads to good outcomes, but depression remains underdiagnosed and undertreated in many cases.
A presentation about panic attacks and panic disorder. this presentation composed of the definition, causes, symptoms, diagnosis, treatment, prevention and prognosis of panic disorder.
Schizophrenia is a chronic mental disorder characterized by disturbances in thoughts, perceptions, emotions, and behaviors. It is marked by psychosis like delusions and hallucinations. The exact causes are unknown but genetics and brain chemistry imbalances are thought to play a role. Diagnosis involves symptoms lasting at least six months including two or more of delusions, hallucinations, disorganized speech or behavior. Treatment aims to minimize symptoms and involves antipsychotic medications as well as psychotherapy. First generation antipsychotics mainly block dopamine receptors while second generation drugs also target serotonin receptors, with fewer side effects. However, there is currently no cure for schizophrenia.
- Schizophrenia was originally described as having distinct subtypes with different symptoms, but all involve dissociative thinking. Genes on multiple chromosomes have been implicated in schizophrenia risk. Environmental factors like lower birth weight, stress in pregnancy, and advanced paternal age may also play a role.
- Brain abnormalities in schizophrenia include enlarged ventricles, reduced hippocampal and prefrontal cortex volume, and abnormal prefrontal function. The hypofrontality hypothesis suggests dysfunction in prefrontal regions, supported by brain imaging studies. Psychedelic drugs can induce schizophrenia-like symptoms, and NMDA receptor antagonists like PCP and ketamine also produce similar effects in animals. Current drug treatments target dopamine and serotonin receptors.
obsessive-compulsive disorder is a mental disorder whose main symptoms include obsessions and compulsions, driving the person to engage in unwanted, often-times distress behaviors or thoughts. The obsessions are usually related to a sense of harm, risk or injury. The common Obsessions include concern about contamination, doubt, fear of loss or letting go, fear of physically injuring someone.It’s treatment is done through a combination of psychiatric medications and psychotherapy.
Obsessive-Compulsive Disorder (OCD) is a common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over.
An obsession is defined as an idea, impulse, or image which intrude into the conscious aware repeatedly.
Schizophrenia is a disorder that affects approximately 1% of the population. It has genetic influences and possible causes include abnormalities in brain functioning and chemical imbalances. Treatment involves psychotherapy, group therapy, family therapy, and medications. Antipsychotic medications help normalize biochemical imbalances and reduce relapse risk, though they can cause side effects ranging from mild to serious.
This case presentation discusses a 50-year-old African American female patient admitted to the hospital for schizoaffective disorder, manic episode. The patient has a history of schizoaffective disorder and has been living in a nursing home. The goals of hospitalization are to decrease restlessness, irritability, worry, anxiety and increase self-control and medication compliance. Interventions include medication management with Lamictal and Invega, nursing care, social work support, and education. The presentation provides context on schizoaffective disorder, symptoms, course, and treatment goals for managing the manic episode.
The document summarizes a presentation on the holistic medicine approach to treating schizophrenia. It discusses the multiple domains affected by schizophrenia, including positive and negative symptoms, cognitive dysfunction, and social deficits. It reviews the etiology and pathogenesis of schizophrenia. It then presents a case study of a patient with schizophrenia who was treated holistically over many years with integrative testing to identify deficiencies and allergies, dietary changes, supplements, low dose lithium, and antifungals. The patient showed significant improvement with this approach.
The integrative treatment of schizophrenia brazil 2019Louis Cady, MD
This is the English language version of Dr. Cady's presentation given at UNIP (Campus Paraiso - Sao Paulo, SP Brazil) for the 2019 Congresso de Saude Mental (Conference on Mental Health). It was delivered April 20, 2019.
This presentation also includes extra slides in the appendix that were not presented, and, unfortunately, these slides of the appendix have not been translated in the Portuguse version of this presentation.
In this presentation (Portuguese presentation will also be posted next), Dr. Cady briefly reviews the history of schizophrenia, the failure of the dopamine D2 receptor blockage as a universal cure-all in schizophrenia, and various holistic interventions which can strongly and positively impact symptoms of schizophrenia. Included in Dr. Cady's survey were the role of essential fatty acids, nutrient deficiencies (particularly B vitamins), the danger of overgrowth of candida , pharmacogenomic testing, MTHFR polymorphisms, and more.
It was an honor and a privilege to deliver this presentation in
São Paulo,.
For further information in Brazil on this topic, or to order a video/audio recording of the conference (in Portuguese),contact Luiz Dias of Laboratorio Great Plains in Brazil.
1. Schizophrenia is a chronic neuropsychiatric disorder affecting about 1% of the world's population that imposes a large economic burden.
2. While the exact causes remain unclear, current research suggests schizophrenia involves alterations in brain development and circuits during early development. Genetics also play a role as risk factors.
3. Recent advances in treatment include new atypical antipsychotic medications that target both dopamine and serotonin receptors, as well as research into alternative treatments targeting negative symptoms, cognitive impairments, and underlying neuropathology and metabolic abnormalities.
The document discusses schizophrenia, including its characteristic symptoms, subtypes, treatments, and theories about its causes. Some key points include:
- The main symptoms of schizophrenia are delusions, hallucinations, and disorganized speech.
- There are several subtypes of schizophrenia including paranoid, catatonic, and undifferentiated.
- Both older "conventional" and newer "atypical" antipsychotic medications are used to treat schizophrenia by reducing positive symptoms.
- The dopamine hypothesis suggests psychotic symptoms are related to excess dopamine activity in the brain, which newer theories have expanded on to include other neurotransmitters.
Ms. RS is a 35-year-old female patient with schizophrenia and hypothyroidism who presents with auditory and visual hallucinations, disturbed sleep, and suspicious thoughts. She exhibits both positive symptoms like delusions and hallucinations as well as negative symptoms like lack of activeness. She was initially prescribed typical antipsychotics like haloperidol and fluphenazine but developed resistance, so she was switched to clozapine and olanzepine, both atypical antipsychotics. Depot injections of antipsychotics are beneficial for schizophrenia management as they ensure medication adherence and more stable drug levels over time, reducing relapse risk compared to oral medications.
Depression is a common and serious mental disorder characterized by depressed mood, loss of interest, feelings of guilt and low self-worth, and poor concentration. It is the leading cause of disability worldwide. Depression can be reliably diagnosed and treated, although currently less than 25% of those affected have access to effective treatments. Treatment options include antidepressant medications like SSRIs and psychotherapy.
The document discusses the history and evolution of somatic symptom and related disorders. It describes how concepts like hysteria, hypochondriasis, and psychosomatic disorders developed before being categorized under somatic symptom disorder, illness anxiety disorder, conversion disorder, and other diagnoses in DSM-5. It provides details on the characteristic symptoms, thresholds, and specifiers for each DSM-5 disorder category. Theories on the causes of related conditions like pseudocyesis are also summarized.
This document summarizes key aspects of schizophrenia including its diagnosis, classification, biological and psychological approaches and therapies. It discusses two major diagnostic systems (DSM and ICD) that identify positive and negative symptoms. Issues with diagnosis include reliability between psychiatrists and validity given co-morbidity with other disorders. The biological approach emphasizes the dopamine hypothesis and genetic factors but environmental influences are also important. Biological therapies include drugs and electroconvulsive therapy that can reduce symptoms but have side effects and don't treat the underlying causes. Psychological approaches include behavioral, cognitive and therapies like CBT and token economies that can help some symptoms but also have limitations since cognition alone does not fully explain schizophrenia.
1. The patient, K. Ganga, was admitted to the psychiatry ward for bipolar disorder symptoms including excessive talking, reduced sleep, and indecent behavior observed for 2 months.
2. She was diagnosed with bipolar disorder based on her history of mood fluctuations and manic episodes over 2 years.
3. Her treatment included mood stabilizers, antipsychotics, benzodiazepines, antidepressants, psychotherapy, ECT, and monitoring to reduce her symptoms and prevent relapse. Her symptoms improved over her 3 week hospital stay before she was discharged.
1. Said Mohammad, an 18-year-old male from Peshawar, presented with suspiciousness, aggression, insomnia, lack of appetite, and social withdrawal over the past month.
