Posted by Larry Hoover on November 7, 2002, at 9:05:07
In reply to Re: PTSD/Social Anxiety-Herbals, posted by pelorojo on November 6, 2002, at 17:58:08
> After reading that article on the neurophysiology of PTSD and many others, I've been wondering:
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> -is an SSRI really the answer in such a complicated physiological chain of events? It seems like some way to go to the root of the problem would be betterYes, but the beginning of the healing journey may begin with medication which facilitates e.g. cognitive-behavioural therapy. If your thinking is distorted by chronic or recurrent dysthymia or depression, you have to address the symptoms in order to permit useful insight.
> -do the "adaptogenic" herbs, which claim to "modulate" or "normalize" the stress response, have any role here? I'm thinking of ashwagandha, astragalus, reishi, shiitake/maitake, rhodiola rosea, adapton, suma, cordyceps, licorice, etc., etc. Might they help "normalize" cortisol?
There is some evidence that adaptogens may have much lesser effect the longer the chronic stress has continued. The HPA can become 'locked in' to a vicious cycle caused by what some call burn-out.
That said, gingko or Siberian ginseng have quite different modes of action when compared to e.g. rhodiola or witheria or licorice root. For example, licorice root blocks liver enzymes affecting interconversion of some of the steroids. I don't like the 'lumping together' of herbs like this.
> - could a cortisol-reducer (such as Relora or cortitrol) help in acute situations of stress when PTSD is triggered? I have "complex" PTSD and know of some (but not all) situations that trigger it. Perhaps a cortisol-reducer would help?I've never even heard of these drugs before (but I'll certainly look into it). You need to do a 24-hour cortisol/DHEA/DHEA-S to determine your circadian secretion level/pattern. Before you muck around with your hormones, you need both baselines and justification.
> -what neurotransmitters are most important in PTSD? My limited reading on social anxiety suggests that they may be similar and the prime suspects are dopamine, serotonin, and gaba.I think norepinephrine (noradrenaline) is actually the key player. It's secreted by the adrenals, and in some respects, dysregulates all the others.
Whatever. Theories aren't going to make you well. What I'm getting at is that you need to do a series of trials with n=1. You have to try interventions, assess the outcome, go off the intervention, re-assess, and go on it again. That's the only way to know what works for you. I tried rhodiola after someone I knew had astounding results, including sleep normalization. It exacerbated *my* insomnia, and made *me* more anxious. No thought experiment will tell you anything with any certainty.
> -could amino acid precursors be effective? L-tyrosine, 5-htp, etc.
I'd stay away from 5-HTP. You bypass the rate-limiting step, which your body uses to limit the amount of serotonin in general circulation. You don't want serotonin in your blood, but 5-HTP will do that, because the aromatic-decarboxylase enzyme is found in every organ compartment.
You can buy tryptophan for veterinary purposes. It is of equal quality to pharma grade.
> -are other amino acids useful for other reasons? D,L-phenylalanine, L-theanine come to mind here.I forget what theanine does, but DLPA gives two bangs for the buck. It's a precursor to the feel-good PEA, as well as being converted into tyrosine.
> -I had largely given up on St. John's Wort because of the studies that questioned its efficacy and showed potential interactions (in the form of reduced effectiveness) of other drugs..but is there something I'm missing? There's also a herbal SSRI, sceletium (sp?)...You're probably referring to this study, which also showed that sertraline (Zoloft) doesn't work. I'm surprised that the press didn't run with the 'proof' that a pharmaceutical drug failed this test. If you read the full-text, you'll see that the SJW they used was not standardized to contain the industry-standard minimum level of active ingredients. The study was methodologically flawed, and therefore, worthless.
Or perhaps you're thinking of this one, declaring SJW infeffective for major depression, despite the finding that, "The number reaching remission of illness was significantly higher with St John's wort than with placebo (P =.02)", and that SJW doses routinely used in Europe for more severe depressive symptoms were not emloyed in this study (funded by a major pharmaceutical corporation).
Funny, but a recent report in Am. J. Psych. showing the effectiveness of SJW gets no press.
Nor does this one:
Here's the most recent meta-analysis, demonstrating the effectiveness of SJW:
> -finally is there a creative approach that might work best? For example, taking certain amino acids on certain days, certain herbs for a period of time, etc. etc. Instead of chronically taking something taking them on cycles or "pulsing" them (i.e., L-Tyrosine Monday, SAMe Tuesday, herbal L-dopa Wednesday, etc).
I take many of my supplements in pulses. My intuition guides me on this, and I just let it happen that way. Your brain/body may vary.
Some supplements need to be taken daily to have maximum effect, like SJW. It takes eight weeks on SJW for significant changes in the biochemistry of the hypothalamus and hippocampi.
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> No one can probably answer these questions for certain but is anyone thinking along these lines? Any resources to bear on it?I'm trying to keep my answer short. I've been studying this for years, but you have raised ideas I have not yet considered. I'll have to get back to you on some of this.
> I've been on SSRIs for 2 long cycles. They work in that they make me less depressed and less anxious but it seems like the underlying issues remain unaddressed. I'm working on them in therapy as well but that is very slow going ...
I think you may need a slight adjustment in attitude. Rhetorically, why do you think it is that Olympic teams are largely composed of athletes in their late teens and early twenties? There are changes which come with age, and PTSD might well 'age' some parts of us a little faster than we'd like. Comparisons of your 'now' self to your past self may be maladaptive.
>I guess I'm a little desperate to find things that help.
Just so long as you're not thinking 'cure'.
> thanks
> Ken
> Austin, TXLar
poster:Larry Hoover
thread:126446
URL: http://www.dr-bob.org/babble/20021101/msgs/126803.html