Alternative Treatment Options

  • It’s important to understand what role vitamins and supplements can have in supporting mental wellness, and what roles they generally aren’t capable of performing. All of the products listed below have. research-based rationales to support their consideration.

  • Each, however, is merely playing a part in a multifaceted biochemical process that will be more supportive for some than for others, depending upon each person’s individual biological needs. Likewise, the dosing strategies and any potential risks of overexposure are relative to each person’s biology and baseline functioning.

  • Also, it’s important to note that I give specific brands and/or active ingredients because there is huge variability between products as they are not passed through the same rigors as FDA approved medications.

  • So, the recommendations I give below are not at all exhaustive but are based upon the closest approximations to what I find in research trials and those brands utilizing safeguards such as third-party testing.

 

Circadian Rhythm

Listen to CBT for Insomnia: A Patient Guide by Carlat Psychiatry for background regarding the following recommendations (see Dark Therapy in 6 Steps for material referenced in the above guide)

You can also listen this podcast episode by Carlat Psychiatry for bipolar-related circadian rhythm information

 

Light Therapy and dawn simulators

Light therapy is studied for its impact on mood and is recommended to use around 20 minutes as soon as you wake up in the morning and requires the bulb meets certain specs (10,000LUX, full-spectrum white light).

  • make sure the light is within 2-3 feet of your face and to the side so it's hitting the sides of your eyeballs

  • not recommended for use throughout the day or for more than 25 minutes (can cause some irritability)

  • Under $25 option

Similarly, dawn simulators are utilized in particular to help circadian rhythm develop and keep a healthy schedule, which has wide-reaching impact on mental health.

Light Therapy and Dawn Simulators:

Valerian Root Supplement

(standardized to 0.8% valerenic acid) - not for those with liver disorder or taking other medications potentially causing liver damage

  • take 1-2 capsules approx 1-2 hrs before bed every night

  • intended for use to improve the quality of sleep

blue light blocking glasses

Uvex has some affordable options that block up to 100% of blue light

  • to be worn only in evening around 2hrs prior to bedtime

melatonin

These brands certified by Consumer Labs or USP or used in clinical trials

Instant Release

 

Anxiety-Specific

Silexan

‘Silexan is a branded extract of lavender that was developed by Schwabe Pharmaceuticals in 2002. Its active ingredients—linalool and linalyl acetate—comprise 71% of the oil, with the remaining 29% made up of trace amounts of over a hundred other compounds from the lavender plant. Silexan is regulated as a prescription and licensed for anxiety in 14 countries. In the US, it is available over the counter as CalmAid, through Schwabe’s “Nature’s Way” line” (The Carlat Psychiatry Report, Volume 18, Number 8, August 2020. https://www.thecarlatreport.com/newsletter-issue/tcprv18n8/)

  • CalmAid - Nature’s Way

  • start with 1 gelcap (80mg) at night for 1 week, then increase as tolerated to 2 gelcaps (160mg) at night

 

Mood and Brain/Gut Health

 

exercise prescription

Believe it or not, some researchers are discovering a type of exercise that works best for treating and preventing depression

Microbiome

Guide for improving microbiome (i.e. gut-mind connection)

Omega-3s (aka fish oil) - EPA/DHA

Support for mood, inflammation and neurological health

Important to take products consisting of two particular subtypes of omega-3s, EPA and DHA, and manufactured sustainably without concentrations of toxins/heavy metals.

Generally, I recommend the EPA daily dose be 1,000mg or more and DHA somewhere around half that (roughly 60%/40%), though products containing mostly high-dose DHA also may function similarly.

Vegan Option: Opti3

vitamin d3 (with vitamin k2)

Thorne Vit D/K2 liquid

Healthy Origins VitD/K2

AMMD 10,000iuD3/K2 - only if you have a history of low Vitamin D and mostly for Fall/Winter

SR Vit D/K2 - vegan

Methylfolate

(aka L-M-5-Methyltetrahydrofolate, L-5-MTHF, L-5-Methylfolate, L-Methylfolate)

  • synthetic derivative of folic acid that is analogues to a reduced form of folic acid

  • take with Vitamin B12

Much of the talk around this supplement is in regards to a genetic variant that is theorized to correlate with a higher risk of depression and anxiety.

Methylfolate Only:

Methylfolate + Vit B12:

SAM-e (s-adenosyl-Methionine)

Research supports use for mood and anxiety. Methionine also helps your body get rid of heavy metals, like lead and mercury.

Some interesting research on this topic relates to a genetic variant that influences the activity of an enzyme referred to as COMT

N-Acetylcysteine (NAC)

An amino acid that the body uses to synthesize glutathione, a major antioxidant.

It has been used to treat Tylenol toxicity and recently shown some efficacy in research (especially when taking in combination with an antidepressant) for the treatment of OCD and possibly even decreasing the risk of certain dementias.

In combination with this supplement, I recommend eating foods high in folate and B6 or taking a supplement of the folate derivative l-methylfolate (refer to the section on this recommendation).

  • Swanson Premium: start with 1 capsule (600mg) twice a day (you can take both once a day if needed) and talk with your provider about when it might be time to increase the dose.

 
 

Multivitamins

  • EnLyte / EnbraceHR (methylfolate, B vitamins, Iron, CoQ10)*

  • Ritual (methylfolate, Magnesium, Iron, Vit D/K2, Vit B12, DHA)

  • NutriDyn (methylfolate, B6 &B12, NAC)

  • Adrecor with SAMe (methylfolate, B6 & B12, Magnesium, Rhodiola and caffeine from green tea leaf extract)

*may require a prescription, which I will be happy to provide

 
 

The content within these pages is intended to be a resource of information about treatment recommendations made by the provider and for use only by patients at Rainwater Psychiatry. Rainwater Psychiatry and any of its representatives has no affiliation, conflicts of interest or financial incentives with any of the products recommended here, and by utilizing any resource here you are consenting to the provisions in the Service Agreement and Privacy Practices that are provided to all patients upon intake.