2. His symptoms began one month ago when he started socially withdrawing and expressing beliefs that his family was plotting to kill him. Over the past three days, he became aggressive, refused to eat or sleep, and believed his family would poison him.
3. He was brought to the hospital by his family after attempts to treat him with spiritual healers were unsuccessful. His symptoms appeared to develop after recently relocating with his family due to security concerns.
This document describes the case of a 37-year-old man presenting with psychotic symptoms including delusions of poisoning, morbid jealousy, and unpredictable behavior. He has a history of schizophrenia and was non-compliant with medications. On admission, he was refusing food and water due to delusional beliefs. He was started on antipsychotic medications and monitored closely in the psychiatric ward. The specialist diagnosed him with schizophrenia exacerbated by borderline personality traits and medication non-adherence. Nurses focused on safety, monitoring for acute psychotic episodes, and establishing trust to effectively care for the patient.
Schizophrenia is a long-term mental disorder involving breakdowns in thought, emotion, and behavior. It has genetic and environmental causes and is associated with excessive dopamine in the brain. Symptoms include positive symptoms like hallucinations, negative symptoms like lack of pleasure, and cognitive symptoms like poor executive functioning. Diagnosis is clinical based on symptoms, and treatment involves antipsychotic medication as well as family and social support.
This document summarizes information presented about schizophrenia on World Mental Health Day. It discusses what schizophrenia is, including that it is a severe brain disorder causing abnormal interpretations of reality. It provides statistics on schizophrenia prevalence and disability rates. It also outlines causes of schizophrenia like genetics and environment, symptoms, treatment options including medication and psychosocial therapies, and living with the condition. The presentation aims to increase understanding of schizophrenia.
Generalized anxiety disorder (GAD) is characterized by excessive, uncontrollable worry about everyday things for at least six months. It is a common chronic disorder not focused on any single object or situation. Women are two to three times more likely than men to suffer from GAD, which typically develops between childhood and late adulthood, with median onset at age 31. Causes include genetics, abnormal brain chemistry, trauma, stressful life events, and environmental factors. Diagnosis requires excessive anxiety and worry for over six months that is difficult to control and associated with restlessness, fatigue, irritability, muscle tension, sleep issues, or difficulty concentrating. Treatment involves medication like benzodiazepines or antidepressants as well as cognitive
Depression is a common and treatable mental health condition that presents in various ways. It involves more than just sadness, and can include loss of interest, changes in appetite, sleep disturbances, fatigue, guilt, poor concentration, and sometimes psychosis or physical symptoms. Major depression affects about 1 in 6 people at some point in life. It is diagnosed using criteria from the DSM or ICD, and rating scales can aid assessment. Treatment involves medication, psychotherapy, and lifestyle changes. Proper diagnosis and treatment leads to good outcomes, but depression remains underdiagnosed and undertreated in many cases.
A presentation about panic attacks and panic disorder. this presentation composed of the definition, causes, symptoms, diagnosis, treatment, prevention and prognosis of panic disorder.
Schizophrenia is a chronic mental disorder characterized by disturbances in thoughts, perceptions, emotions, and behaviors. It is marked by psychosis like delusions and hallucinations. The exact causes are unknown but genetics and brain chemistry imbalances are thought to play a role. Diagnosis involves symptoms lasting at least six months including two or more of delusions, hallucinations, disorganized speech or behavior. Treatment aims to minimize symptoms and involves antipsychotic medications as well as psychotherapy. First generation antipsychotics mainly block dopamine receptors while second generation drugs also target serotonin receptors, with fewer side effects. However, there is currently no cure for schizophrenia.
- Schizophrenia was originally described as having distinct subtypes with different symptoms, but all involve dissociative thinking. Genes on multiple chromosomes have been implicated in schizophrenia risk. Environmental factors like lower birth weight, stress in pregnancy, and advanced paternal age may also play a role.
- Brain abnormalities in schizophrenia include enlarged ventricles, reduced hippocampal and prefrontal cortex volume, and abnormal prefrontal function. The hypofrontality hypothesis suggests dysfunction in prefrontal regions, supported by brain imaging studies. Psychedelic drugs can induce schizophrenia-like symptoms, and NMDA receptor antagonists like PCP and ketamine also produce similar effects in animals. Current drug treatments target dopamine and serotonin receptors.
obsessive-compulsive disorder is a mental disorder whose main symptoms include obsessions and compulsions, driving the person to engage in unwanted, often-times distress behaviors or thoughts. The obsessions are usually related to a sense of harm, risk or injury. The common Obsessions include concern about contamination, doubt, fear of loss or letting go, fear of physically injuring someone.It’s treatment is done through a combination of psychiatric medications and psychotherapy.
Obsessive-Compulsive Disorder (OCD) is a common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over.
An obsession is defined as an idea, impulse, or image which intrude into the conscious aware repeatedly.
Schizophrenia is a disorder that affects approximately 1% of the population. It has genetic influences and possible causes include abnormalities in brain functioning and chemical imbalances. Treatment involves psychotherapy, group therapy, family therapy, and medications. Antipsychotic medications help normalize biochemical imbalances and reduce relapse risk, though they can cause side effects ranging from mild to serious.
This case presentation discusses a 50-year-old African American female patient admitted to the hospital for schizoaffective disorder, manic episode. The patient has a history of schizoaffective disorder and has been living in a nursing home. The goals of hospitalization are to decrease restlessness, irritability, worry, anxiety and increase self-control and medication compliance. Interventions include medication management with Lamictal and Invega, nursing care, social work support, and education. The presentation provides context on schizoaffective disorder, symptoms, course, and treatment goals for managing the manic episode.
The document summarizes a presentation on the holistic medicine approach to treating schizophrenia. It discusses the multiple domains affected by schizophrenia, including positive and negative symptoms, cognitive dysfunction, and social deficits. It reviews the etiology and pathogenesis of schizophrenia. It then presents a case study of a patient with schizophrenia who was treated holistically over many years with integrative testing to identify deficiencies and allergies, dietary changes, supplements, low dose lithium, and antifungals. The patient showed significant improvement with this approach.
The integrative treatment of schizophrenia brazil 2019Louis Cady, MD
This is the English language version of Dr. Cady's presentation given at UNIP (Campus Paraiso - Sao Paulo, SP Brazil) for the 2019 Congresso de Saude Mental (Conference on Mental Health). It was delivered April 20, 2019.
This presentation also includes extra slides in the appendix that were not presented, and, unfortunately, these slides of the appendix have not been translated in the Portuguse version of this presentation.
In this presentation (Portuguese presentation will also be posted next), Dr. Cady briefly reviews the history of schizophrenia, the failure of the dopamine D2 receptor blockage as a universal cure-all in schizophrenia, and various holistic interventions which can strongly and positively impact symptoms of schizophrenia. Included in Dr. Cady's survey were the role of essential fatty acids, nutrient deficiencies (particularly B vitamins), the danger of overgrowth of candida , pharmacogenomic testing, MTHFR polymorphisms, and more.
It was an honor and a privilege to deliver this presentation in
São Paulo,.
For further information in Brazil on this topic, or to order a video/audio recording of the conference (in Portuguese),contact Luiz Dias of Laboratorio Great Plains in Brazil.
Integrating the Functional, Psychodynamic, and Immunologic Matrix: New Advent...Louis Cady, MD
In this presentation (here represented in English before translation) Dr. Cady deconstructs the curious and sometimes perplexing manifestations of delayed sensitivity food allergy testing, supporting it with citations from the peer-reviewed medical literature and extensive bibliographic references. The importance of understanding the potential immunologic contribution to a patient's mental state is reviewed.
The Moral Imperative of Integrative Medicine - IMMH 2020Louis Cady, MD
IN this presentation, Dr. Cady reviews several of the handful of functional, integrative medicine techniques required for a holistic and comprehensive management of psychiatric issues. MTHFR, hormone balance, diagnosis and treating intestinal dysbiosis, need for trace elements, and hormones (including thyroid, testosterone and estradiol) are reviewed.
In his third of five lectures, Dr. Cady reviews the concepts of food allergy testing with IgG and IgE antibodies, traces the development of this body of knowledge from the 1960's, and reviews two illustrative cases.
