Alternatives to Prozac
Many experts now believe that diet and supplements can make a big difference in treating depression, though not every type. People who can tie their sadness to a particular event, like the breakup of a relationship or a job loss, are much more likely to find success with mood-boosting supplements. "But if your depression is unexplained, you should be seeing a professional and asking serious questions -- not just popping 5-HTP," says Timothy Birdsall, director of naturopathic medicine for Cancer Treatment Centers of America. Depression might be the result of heart trouble that doesn't allow enough oxygen to get to the brain, for instance, or an intestinal problem that prevents efficient absorption of vitamin B-12.
In fact, professional guidance can make any program more effective by making it more targeted, says Mark Hyman, editor-in-chief of Alternative Therapies in Health and Medicine. Physicians can test patients first to diagnose chemical imbalances, and then take it from there. Working with a doctor also helps determine what does and doesn't work. "We're not the best judge of our own condition when it comes to depression," says Kenneth Pelletier, clinical professor of medicine at the University of Maryland School of Medicine. "It's something you shouldn't tackle alone."
B vitamins Many people, particularly women over 65, have B-12 deficiencies and respond dramatically to injections of the vitamin. But all B vitamins can boost mood; they work by facilitating neurotransmitter function. Other pluses: B vitamins are critical for preventing other maladies, including heart disease, cancer, and Alzheimer's. Dosage: Take at least 800 micrograms of folate, 1,000 mcg of B-12, and 25 to 50 milligrams of B-6. A B-complex vitamin should do the trick, says Hyman, and if you're depressed, take more. Take them in combination because otherwise one can mask another B vitamin deficiency. Risks: None.
Essential Fatty Acids Their benefits are among the best documented. The reason they're so effective? Essential fatty acids are part of every cell membrane, and if those membranes aren't functioning well, then neither is your brain. Dosage: For depression, take at least 2,000 to 4,000 mg of fish oil a day. Should be purified or distilled so it's free of heavy metals. Risks: Very safe, albeit unstable. Since it can oxidize in your body, take it along with other antioxidants, like vitamin E (400 IUs a day).
Amino acids The building blocks of neurotransmitters; 5-HTP is the most popular. Taking it can elevate mood in cases of depression, anxiety, and panic attacks, and relieve insomnia. Increases production of the neurotransmitter serotonin. Dosage: Start with a low dose, 50 mg two to three times a day; after two weeks, increase the dose to 100 mg three times a day. Risks: Mild nausea or diarrhea. Before starting, get off antidepressants (under a doctor's supervision); the combination can produce an overload of serotonin.
Saint-John's-wort One of the best-known remedies. Best for mild to moderate depression. Dosage: Start on a dose of 300 mg (standardized to 0.3 percent hypericin extract) two to three times a day, depending on severity of depression; it can take three weeks to show benefits. Risks: It may interfere with up to half of all drugs, prescription and over-the-counter.
SAM-e An amino acid combination produced by humans, animals, and plants. Supplements come from a synthetic version produced in a lab that has shown a lot of promise in European studies. May affect the synthesis of neurotransmitters. Has fewer side effects than 5-HTP and fewer drug interactions than Saint-John's-wort. Dosage: Can range from 400 to 1,200 mg a day, though high doses can cause jitteriness and insomnia. Risks: People with bipolar disorder shouldn't use it without supervision because it can trigger mania.
Rhodiola rosea Considered an adaptogen, which means it can increase your resistance to a variety of stressors. May be good for mild to moderately depressed patients. Dosage: Take 100 to 200 mg three times a day, standardized to 3 percent rosavin. Risks: More than 1,500 mg a day can cause irritability or insomnia.
DHEA This hormone is marketed in Europe specifically for postmenopausal depression, though it may be helpful for other forms as well. Has been used in conjunction with estrogen to treat hot flashes. Not clear why it helps boost mood and energy. Dosage: 25 to 200 mg a day. Risks: Any hormonal supplement has the potential to increase cancer risk.
Finding professional help. To find an integrative doctor, visit drweilselfhealing.com and click integrative medicine clinics; or check holisticmedicine.org/public/public.shtml. For an orthomolecular physician, visit orthomed.org and alternativementalhealth.com, which is also an excellent source of information about natural alternatives to medication.
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