The document provides information about a 17-year-old male patient from Oman named Abdulla who is being treated for schizophrenia. It includes details about his symptoms, diagnosis, treatment history and current treatment plan. Specifically, it notes that Abdulla experiences hallucinations and delusions. He has been diagnosed with schizophrenia and has been admitted to the hospital multiple times previously. His current treatment involves antipsychotic medications as well as psychosocial therapies to help manage his symptoms.
This case presentation summarizes a 42-year-old female patient with obsessive-compulsive disorder (OCD) and comorbid conditions including borderline intellectual disability, attention deficit disorder, and borderline personality disorder. She exhibited checking rituals and obsessions about cleanliness. Her treatment plan included fluoxetine 20mg daily and clomipramine 25mg daily along with cognitive behavioral therapy to target her rituals and anxiety. The goals were to improve her symptoms and functioning over 12 months before potential discharge to primary care.
Introduction to Integrative Medicine for Mental HealthLouis Cady, MD
This is the first of three lectures that Dr. Cady will present in Sao Paulo, Brazil, for Laboratorio Great Plains. In it, he reviews key concepts of integrative medicine, functional testing, and a rational style of thinking through a patient's problems down to the fundamental level. IgG food allergies, depression, low testosterone, and nutrient deficiencies are all covered
The Moral Imperative of Integrative Medicine 2022.pptLouis Cady, MD
The document discusses the case of a 16-year-old teenager with a long history of treatment-resistant depression and anxiety. Previous medication trials with SSRIs, SNRIs, atypical antipsychotics, and lamotrigine had failed to provide sustained relief. Upon further evaluation, the doctor found potential contributing factors including an undiagnosed MTHFR gene mutation and hormonal imbalances. The doctor adjusted the teenager's supplements and medications, focusing on addressing the underlying functional issues. At follow-up several months later, the teenager reported significantly improved mood with only brief periods of low mood, though menstrual irregularities persisted.
Emily Boyles is a senior in high school taking psychology courses who is interested in a career in criminal psychology. She chose to research mental illness for a school project. Her plan is to define mental illness, explore criminal psychology as a career path including the education and job outlook, and examine the daily life, treatment, myths, and life expectancy of those with mental illness. She interviewed a licensed mental health counselor to learn more about their career path and experiences treating mental illness.
This document provides an overview of schizophrenia, including its definition, epidemiology, etiology, classification, pathophysiology, clinical presentation, diagnosis, and management. Some key points are:
- Schizophrenia is a chronic mental disorder characterized by delusions, hallucinations, disorganized speech/behavior, and impaired cognitive ability.
- It affects over 21 million people worldwide, with about 1.1% of the US population affected. Onset is typically earlier in males.
- Etiology includes genetic, viral, immune, and birth complications. Family history increases risk.
- Symptoms include positive symptoms like hallucinations and delusions, as well as negative symptoms impacting emotion and cognition.
Identification of psychiatric disorders in primary care settingsSujit Kumar Kar
This document provides an overview of psychiatric disorders and their identification in primary care settings. It discusses common psychiatric conditions like mood disorders, schizophrenia, anxiety disorders, and substance use disorders. It outlines factors like biological, psychological, and socio-cultural elements that can contribute to developing a psychiatric disorder. The importance of early diagnosis and treatment in primary care is highlighted. Symptoms of psychiatric disorders that can present in primary care are described. Two case vignettes of patients presenting with obsessive-compulsive disorder and depression are then summarized. Key issues from each case are discussed.
Schizophrenia is characterized by psychosis, or a loss of contact with reality. It has a prevalence of 1% of the population and is classified into positive and negative symptoms. Positive symptoms include delusions and hallucinations, while negative symptoms involve a reduction in emotions and behaviors. Biological factors like genetics and dopamine levels are thought to contribute to schizophrenia. Treatment involves atypical antipsychotic drugs which target both positive and negative symptoms with fewer side effects than conventional drugs. However, antipsychotics may also have disadvantages like sudden death or involuntary movements.
Subtitle: The Moral Imperative of Integrative Medicine
This presentation, two hours in length, was delivered to the A4m MMI Audience in their Frontiers of Neurology - Module 3.
The following topics are reviewed:
- ADHD, Autism, Depression, Schizophrenia
- the impact of neuroinflammation on all of these.
- confounding factors and the ways to mitigate them: Omega6/Omega 3 imbalance in the Western diet, MTHFR polymorphism, the use of elemental lithium, the presence of intestinal dysbiosis and the role of gluten/dairy IgG Food allergies.
- pharmacogenomic testing
A 33-year-old male presented with symptoms of loss of interest, lethargy, and reduced mental and physical well-being for the past 6-7 years. He has a family history of possible psychiatric illness in his grandfather. On examination, he displayed anxious and inappropriate behavior, impaired comprehension, rapid speech, an anxious mood, paranoid delusions, and impaired judgment and insight. He was diagnosed with paranoid schizophrenia based on his symptoms. Schizophrenia is a chronic mental disorder caused by genetic and environmental factors. It involves positive symptoms like hallucinations and delusions as well as negative symptoms and is typically treated with antipsychotic medication.
This document provides an overview of psychopathology and mental disorders. It discusses definitions and classifications of mental disorders, as well as diagnosis. Specific disorders like schizophrenia and mood disorders are examined in more detail. For schizophrenia, it describes symptoms, course, heritability, neuroanatomical deficits, and treatment approaches. For mood disorders, it distinguishes between depression and mania, provides DSM-IV criteria for major depressive disorder, and discusses prevalence and causal factors. Biological, psychological, and social aspects of mental disorders are considered throughout.
This is an in dept look about disorders from a psychological standpoint. The disorders talked in this are eating and anxiety disorders. They are looked at from a Biological, Cognitive, and Socio-Cultural standpoints which are the 3 key areas of research in psychology.
This document discusses alternative approaches to treating ADHD without medication. It notes that ADHD is often misdiagnosed and many conditions can cause ADHD-like symptoms. Stimulant medications for ADHD like Ritalin have many potential side effects and may cause long-term brain changes. Lifestyle factors like nutrition, sleep, screen time, and treating underlying conditions provide a safer alternative or addition to medications for managing ADHD symptoms.
1) The document discusses trying to understand the brain and autism spectrum disorder (ASD). It provides information on what a spectrum means, the history and definitions of autism from Kanner and Asperger, and how the brain works in processing sensory information, attention, and social interactions.
2) The document summarizes challenges people with ASD face in understanding the world, others' perspectives, and their own bodies/emotions. It reviews research on potential causes of ASD including hundreds of genetic factors.
3) Research on treatments is summarized including inconclusive evidence for supplements/diets but some evidence risperidone and melonin can help manage behaviors and sleep. Evidence for early intensive behavioral
Similar to The Integrative Medicine Treatment of Schizophrenia (20)
SEND IN THE SHRINKS - 2009 Oliver CME seminarLouis Cady, MD
This one was fun.
I was invited by Dr. Randalll Oliver, MD, Founder of the Oliver Heachache and Pain Clinic in Evansville, to present to an audience of primary care practitioners about how to use pysychiatric mediations ("psychopharmacology") in clinical practice.
Along the way, I covered, ADHD and treatments, depression, anxiety, erectile dysfunction, hypoadrenia, and even touched on hypothyroidism. Although this presentation was in 2009, all of the drugs covered are stills in use, and, at times.... stupidly.
This presentation deconstructs the intricacies of selecting and antidepressant, particularly in the SSRI class.
What is the nature of QUALITY in medicine -for ASQ 11 14 2023.pptLouis Cady, MD
In this presentation, Dr. Cady deconstructs the tensions and stressors on both patients and health care providers in today's system.
This presentation reviews checklists foe liminating mistakes, the actual number of mistakes that are being made in medical practice, and what patients and their loved ones can do for self protection.
This isn't a "bash the doctor" presentation. It's a thoughtful, careful exploration of stresses and ramifications to the current US healthcare system.
This document provides information about a presentation given by Dr. Louis B. Cady on transcranial magnetic stimulation (TMS) as a treatment for depression. It begins with Dr. Cady's credentials and commercial disclosure stating he has received honoraria from several companies but that this presentation is not being underwritten by any company. The presentation then covers how TMS works, its safety and effectiveness compared to antidepressant medications and electroconvulsive therapy (ECT), and its inclusion in treatment guidelines for depression.
Hormones and Mental Health - Thyroid and Testosterone.pptxLouis Cady, MD
In this presentation for the Psychiatry Redefined program, Dr.
Cady breaks down and deconstructs the accepted, unthinking, "practice guideline based" notions of thyroid and tesotsterone, with there seemingly "normal" levels and dosing, versus what the actual peer reviewed medical literature says. In this presentation, do use of all forms of thyroid, and all forms of testosterone are reviewed. The idiocy of "T4 only treatment" is covered. The use of T4, T3, a combination of T4 and T3, and all of the porcine and compounded products is review.
In terms of testosterone, dr. Katie reviews the concept of "do you want to be optimal or do you want to be normal." He notes that it is "normal" for oil in cars to deteriorate and break down with age. It's also "normal" for men's and women's testosterone (as well as thyroid) to go down with age. The question is, "do we want to do anything about it?"
Logical ways of intervening in both the thyroid and female and male gonadal axes are covered. There is scrupulous attention paid to the thyroid hormone pathways, and the relevance of reverse T3 versus free T3. Similarly, in terms of women, the downstream effect of estradiol coming from testosterone is also reviewed.
CORONOFOBIA - Passos práticos para equilibrar as defesas do corpo e da menteLouis Cady, MD
Esta palestra, apresentada em 29 de maio de 2021 para o Congresso de Medicina Integrativa para a Saúde Mental 2020, promovido pelo Laboratório Great Plains no Brasil, enfocou coisas simples e de bom senso que os pacientes (e seus médicos) podem fazer para se manter seguros e viver durante o Pandemia do covid.
Os seguintes conceitos holísticos foram revisados:
- sono adequado e por que é tão importante;
- o uso de melatonina, cientificamente validada como tendo atividade antiviral (referências citadas);
- a importância de diminuir o estresse e técnicas para fazê-lo;
- a necessidade de "comer frutas e vegetais" como sua mãe e sua avó ensinaram devido à ingestão de carotenóides e antioxidantes ((referências citadas);
- o uso adequado de suplementos vitamínicos / nutricionais (referências citadas).
O foco desta apresentação não foram medidas heróicas para salvar vidas na unidade de terapia intensiva para pacientes gravemente enfermos com COVID, mas, sim, técnicas de bom senso, práticas, baratas e (em alguns casos) GRATUITAS para melhorar você e seus pacientes 'saúde e resistência às doenças.
THE MORAL IMPERATIVE OF INTEGRATIVE MEDICINE - O IMPERATIVO MORAL DA MEDICINA...Louis Cady, MD
Neste programa, o Dr. Cady baseia-se em uma série de casos clínicos para ilustrar a necessidade absoluta e moral do tratamento de precisão de nossos pacientes com todas as ferramentas disponíveis para uso por meio da medicina integrativa.
O uso de testes de polimorfismo MTHFR, testes convencionais e laboratoriais e testes farmacogenômicos foram revisados.
Os casos apresentados ilustram a trágica dificuldade de um menino com deficiência de MTHFR que estava prestes a desviar sua vida; um paciente esquizofrênico com vários problemas de medicina funcional que precisavam ser resolvidos (levedura, glúten, sensibilidade alimentar de IgG); uma estudante universitária a quem foi dito "não há nada de errado com você; seus laboratórios estão bem", embora ela tenha manifestado todos os sintomas relevantes de hipotireoidismo; e um CEO do sexo masculino de 42 anos que estava "tão cansado que parecia morrer" e que, na verdade, estava funcionalmente com pouco testosterona. O último caso revisado foi de um adorável garotinho que tinha autismo e foi recuperado por meio de uma abordagem focada e intensa de medicina integrativa.
Dr. Cady deconstructs some the medical literature about the use of nutrients - and the evidence of what happens in the presence of their insufficiency. Everything for decreased viral replication to decrease brain shrinkage is covered. The role of antioxidant and carotenoids, measured by the Pharmanex Biophotonic Scanner, is reviewed.
Please note - there is no representation that any nutrient or supplement can treat, prevent, mitigate, or cure any medical condition. It does seem, however, upon reflecting on the medical literature, that there seems to be a lot of evidence for therapeutic effect in the presence of good levels of nutrient, and harm to patients if they have insufficient levels.
This brief webinar, a gift to the local Jewish community and Temple Adath B'Nai Israel here in Evansville, IN, reviews the tradition of mindfulness and the interdigitation of Buddhist practices with some Jewish traditions. Dr. Cady reviews the downstream effects of stress, how meditation and mindfulness are useful tools and techniques, and actually how to practice it. Multiple references without being complicated or overdone are provided.
Webinar 5: Designing Your Future: WHAT'S COMING NEXT?Louis Cady, MD
In this capstone webinar presentation, closing out Dr. Cady's series on dealing with COVID 19, he turns his attention to a nunmber of interesting thems:
- what's the REAL case fatality rate of COVID 19
- How is it likely that society will reopen?
- What's going to happen in education and medicine?
- What's going to happen when the robots and AI arrive?
- What's the future going to be out 500 years?
HOW TO SAVE MONEY ON YOUR HEALTHCARE: An Integrative Medicine ApproachLouis Cady, MD
In this webinar, the fourth in a series of five from Dr. Louis Cady and the Cady Wellness Institute, we focus on the actual dollars and cents of health care expenditures, and the societal and PERSONAL costs of poor health maintenance behavior. We examine the essentially passive US medical system, that would rather drug a symptom than fix the underlying problem.
Great attention is paid on not shaming the patient or the doctors as they exist in the current system. Both groups "do not know what they do not know." Confirmation bias is rampant.
This webinar points the way to living a more vital, energetic life, with a minimum of cost, grief, and misery.
The Do It To Yourself Treatment of Depression - Webinar #3Louis Cady, MD
This is the third in a series of five webinars. The first was on staying alive by boosting your immunity during COVID 19. The second was on not screwing yourself up inside your head. This third one encompasses a romp through the peer reviewed medical literature looking for supplements and nutrients that you could use to self treat depression at home, CAREFULLY. Numerous cautions and warnings are included.
The driving impetus to this program is that many people - due to social isolation and their mental health care, or medical practitioners' offices being closed down - have not been able to get help or succeed in optimizing their treatment for depression. There are multiple useful nutrients for both depression and anxiety in nature's abundant pharmacopeia, and this webinar touches on just a few of them.
I hope you enjoy it.
HOW TO COPE WITH THE PSYCHOLOGICAL IMPACT OF COVID 19 AND SOCIAL DISTANCINGis...Louis Cady, MD
In this presentation, Dr. Cady will review:
- What did Sparky learn about not being an emotional support animal?
- "Do it to yourself psychotherapy." Learn the following:
- What are the wrong - and the RIGHT ways of any sort of "behavioral therapy"?
- How to use a journal to think RATIONALLY and “get out of your head.”
- How to get out of your HEAD and into your LIFE.
- We'll cover all 10 of David Burns’ cognitive distortions, customized and gift-wrapped for dealing with COVID 19.
- We will cover actionable examples of how to reprogram yourself.
We will review What are the 3 P's of Positive Psychology and Learned Optimism?
The Cady 5 "5P’s” and “How to shrink yourself."
Can we find the GOOD in COVID?
This presentation is meant to be provocative and to challenge you mentally, intellectually, and emotionally. Some of the great thinkers and exemplars of human performance and possibility are featured.
BOOSTING YOUR IMMUNITY During the COVID 19 PandemicLouis Cady, MD
In this presentation, presented as a live webinar on Monday, April 27th, Dr. Louis Cady of the Cady Wellness Institute reviewed practical, common-sense things that can be done to boost your immunity, with documentation from the peer-reviewed medical literature. Dr. Cady also reviews supplements and nutrients that are established in the peer-reviewed medical literature as having antiviral capabilities. These include Vitamins C,D, and E, Zinc, carotenoids and antioxidants, probiotics, the reishi mushroom, elderberry, cannabidiol (CBD - not marijuana or weed!).
Points presented are scrupulously documented from the medical literature. This presentation does not guarantee or represent that using ANY of these nutrients will "keep you from getting infected or dying" from COVID 19. They are presented for your thoughtful consideration.
Tratamento holistica de ezschizophrenia - São Paulo, Brazil April 20, 2019Louis Cady, MD
Esta é a versão em inglês da apresentação do Dr. Cady feita na UNIP (Campus Paraiso - São Paulo, SP Brasil) para o Congresso de Saúde Mental de 2019 (Conferência sobre Saúde Mental). Foi entregue em 20 de abril de 2019.
Nesta apresentação, o Dr. Cady analisa brevemente a história da esquizofrenia, a falha do bloqueio do receptor de dopamina D2 como uma cura universal na esquizofrenia, e várias intervenções holísticas que podem impactar forte e positivamente os sintomas da esquizofrenia. Incluídos na pesquisa do Dr. Cady estavam o papel dos ácidos graxos essenciais, deficiências nutricionais (particularmente vitaminas do complexo B), o perigo de supercrescimento da cândida, testes farmacogenômicos, polimorfismos da MTHFR e muito mais.
Foi uma honra e um privilégio entregar esta apresentação em
São Paulo.
Para mais informações no Brasil sobre este tema, ou para solicitar uma gravação em vídeo / áudio da conferência, entre em contato com Luiz Dias do Laboratório Grandes Planícies no Brasil.
Slides, até o apêndice, são traduzidos por Luiz Dias.
Natural Treatments for ADHD (TADH) in Sao Paulo, Brazil, for Laboratorio Grea...Louis Cady, MD
In this presentation, given at UNIP (Campus Paraiso - Sao Paulo, SP Brazo) for the 2019 Congresso de Saude Mental (Conference on Mental Health), Dr. Cady reviewed the prevalence, inheritability, and social ramifications of ADHD (TADH in Brazil). He specifically reviewed multiple holistic interventions, including limiting "electric screen time,"good quality diet with adequate amounts of essential fatty acids and critically important trace elements, and the use of pharmacogenomic testing as well as functional, integrative medicine testing, all to better characterize logical and reeasonmable points for holistic intervention.
This presentation was simultaneously translated into Portugue for the attendees, but unfortunately the slides were not available in translated form.
For further information in Brazil on this topic, or to order a video/audio recording of the conference (in Portuguese),contact Luiz Dias of Laboratorio Great Plains in Brazil.
Thyroid, Adrenals, and Sex Steroids - A Balancing ActLouis Cady, MD
This was the second presentation gibven on MZarch 29, 2019 at the Manlove Psychiagtric Group and Brain Injury Institute spring conference in Rapid City, SD.
In this presentation, Dr. Cady carefully goes over the necessity of integrating and overview and awareness of hormones and their levels in the elucidation of what truly is going on with the patient.
This was an overview lecture only. Dr. Cady will be presenting a 16 hour CME program in Austin Texas on June 22 and 23 for the National Procedures Institute, and will explore all aspects of all relevant hormones and what can be done to manage and optimize them.
This lecture was presented on March 29, 2019 in Rapid Citry, South Dakota, for the conference co-sponsored by the Manlove Psychiatric Group and the Brain Injury Center.
It reviews the uptick in diagnosis of ADHD, the raiontale for its concern, causative factors, and how it can be worked up holistically and in a balanced, not necessarily medication-oriented way.
Use of high dose fish oil, iron supplementation, and how to overrcome nutritional deficiencies are discussed.
Medical Discussion of the Endocannabinoid SystemLouis Cady, MD
This document contains a slide deck presentation on hemp oil and the endocannabinoid system. It discusses the history of research on cannabis, the endogenous cannabinoid system, and how various interventions can upregulate this system. Throughout, it stresses that the information is for educational purposes only and that no claims are being made about Zilis products treating, preventing, or curing any diseases.
This document provides an overview of a lecture on thyroid health. It begins with the speaker, Louis Cady, MD, disclosing commercial relationships and interests. It then outlines the structure of the lecture, which will cover thyroid basics, practical information, and conclusions. The document discusses conventional thyroid testing and its limitations. It also reviews factors that affect thyroid hormone production and conversion. Overall, the document introduces topics to be covered in the lecture regarding thyroid function and testing.
Natural Treatments for ADHD - April 11, 2018Louis Cady, MD
This presentation will be delivered April 11, 2018 on recorded webinar for the Autism Global Conference. It was my pleasure to prepare and present this lecture (in webinar form), outlining a coherent philosophy of finding biological underpinnings that can cause or contribute to, or exacerbate, mental dysfunction. In the case of this presentation, the question is "How much of ADHD symptomatology is caused by a lack of a good medication, or, rather, lack of a coherent strategy for finding and fixing underlying biological abnormalities?"
Those biological abnormalities in this presentation include MTHFR polymorphisms, COMT polymorphisms, elemental deficiencies (lithium, magnesium, zinc, iron, and copper), essential fatty acid deficiencies, the confound of high fructose corn syrup, and many others.
Rational strategies for nutraceutical intervention are reviewed.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
2. “Streaking”, or…..
Better Buckle Up!!!
• Definition: Streaking is the act of taking off
one's clothes and running naked through a
public place. [ref:
http://en.wikipedia.org/wiki/Streaking - accessed 09
02 2013]
• “In 1973, what the press called a ‘streaking
epidemic’ hit Stephen F. Austin State University in
Nacogdoches, TX, with streakers being seen in
residence halls, at football games and at various
other on-campus locations and events, including
Spring graduation.(Harvard-Yale game, 2006)
4. Schizophrenia – multiple domains and
defects
• Positive symptoms
– (delusions, auditory & visual hallucinations)
• Morris R et al. Schizophrenia Bulletin (2012). 39, 575-582
• Negative symptoms
– Anhedonia, apathy, amotivation, and inappropriate (blunted) affect.
• Rabinowitz J et al. (2012) Schizophrenia Research 137, 147-150.
• Neurocognitive dysfunction, including attention deficits
– Fioravanti M et al. Neuropsychol. Rev. 15, 73-95.
• Learning & memory problems
– Goldman-Rakie PS. (1994). J Neuropsychiatry Clin. Neurosci. 6,348-357.
• Decreases in executive functioning, processing speed, and IQ
– Hutton SB et al. (1998) Psychol Med. 28, 463-473.
– Rodriguez-Sanches JM et al. (2007) Br. J Psychiatry Suppl. 51, s107-s110.
• More recently noted: defects in social cognition and function.
– Nuechterlein K H, et al. (2004) Schizophrenia Res. 72,29-39.
– Fett AK et al. (2011) Neurosci. Biobehavioral Research Rev. 35, 573-588.
5. Schizophrenia
• Historically:
– “Dementia praecox” - Heinrich Schule in 1886.
– Emil Krapelin (1893) refined classification between
dementia praecox and a mood disorder.
– Eugene Bleuler(1908) – coined term schizophrenia
– a “splitting of the mind.”
• Currently - diagnosed per
American Psychiatric Association’s Diagnostic and
Statistical Manual of Mental Disorders, or the World Health
Organization’s International Statistical Classification of
Diseases and Related Health Problems (ICD-10).
– DSM 5 removed all previous subtypes (paranoid type, disorganized,
catatonic, undifferentiated, and residual types)
12. Schizophrenia Etiopathogeneses:
some theories
• Immuno-inflammatory response
– From dysfunctions of brain-gut axis
– Intestinal pathological processes.
• Alterations in intestinal microbiome
• Permeable intestine (leaky gut syndrome)
• Hypersensitivity to food antigens – especially
gluten and casein of cow’s milk.
13. Case presentation
• Alan – presents on Feb 16, 2007,
diagnosed with depression vs. psychosis.
– Previous treatment at Pfeiffer Treatment Center
• He appeared notably fatigued and grossly
over-sedated.
• Morose and depressed. Lucid. Intelligent.
14. Past history• “Ever since I can remember, I’ve always had
the same feelings about things – how people
treat each other and stuff like that.” “My
feelings just kept getting worse and worse the
more I was picked on. That was the only
thing that was wrong, people just calling you
names and stuff.”
• Alan became suicidal in middle school – 8th
grade year. “I just thought everyone was
making fun of me, so why should I go on.”
15. • Treated with fluoxetine in the past for depression
• Stopped being able to do homework as a sophomore
in high school
• “I was just really resentful of my parents a lot during
the past few months [at that time] – I just started
yelling at them in front of the therapist guy.”
• Ultimately stabilized by previous MD on aripiprazole
(20 mg), olanzapine (20 mg) and sertraline (50mg).
• Per Mom – “It was hard for him to be out and be
around a lot of people.”
Past history
16. March 2007• Evaluated for obstructive sleep apnea & now on
CPAP (continuous positive airway pressure
device).
• Improved energy.
• Conventional labs ordered
• Sertraline changed to duloxetine, which helped.
• Sertraline and olanzapine both decreased by 5
mg. Modafanil stable at 100 mg
• Very specific about self-identified “Paranoid
thoughts.” “I didn’t used to have them.”
17. Clinical course through July
2007• Continued in treatment with me every 1 – 3
month appointments. Still isolated.
• Seemed to improve on;
– Duloxetine 60 mg twice daily
– Olanzapine 30 mg @ 9 pm
– Aripiprazole 20 mg in the a.m.
– Topirimate – 100 mg at bedtime (originally for
weight loss, but improved mood).
– L-methylfolate 7.5 mg per day, empirically started
– 5HTP 100 mg tid
18. 2007 - 2009
• More explosive outbursts. Lamotrigine
(200 mg) added topirimate continued
• “I know that I’m acting ridiculous – like a
schizophrenic, but I feel good, and I’m
talking more to everybody, and I’m trying
to get my point across, and I don’t feel as
evil as I used to.”
19. June 30, 2009• He comments that he
feels his “mouth is
going faster than his
thoughts.”
• Mom reports that
“traveling out here (to
appointment) wears on
him.” “He does better
when he’s quiet and in
the house.”
• RX:
– Olanzapine 30 mg 9 pm
– Aripiprazole 20 mg a.m.
– Topirimate 100 mg HS
– Lamotrigine 200 mg in
a.m.
– Duloxetine – 120 mg /
day
– Modafanil – 100 mg daily
– 5HTP 100 mg in the a.m.
INTEGRATIVE MEDICINE
TESTING finally ordered!
20. Integrative (“functional”)
medical testing done
TESTING• Micronutrient analysis (functional
intracellular analysis) – deficiencies in:
– Vitamins A & D, zinc, Oleic acid, antioxidant
capacity
• IgG food allergy testing 7/22/2009
– 12 total sensitivities
• 2+ to eggs, cow’s milk, wheat, brewer’s yeast
• 1+ to cheese, mung bean, oat, pork, pumpkin,
sesame, tuna & baker’s yeast.
21. 8/12/2009 Follow-up
• Very irritable and sarcastic at
appointment.
• Continue baseline Rx as is.
• NEW: start diet – dairy free, gluten free
• NEW: start vitamins:
– 4000 IU Vitamin D daily
– Flavored cod liver oil
– “ACES” – A, C, E, and Selenium
22. Last four months January 21,
2010• On IgG diet. “He has been doing well on it.”
• At Christmas, however, he “went off of it.” Had cookies
everywhere – couldn’t keep him out of the wheat.
Following that gluten feast he exploded on New Year’s
eve.
• Prior to that, his last explosive episode was in May – and
has been good pretty well up until New Year’s eve.
When the two brothers got in the car it set Alex off. “It
was bad.”
• After the outburst, Alan specifically wanted to go back on
the diet program. “He seems really good [now].”
• More functional medicine testing ordered.
25. January 2010 to present
• November 2012 – high IgG allergies to dairy and
wheat. Diet again emphasized.
• August 2014 – elevated Arabinose on OAT test –
treated with Nystatin
• Probiotics added to deal with acid reflux
• Macro and Micronutrient deficiencies identified in
hair testing and organic acid testing.
• Generally stable. Subtle improvement. No more
meltdowns. No more concerns about going out in
public.
30. Candida – what is it?
• “C. albicans is a diploid, polymorphic
yeast residing in mucosal surfaces of
the human respiratory,
gastrointestinal (GI) and genitourinary
tracts.”
– Severance EG . NPJ Schizophr. 2016; 2: 16018.
33. The only four papers in the
literature
• 1. Clozapine found to inhibit yeast budding to
hyphal transition. This and other antifungals
might have therapeutic activity in the future.
– Midkif J et al. Small molecule inhibitors of the Candida albicans
budded-to-hyphal transition act through multiple signaling pathways.
PLoS One. 2011;6(9):e25395.
• 2. Cyclic dipeptides from food and intestinal yeast cyclic
dipeptides may play a role in causing psychiatric
disorders such as schizophrenia. From cancer research,
cyclic dipeptides such as cyclo (proline-phenylalanine)
have been found to activate the pathways of apoptosis
and to cause programmed cell death.
– Semon BA. Dietary cyclic dipeptides, apoptosis and psychiatric
disorders: a hypothesis. Med Hypotheses. 2014 Jun;82(6):740-3.
34. 3. Odds ratio of schizophrenia with
candida albicans seropositivity
• Case control differences investigated regarding candida
albicans.
• 947 individuals studied
– 261 with schizophrenia (139 of which had 1st
episode schizophrenia
– 270 with bipolar disorder
– 277 non-psychiatric controls
• C. albicans seropositivity conferred increased odds for a
schizophrenia diagnosis (OR 2.04-9.53, P 0.0001).⩽
• Severance EG et al. Candida albicans exposures, sex specificity and cognitive deficits
in schizophrenia and bipolar disorder. NPJ Schizophr. 2016; 2: 16018.
• Published online 2016 May 4.
– Full article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4898895/
35. 4. Probiotic normalization of Candida
albicans in schizophrenia: A randomized,
placebo-controlled, longitudinal pilot study.
• Longitudinal, double-blind, placebo-controlled pilot
investigation of 56 outpatients with schizophrenia.
Studied impact of probiotic treatments on yeast
antibody levels, and between levels of antibodies
and abdominal discomfort/ psychiatric symptoms.
• “Results from this pilot study hint at an association
of C. albicans seropositivity with worse positive
psychiatric symptoms, which was confirmed in a
larger cohort of 384 males with schizophrenia.”
Severance EG et al. Brain Behav Immun. 2017 May;62:41-45.
36.
37.
38. • HPHPA found in higher concentration in urine samples of
children with autism compared to controls.
• Highest value ever measured was 300X the median normal
adult value, in a patient with acute schizophrenia during an
acute psychotic episode.
• HPHPA source – appears to be from multiple species of the
Clostridium genus.
• Appears to be a metabolic of 3-hydroxyphenylalanine – a
tyrosine analog which depletes brain catecholamines and
causes symptoms of autism in experimental animals.
40. June 23, 2015
• “The past few days I’m
doing pretty good. It’s
been a miraculous few
days. This week has
been pretty good. We
have been going out a
little bit more. We’re
going to Biaggi’s after
this. That’s going to be
a first in a long long
time.”
• RX:
– Olanzapine 30 mg 9 pm
– Aripiprazole 20 mg a.m.
– Topirimate 100 mg HS
– Lamotrigine 100 mg in
a.m.
– Duloxetine – 60mg / day
– Liothyronine 5
MICROgrams 2x/day
• PLUS SUPPLEMENTS
41. 2015 supplementation – in
collaboration with CWI biomedical
specialist
• N-acetyl cysteine complex (glutathione
precursor) – 3 two times/day
• D3 (2,000 IU) – one per day
• ACES – one tablet per day (Vitamin A –
10,000 IU in 2 soft gels, Vitamin C 1000 mg
in two capsules, Vitamin E 400 IU in two
capsules , Calcium 119 mg in two capsules
• Selenium 100ug in two capsules).
• Vitamin C (500 mg. twice daily)
• Zinc (25 mg. 2x/day) – 50 mg per day
• Lithium Orotate (10 mg./day)
• CoQ10 (200 mg.)
• Fish Oil - Previous had (EPA 1100 mg.;
DHA 720 mg.; Other Omega 3: 230 mg.)
• Niacinamide – 500 mg three times daily
recommended by Marci.
• B5 (Pantothenic Acid) – 250 mg. 1x/day
MWF
• Manganese 15 mg./day
• Chromium polynicotinate 200 mcg./day
• Magnesium glycinate 200 mg 2x/day
• P-5-P 50 mg. 2x/day
• Grapefruit Seed Extract – as
recommended on the label (for yeast) –
liquid form
• Olive Leaf Extract – 1 per day (for yeast
and bacterial overgrowth) – liquid form
(with the grapefruit seed extract)
• Enzymedica Digest + Probiotics – take 1
capsule at the beginning of each meal
– Probiotic: Ther Biotic Complete from Klaire
Labs – 1 capsule per day
• Copper (1 mg./day) – added in a
multivitamin (“Headache Free”)
• Potassium was added 99mEq twice daily
46. Differential antibody responses to gliadin-
derived indigestible peptides in patients
with schizophrenia
• IgG and IgA antibodies against indigestible
gliadin-derived peptide antigens by ELISA
• 169 patients with schizophrenia; 236 controls.
• RESULTS:
– Patients with schizophrenia had increased levels of
plasma IgG against the gamma-gliadin-derived
fragment (AAQ6C) compared to control subjects.
– No difference against NATIVE gliadins between
patient and control groups.
McLean RT et al. Translational Psychiatry. 2017
May 9;7(5):e1121.
47. Immunoglobulin G genotypes and risk
of schizophrenia
• Assessment of highly polymorphic immunoglobulin GM
(gamma marker) genes in schizophrenia.
• N=798: 398 patients with schizophrenia, 400 controls
• GM Alleles were determined by the TaqMan® genotyping
assay.
• GM 3/3;23-/23- genotype were over three times as likely
to develop schizophrenia as those without the genotype
[Odds Ratio 3.4]
• Notably GM alleles have been implicated in gluten
sensitivity
Pandey JP et al. Human Genetics. 2016
Oct;135(10):1175-9.
48. “Bread and Other Edible Agents of
Mental Disease”
• Cereal grains – the world’s most abundant food source – can
affect human behavior.
• “Bread makes the gut more permeable and can thus
encourage the migration of food particles to sites where they
are not expected, prompting the immune system to attack
both these particles and brain-relevant substances that
resemble them.”
• Causes release of opioid-like compounds
• “A grain-free diet, although difficult to maintain… could
improve the mental health of many and be a complete cure
for others.”
Bressan P, Kramer P. Frontiers of Human
Neuroscience. 2016 Mar 29;10:130
51. Some current research
• “Patients with schizophrenia have low plasma Vitamin D level.”
(Does not appear to be associated with severity or type of
antipsychotics used.)
– Akindlade KS et al. Frontiers of Psychiatry June 2017
• “Average Vitamin D values were deficient for first episode of
psychosis patients, especially those 22 with a final diagnosis
of schizophrenia.”
– Salavert J et al. Association between Vitamin D Status and
Schizophrenia: A First Psychotic Episode Study.
• Vitamin D Deficiency highlighted as potential environmental
risk factor in multiple sclerosis, schizophrenia, and autism.
– (Causation versus consumption duality reviewed.)
– Kocovska E et al. Frontiers of Psychiatry 2017 Mar 27;8:47.
– Link to full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5366333/
52. More Vitamin D Research
• Evaluation of 80 patients with chronic stable schizophrenia with residual
symptoms and Vitamin D deficiency were recruited randomly and received
600,000 (!!) IU Vitamin D injection along with their antipsychotic regimen.
– A negative but not significant correlation was found between serum Vitamin D level changes
and PANSS []Positive and Negative Syndrome Scale] negative subscale score.
• Vitamin D deficiency in a psychiatric population:
– 118 patients with bipolar disorder
– 202 patients with schizophrenia or schizoaffective disorders.
– Vitamin D levels were deficient in 30.3%
– Vitamin D deficiency was 4.7 times more common among outpatients with bipolar disorder,
schizophrenia, or schizoaffective disorder than among the Dutch general population.
– “We believe that outpatients with bipolar disorder, schizophrenia, or schizoaffective disorder
should be considered at risk of having low levels of Vitamin D.”
– Boerman R et al. J Clin Psychopharmacol. 2016 Dec; 36 (6):588-592.
• “In up to 16,125 individuals with measured serum 25 (OH)D, there was no
clear evidence that genetic risk for schizophrenia causally lowers serum
25(OH) D).”
– Taylor AE et al. Investigating causality in the association between 25(OH)D and schizophrenia.
Sci Rep. 2016 May 24;6:26496.
53. Patients vs. professional
staff• Naturalistic study – the Netherlands
• Study:
– Vitamin D levels measured in therapy-resistant schizophrenia in
April, after the winter, and in patients and staff members in June
after an exceptionally sunny spring.
– Patients had HIGH rates of Vitamin D deficiency (79-90%) and
lower levels of vitamin D than staff members (p<0.001).
• Conclusions: “The vitamin D deficiency of therapy-resistant
schizophrenia patients is pronounced and cannot be explained by
differences in skin pigmentation, or by an inactive, indoor lifestyle on
the ward.”
– (“Even theoretically sufficient exposure of the patients to daylight did not
ameliorate the low vitamin D levels”)
55. Vitamin D & Omega 3 fatty acids –
relevance for SCHIZOPHRENIA
“VITAMIN D & marine omega 3 fatty acid intake may help prevent and
modulate the severity of brain dysfunction.”
“VITAMIN D & marine omega 3 fatty acid intake may help prevent and
modulate the severity of brain dysfunction.”
JUNE 2015
58. Gut bugs and brain
• “Intestinal microbes in
the gastrointestinal tract
regulate peripheral
immune responses,
CNS function and
behavior.”
• Probiotics such as
Bifidobacterium and
Lactobacillus have
potent anti-
inflammatory properties
that reduce behaviors
associated with anxiety
and depression.
Fung TC, et al. Nat Neurosci. 2017;20(2):145-155.
59. Inflammation and schizophrenia
• Short chain fatty acids (SCFAs) linked to a
shortened lifespan with schizophrenia. Use of
Mediterranean diet, omega 3 fatty acids, and
probiotics may improve immune and
cardiovascular outcomes.
– SCFA derived from gut fermentation of fiber.
• Evolving literature that short chain fatty acid can
cross the blood brain barrier and target key
inflammatory pathways.
– Joseph J et al. Modified Mediterranean Diet for Enrichment of Short
Chain Fatty Acids… Frontiers of Neurosceicne. 2017 Mar 27;11:155.
60. B-vitamins and inflammation
References:
Mikkelsen K, et al. Maturitas. 2017;’96:58-71.
Brown HE et al. Vitamin Supplementation in the Treatment of Schizophrenia. CNS Drugs. 2014 Jul;28(7):611-
622.
B vitamin Immune response Deficiency outcome
B1 – Thiamin Antioxidative effect
Suppressed oxidative stress activation of NF-
kB
Neuroinflammation
Stimulation of CD40 & CD40L which triggers death
of neurons
Memory defects, cognitive decline emotional
disturbances
B2 – Riboflavin Activates MAIT [mucosal-associated invariant
T cells]
Interferes with macrophages adherent
Enhance apoptotic d4ath
B3 – Niacin Positive benefits on lipids
Dampens inflammation
Inhibits NF-kB activity
Historically used by Abraham Hoffer to treat
schizophrenia
B6 – (P5P) –
pyridoxal-5-
phosphate
Down regulates NF-kB activity levles in LPS
stimulated mouse macrophages
Adverse effects on methylation reactions
Altered lymphocyte differentiation and maturation
Triggers many diseases related to chronic
inflammation; possible consequences in depression
B9 Folic acid Regulation of immune response
Inhibits homocysteine induced NF-kB
activation in cultured human monocytes
IMPAIRED IMMUNE RESPONSE
Decreased response of T lymphocytes
Alterations of thymus function
.
B12 - Cobalamin
Immune system regulation
Immunomodulator of cellular immunity
Involved in cell division
Reduced cytotoxic T cells (CD 8+)
Reduced natural killer cells
Ghigh CD4/CD8 ratio
High levels of TNF-alpha; IL-6 decreased
61. Decreased Brain levels of Vitamin
B12 in Aging, Autism and
Schizophrenia
• Cobalamin exists in multiple forms, including
methylcobalamin & adenosylcobalamin
• Cobalamin levels measured in postmortem human frontal
cortex of:
– 43 controls – from 19 weeks of fetal development through 80 years
of age.
– 12 autistic subjects
– 9 schizophrenic subjects.
• In autistic and schizophrenic subjects: methyl-
and adenosylcobalamin levels were 3 times
lower than age-matched controls.
Zhang Y et al. PLoS One. 2016 Jan 22;
11(1):e01467978.
62.
63. Stahl SM. L-methylfolate: a vitamin for your monoamines. J
Clin Psychiatry. 20089 Sep;69(9):1352-3
Strategy: test for “MTHFR genotype.”
References:
www.genomind.com www.genesight.comn
64. Folinic acid treatment for schizophrenia
associated with folate receptor
autoantibodies
• Autoantibodies against folate receptor alpha at the
choroid plexus that block methyltetrahydrofolate
(MTHF) transfer into the brain found in catatonic
schizophrenia. .
– Acoustic hallucinations disappeared following folinic acid
treatment.
• Study examines patients with schizophrenia
unresponsive to conventional treatment.
– had normal levels of homocysteine, folate, and B12.
– But had positive FR Autoantibodies of the blocking type.
• Conclusion: assessment of FR auto-antibodies in serum
is recommended for schizophrenia patients.
Ramaekers VT et al. Mol. Genet Metabolism. 2014
Dec; 113(4):307-14.
65. Modified Mediterranean Diet for Enrichment of Short Chain
Fatty Acids: Potential Adjunctive Therapeutic to Target
Immune and Metabolic Dysfunction in Schizophrenia?
Joseph J et al. Front Neurosci. 2017;11:155
• Multiple immune pathways that accompany
systemic inflammation are dysregulated in
schizophrenia.
• “The presence of inflammatory markers
indicates that a tissue injury mechanism is
active.”
• Dysregulated reward circuitry leads to unhealthy
dietary intake.
– [hyperdopaminergic mesolimbic pathway combined
with poor cognitive control]
Link to full text article:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5366345/
66. Modified Mediterranean Diet for Enrichment of Short Chain
Fatty Acids: Potential Adjunctive Therapeutic to Target
Immune and Metabolic Dysfunction in Schizophrenia?
Joseph J et al. Front Neurosci. 2017;11:155
INTERVENTION STRATEGIES
• Gluten free diets.
– Celiac disease and non-celiac gluten sensitivity is higher in schizophrenia
than the general population.
• Psychotic symptoms can be triggered by gluten in those with a gluten intolerance [Lionetti et
al, 2015]
• Omega 3 fatty acid supplementation (especially docosohexanoic acid)
• Ketogenic diets
• Colonic generation of short chain fatty acids and transport (via
probiotics, if necessary.)
• Mediterranean style diets
– Have already been shown to reduce overall heart disease risk.
– Adherence reduces c-reactive protein and TNF-alpha.
Link to full text article:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5366345/
67. • Case reports of two patients
with schizoaffective disorder
• Both had failed clozapine
– 1 patient failed 12 Rx.
– 1 patient failed 17 Rx.
• Ketogenic diet tried by
female patient for weight
loss.
– All delusions resolved (and
she lost 10 lbs)
• Also tried by 322 lb male,
who lost 104 lbs during a
year.
– Coincidentally, his PANSS
scores dropped from 98 to only
49.
68. Alan – the rest of the story
October 25, 2014
http://cadywellness.com/a-shattered-mind-and-
music-within/
Tip: www.youtube.com - type in Bethany Yeiser
69. Alan & Clozapine
• Maximum benefit on meds and
supplements reached. Still symptomatic.
• Clozapine was suggested in 2016.
• Started Clozapine March 3, 2017
• Seen on March 30th
. Vastly better.
Chuckled, “I’ve been paranoid for ten
years.
70. What it’s like from the inside-
March 30, 2017
• Alan: “I am not as dizzy – still feel like I’m in a dreamlike
state – but not as bad.” “There is a whole world of
difference since taking this stuff. We’ve been going out
more.” “
• Clozaril® (Clozapine) has eliminated basically every
paranoid thought I’ve had – I know they’re there. I
noticed it the first day.” He notes that he has been “too
sedated for them to hit me. It’s like the paranoid
thoughts can’t catch up.”
• Mother comments when he goes places, he is not
troubled by voices.
71. March 30, 2017
• Clozapine – 100 mg
a.m. + 175 mg pm
• Olanzapine +
Aripiprazole stopped
• Nystatin1.5 million IU 2
– 3X/day
• Topirimate
• Lamotrigine
• Duloxetine reduced
• Liothyronine 5 ug
2x/day
• D3 (2,000 iu) – one per day
• ACES – one tablet twice daily (Vitamin A – 10,000 IU in 2 soft gels,
Vitamin C 1000 mg in two capsules, Vitamin E 400 IU in two
capsules , Calcium 119 mg in two capsules
• Zinc 30 mg – one time per day (elevated from anti-dandruff
shampoo)
• Lithium Orotate (10 mg/day)
• CoQ10 (200 mg.)
• Fish Oil - Metagenics high potency EPA/DHA fish oil
• Niacinamide – 500 mg three times daily recommended by Marci.
• B5 (Pantothenic Acid) – 250 mg. twice daily
• Manganese 15 mg twice daily
• Chromium polynicotinate 200 mcg twice daily
• Neuromag - two capsules before bedtime.
– Marci has expressed interest in more magnesium using Epsom salts
baths.
• P-5-P 50 mg. 2x/day
• Grapefruit Seed Extract – as recommended on the label (for yeast) –
liquid form
• Olive Leaf Extract – 1 per day (for yeast and bacterial overgrowth) –
liquid form (with the grapefruit seed extract)
• Enzymedica Digest + Probiotics – take 1 capsule at the beginning of
each meal
– Probiotic: Ther Biotic Complete from Klaire Labs – 1 capsule per day
• Copper (1 mg./day) – added in a multivitamin (“Headache Free”)
twice daily
• Potassium was added 198 mEq twice daily (increased in
September.)
• Ferrochel added – one tablet per day.
• Rubidium – 100 MICROgrams per day
72. April 14,
2017
• Clozapine – 100 mg a.m.
+ 125 mg pm
• Nystatin 1.5 million IU 2 –
3X/day
• OFF OF:
– Olanzapine
– Aripiprazole
– Topirimate
– Lamotrigine
– Duloxetine
– Liothyronine 5 ug /day
– Rosuvastatin
• DIET: Still casein
free/gluten free
73. Concluding thoughts
• Just because someone has a classic “biological
psychiatry” diagnosis doesn’t mean that there
can’t/won’t be functional (or medical) impairments.
[e.g., obstructive sleep apnea, hypothyroidism,
vitamin deficiency, gluten sensitivity, intestinal
candidiasis etc. ]
• You may not be able to get rid of the main diagnosis,
but you can improve the patient’s quality of life.
• You MAY be able to get rid of a phenotypic diagnosis
if there is an underlying physiological problem that
can be addressed.
• Integrative medicine is of paramount importance in
identifying root causes and helping the patient.
74. Louis B. Cady, MD
Cady Wellness Institute
4727 Rosebud Lane – Suite F
Newburgh, IN 47630 USA
Office (812) 429-0772
info@cadywellness.com
Available on Apple “app store” and
Google Android store.
www.slideshare.net/lcadymd
Louis B. Cady, MD
Speaker notes for my use and review – don’t translate.
- Recent discoveres of lymphatic vessles with the dura mater surrounding the brain, made possible by modern live-cell imaging technologies, have emerged. “Endothelial, epithelial, and glial brain barriers establish compartments sin the CNS that differ strikingly with regard to their accessibility to immune cell subsets.